Pneumococcal vaccine for older adults and people at risk - About the pneumococcal vaccine for older adults and people at risk

Older adults and people aged two and over at higher risk from pneumococcal disease

In Wales, two pneumococcal vaccines are available for people in these groups:

• pneumococcal conjugate vaccine (PCV20, Prevenar 20), and
• pneumococcal polysaccharide vaccine (PPV23, Pneumovax 23).

From early 2026, PCV20 will replace PPV23. You will be given the vaccine available at the time you attend your appointment. Both vaccines work well.

You can learn more about these pneumococcal vaccines by reading the patient leaflets.

Babies under two at higher risk from pneumococcal disease 

Some babies at higher risk may need extra pneumococcal vaccines. This includes babies who have:

• A missing spleen or a spleen that does not work properly
• A condition called complement disorder
• A very weak immune system

If your baby has one of these conditions, they will be offered either the pneumococcal conjugate vaccine 13 (PCV13) or PCV20 (when available). Your baby will be given the vaccine available at the time you attend the appointment. Their specialist doctor or nurse will also let you know if your baby needs more doses.

You can learn more about PCV13 and PCV20 by reading the patient leaflets.

Most people over the age of 65 and people with certain health conditions only need one dose of the vaccine.

A few people at risk may need further doses. This includes people who have:

• Chronic (long-term) kidney disease
• No spleen, or a spleen that does not work very well
• A very weak immune system (due to a genetic condition, complement disorder, or treatment such as chemotherapy or steroids)

If you are not sure how many doses you need, ask your doctor or nurse.

Anyone can get a pneumococcal infection, but some people are more likely to become seriously ill.

You should have the vaccine – even if you feel healthy – if you are aged:

• • 65 or over, or
• Two years or over with a long-term health condition, including:
  • A long-term heart problem (such as heart failure or heart disease that needs regular treatment)
  • A long-term chest or breathing problem (such as chronic obstructive pulmonary disease (COPD) or severe asthma that needs regular steroids)
  • Diabetes (if you take medicine for it)
  • Long-term kidney or liver disease
  • A weak immune system (due to a genetic condition, complement disorder, illness such as HIV, or treatment such as chemotherapy or steroids)
  • A cerebrospinal fluid leak (fluid around your brain and spine leaking due to injury or surgery)
  • A missing spleen or a problem with your spleen (this includes people with coeliac disease that affects the spleen and those with blood conditions like sickle cell disease)
  • A cochlear implant (a type of hearing device)

This isn’t a complete list. If you have a long-term health condition and you are not sure whether you should get the vaccine, contact your GP.

You should also get the vaccine if you work in a job where you regularly breathe in metal fumes. For example, if you work as a welder. This is because there is a link between exposure to metal fumes and pneumonia.

Babies up to two years of age at higher risk from pneumococcal disease

All babies are routinely offered the pneumococcal vaccine at: 

• 16 weeks of age, and
• 12 months of age.

Some babies at higher risk may need extra pneumococcal vaccines. For example, those with:

• A missing spleen or a spleen that does not work properly
• A condition called complement disorder
• A very weak immune system

If you are not sure whether your child needs these extra vaccines, speak to their specialist doctor or nurse.

To find out which other vaccines you may be eligible for, see the Routine immunisation schedules for Wales page.

Yes, the pneumococcal vaccine is safe. It meets all safety standards. Once a vaccine is in use, its safety is closely monitored.

Like all medicines, vaccines can cause side effects, but not everyone gets them. Most side effects are mild and may last a day or two. The most common side effects include:

• Soreness, redness, swelling or hardening where the injection was given
• Fever
• Headache
• Joint or muscle pain
• Tiredness

In addition to this, side effects in children may include:

• A change in eating habits
• Irritability
• Drowsiness or more sleep than usual

Reports of all side effects can be found in the patient information leaflet for the vaccine:

• Prevenar 13 suspension for injection
• Prevenar 20 suspension for injection in pre-filled syringe
• Pneumovax 23 solution for injection in pre-filled syringe

Rarely, people can have a severe reaction soon after the vaccination, which causes breathing difficulties and may cause them to collapse. This is called an anaphylactic reaction, and it can also happen with other medicines and food. These reactions are extremely rare, affecting less than one in a million people. Staff who give vaccinations are trained to manage these reactions.

People who have an anaphylactic reaction can be successfully treated and usually recover within a few hours.

You should report suspected side effects online at  Yellow Card, by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm).

A black triangle symbol on a vaccine or medicine means that it is being closely monitored for any side effects. This will allow quick identification of new safety information. You can help by reporting any side effects you or your child may get.

If you have any questions about side effects, you can ask the person giving you the vaccine.

When the vaccine is given to you or your child, the body’s natural defences make antibodies that help to protect against pneumococcal infections.

The pneumococcal vaccine cannot protect against every type of pneumococcal bacteria. However, the vaccine does help protect against the ones that most often cause serious illness.

It is important to know that the pneumococcal vaccine does not protect against meningitis caused by other bacteria or viruses.

Vaccination is one of the best ways to help prevent severe illness (such as pneumonia, sepsis or meningitis) caused by pneumococcal disease. No vaccine is 100% effective, so it is still important to know the signs and symptoms of pneumococcal disease, even if you have the vaccine.

For more information about the symptoms of pneumonia, sepsis and meningitis, go to the NHS 111 Wales website:

• Meningitis
• Sepsis
• Pneumonia

Very few people cannot have the pneumococcal vaccination. You should not have the vaccine if you have had a serious (life-threatening) reaction to:

• a previous dose of the same vaccine, or
• any ingredient in the vaccine.

Speak to the person giving you the vaccine if you have had a serious allergic reaction to the vaccine or its ingredients in the past.

A cold or other minor illness is not a reason to delay your vaccine. 

If you are unwell with a high temperature (fever) above 38.5 C, it is better to wait until you have recovered to have the vaccine, but you should try to have it as soon as possible. If you cannot go to your vaccination appointment, please cancel and make a new appointment.