| Vaccine | Type | Serotypes | NIP-funded for | Route |
|---|---|---|---|---|
| Prevenar 20 (20vPCV) | Conjugate | 20 | Children <18 yrs | IM 0.5 mL |
| Prevenar 13 (13vPCV) | Conjugate | 13 | Adults ≥70, ATSI ≥50, risk conditions | IM 0.5 mL |
| Vaxneuvance (15vPCV) | Conjugate | 15 | Not NIP-funded (private) | IM 0.5 mL |
| Pneumovax 23 (23vPPV) | Polysaccharide | 23 | ATSI ≥50, risk conditions (2nd+3rd doses) | IM preferred / SC |
23vPPV: IM route preferred — 3× more injection-site reactions with SC, but SC dose does not need repeating.
| Scenario | Minimum interval |
|---|---|
| PCV → 23vPPV (adults with risk / ATSI) | 12 months (2–12 months acceptable) |
| 23vPPV → PCV | 12 months |
| PCV dose → next PCV dose (children <12 m) | 4 weeks |
| PCV dose → next PCV dose (children ≥12 m) | 8 weeks |
| 1st 23vPPV → 2nd 23vPPV | 5 years |
Co-administration: Pneumococcal vaccines can be given same-day with influenza, RSV (Arexvy/Abrysvo), zoster (Shingrix), and COVID-19 vaccines. When 20vPCV + flu given simultaneously: slightly lower responses to some serotypes, higher systemic reactions (chills, myalgia) — clinical significance uncertain.
| Population | Vaccine(s) | Doses & timing | NIP? |
|---|---|---|---|
| All infants (non-ATSI, no risk) | 20vPCV | 2, 4, 12 months (2+1) | Yes |
| ATSI children (all states from 2025) | 20vPCV | 2, 4, 6, 12 months (3+1) | Yes |
| Children with risk conditions | 20vPCV | 2, 4, 6, 12 months; catch-up dose if ≥12 months | Yes (certain) |
| Adults 18–49, non-ATSI, no risk | — | Not recommended | No |
| ATSI adults ≥50 yrs | 13vPCV → 23vPPV ×2 | PCV, then 23vPPV at 12 m, 2nd 23vPPV ≥5 yrs later | Yes |
| Adults ≥18 with risk condition | 13vPCV → 23vPPV ×2 | Same as ATSI adult schedule | Yes |
| Non-Indigenous adults ≥70 (no risk) | 13vPCV ×1 | Single dose; no 23vPPV required | Yes |
| Post-HSCT (any age) | 20vPCV ×3 + 23vPPV ×2 | 3 PCV post-transplant, then 23vPPV ×2 | Yes |
Started with 13vPCV or 15vPCV? Complete schedule with 20vPCV. Once ≥1 dose of 20vPCV given, no further supplementary dose required at 4 years.
Completed with 13vPCV/15vPCV only (ATSI in NT/QLD/WA/SA): Give single 20vPCV at 4 yrs or 12 months after last PCV (whichever is later). If 2 doses of 23vPPV already received → no further 20vPCV needed.
Completed with 13vPCV/15vPCV only (non-ATSI, no risk): No supplementary 20vPCV required. Schedule complete.
Children post-HSCT: 3 doses of 20vPCV after transplant regardless of prior history.
Adults who received 23vPPV without prior PCV: Give PCV ≥12 months after last 23vPPV dose.
Absolute contraindications: Anaphylaxis after any previous pneumococcal vaccine dose; anaphylaxis to any vaccine component.
Pregnancy: Not routinely recommended. Women with risk conditions: vaccinate before planned pregnancy or as soon as practicable after delivery. Breastfeeding: all pneumococcal vaccines are safe to give.
Adverse events (13vPCV / 20vPCV): Pain at site 47–79%; fever >39°C: 2–7% (more common after 12-month booster in children); irritability (infants); fatigue/myalgia (adults).
Adverse events (23vPPV): ~50% soreness after 1st dose; local & systemic reactions more common and more severe after repeat dose (up to 20% more severe local reactions after revaccination).
Storage: +2°C to +8°C. Do not freeze. Transport per National Vaccine Storage Guidelines: Strive for 5.