Pneumococcal disease, which includes pneumonia, meningitis, and bloodstream infections, poses a significant risk to seniors and adults with certain health conditions. The good news is that vaccination is the most effective way to prevent these serious illnesses. Recent updates from the Centers for Disease Control and Prevention (CDC) have refined vaccination strategies, making it easier for seniors to get the best protection available.
2025 CDC recommendations for seniors
The CDC's Advisory Committee on Immunization Practices (ACIP) updated its guidelines in October 2024, lowering the recommended age for routine pneumococcal vaccination from 65 to 50 years. This change reflects a growing understanding of the disease burden in the 50-64 age group and aims to simplify vaccination for providers and patients. The updated recommendations also incorporate newer vaccine options that offer broader protection with fewer shots.
Options for pneumococcal-naive adults (age 50+)
For seniors who have never received a pneumococcal conjugate vaccine (PCV), there are now three primary options:
- One dose of PCV20 (Prevnar 20): This vaccine protects against 20 types of pneumococcal bacteria. The vaccination series is completed with this single dose.
- One dose of PCV21 (Capvaxive): The newest vaccine, approved in June 2024, protects against 21 pneumococcal serotypes. Like PCV20, a single dose completes the series.
- One dose of PCV15 (Vaxneuvance), followed by one dose of PPSV23 (Pneumovax 23): This two-shot series offers protection against 15 and 23 serotypes, respectively. The PPSV23 dose is administered at least one year after the PCV15 shot (or at least 8 weeks later for immunocompromised individuals).
Guidance for previously vaccinated seniors
For seniors with a history of pneumococcal vaccination, the recommendations vary based on the vaccines and timing of previous doses. Your healthcare provider will help determine the best course of action. Examples include:
- If you received only PPSV23 in the past: A single dose of PCV20 or PCV21 is recommended at least one year after your last PPSV23 dose.
- If you received PCV13 in the past: You should receive a dose of PCV20, PCV21, or PPSV23 at least one year after the PCV13 dose.
- If you received both PCV13 and PPSV23 at different times: An additional dose of PCV20 or PCV21 may be offered through shared clinical decision-making, particularly if the PPSV23 was received before age 65.
Comparing the newest vaccine options for seniors
| Feature | Prevnar 20 (PCV20) | Capvaxive (PCV21) | Vaxneuvance (PCV15) | Pneumovax 23 (PPSV23) |
|---|---|---|---|---|
| Protection | 20 serotypes of S. pneumoniae | 21 serotypes of S. pneumoniae | 15 serotypes of S. pneumoniae | 23 serotypes of S. pneumoniae |
| Vaccine Type | Conjugate | Conjugate | Conjugate | Polysaccharide |
| Recommended Use | Single-dose series for pneumococcal-naive adults aged 50+ | Single-dose series for pneumococcal-naive adults aged 50+ | Used in a two-dose series with PPSV23 for pneumococcal-naive adults aged 50+ | Used in two-dose series with PCV15. Also used for specific catch-up scenarios |
| Dosing Schedule | Single dose completes vaccination for pneumococcal-naive adults | Single dose completes vaccination for pneumococcal-naive adults | Requires two doses, with PPSV23 given at least 1 year later (or 8 weeks for immunocompromised) | Given after PCV15, or in some catch-up situations |
| Serotype 4 | Includes serotype 4 | Excludes serotype 4, which is a consideration in some high-risk areas | Excludes serotype 4 | Includes serotype 4 |
| Availability | Widely available | Became available in 2024; rollout is ongoing | Widely available | Widely available |
The importance of getting the right vaccine
The CDC's updated guidance to offer either PCV20 or PCV21 for pneumococcal-naive adults simplifies the decision for many seniors. These newer vaccines provide protection against a broader range of serotypes with a single injection compared to older strategies involving multiple shots. The choice between PCV20 and PCV21 is often based on availability and specific regional prevalence of serotypes. Notably, PCV21 is the newest offering and was designed specifically with adult disease trends in mind.
Why PCV21 and PCV20 offer simpler solutions
For many seniors, the single-shot approach of PCV20 or PCV21 is a welcome change. Previous recommendations often involved a multi-dose series with different types of vaccines (conjugate and polysaccharide), which could be confusing and require multiple appointments. By completing the series with one shot, these newer vaccines improve convenience and increase the likelihood of full vaccination.
What about the PCV15 + PPSV23 combination?
The PCV15 and PPSV23 combination is a valid option, especially if PCV20 or PCV21 are not readily available. However, it requires two separate appointments, with the second shot (PPSV23) administered at least a year after the first. The key takeaway from the 2025 recommendations is that a single dose of PCV20 or PCV21 is now an approved alternative that completes the series in one visit for those who have not been previously vaccinated with a PCV.
Consult your healthcare provider
Due to varying prior vaccination histories, the ideal strategy for a senior can be complex. The CDC's recommendations serve as a guide, but your doctor will be able to provide personalized advice. They will consider your age, medical history, and past vaccinations to determine the best pneumococcal vaccine regimen for you. This is especially important for those with certain chronic conditions or immunocompromising health issues, for whom special timing may apply. Your doctor can also advise you if you are in a population that requires consideration for Serotype 4 protection.
Conclusion
The most current pneumonia vaccine options for seniors in 2025 include the single-dose PCV20 (Prevnar 20) and PCV21 (Capvaxive), which simplify the vaccination process by eliminating the need for a follow-up shot for pneumococcal-naive adults aged 50 and older. An alternative for those who prefer it is the two-shot series of PCV15 (Vaxneuvance) followed by PPSV23 (Pneumovax 23). Given the simplified, age-based recommendations starting at age 50, now is an ideal time for seniors to discuss their options with a healthcare provider and ensure they are protected against pneumococcal disease.
Frequently asked questions
Is one pneumonia shot enough for seniors?
For seniors who are pneumococcal-naive, a single shot of either PCV20 (Prevnar 20) or PCV21 (Capvaxive) is now considered a complete vaccination series. This is a simpler alternative to the older two-dose series.
What is the most up-to-date pneumonia vaccine?
The most up-to-date pneumonia vaccine is PCV21 (Capvaxive), which was approved by the FDA in June 2024 and protects against 21 different pneumococcal serotypes. The PCV20 (Prevnar 20) vaccine, approved in 2021, is also considered a current, single-shot option.
Did the CDC change the age recommendation for the pneumonia vaccine?
Yes, in late 2024, the CDC updated its guidelines to recommend routine pneumococcal vaccination starting at age 50, rather than the previous recommendation of age 65.
Can I get the pneumonia and flu vaccines at the same time?
Yes, you can typically receive the pneumococcal vaccine and the flu shot at the same visit. Many healthcare providers offer both to simplify the process for seniors.
Is Prevnar 20 or Capvaxive better for seniors?
Both PCV20 and PCV21 (Capvaxive) offer excellent, single-dose protection for most seniors. PCV21 covers one additional serotype (21 vs. 20 for PCV20), but excludes one included in PCV20. The best choice depends on availability, local serotype prevalence, and a discussion with your doctor.
Is the pneumonia vaccine covered by Medicare?
Yes, Medicare Part B typically covers the full cost of pneumococcal pneumonia vaccinations for seniors, so there is zero out-of-pocket cost.
What should I do if I’ve had a pneumonia vaccine before?
If you have a prior history of pneumococcal vaccination, your doctor will review your records to determine if and what additional doses are recommended. New recommendations guide catch-up vaccination for different scenarios.
