For most adults, Prevnar 20 is a one-time vaccine. A single dose completes your pneumococcal vaccination, with no booster currently recommended. The schedule is different for infants and young children, who receive a four-dose series, but adults 50 and older typically need just one shot.
One Dose for Most Adults
If you’re 50 or older and have never received a pneumococcal conjugate vaccine, you need one dose of Prevnar 20. Once you get it, your pneumococcal vaccinations are considered complete. There’s no follow-up dose and no need for the older polysaccharide vaccine (PPSV23) afterward. This is a notable simplification from previous schedules, which sometimes required two different pneumococcal vaccines spaced a year apart.
The CDC expanded the routine recommendation in early 2025, lowering the age threshold from 65 to 50 for all adults. So if you’re between 50 and 64 and previously thought you had to wait, the current guidance says you’re eligible now.
Adults Under 50 With Risk Conditions
Adults aged 19 through 49 don’t routinely need the vaccine unless they have certain health conditions that raise their risk of serious pneumococcal infection. If you fall into one of these groups, one dose of Prevnar 20 completes your vaccination:
- Immune-related conditions: HIV, sickle cell disease, a missing or nonfunctional spleen, congenital or acquired immune deficiency, or treatment with immunosuppressive drugs or radiation
- Chronic organ conditions: chronic kidney disease, nephrotic syndrome, chronic liver disease, chronic heart disease (not just high blood pressure), or chronic lung disease including COPD, emphysema, and asthma
- Other risk factors: diabetes, cochlear implants, cerebrospinal fluid leaks, alcoholism, or cigarette smoking
If any of these apply to you, one dose of Prevnar 20 is all that’s needed regardless of your age.
If You’ve Already Had a Pneumococcal Vaccine
Your schedule depends on which vaccines you’ve already received. The key detail is the waiting period before getting Prevnar 20.
If you previously received only PPSV23 (the older polysaccharide vaccine), you should wait at least one year before getting Prevnar 20. After that single dose, no additional pneumococcal vaccines are needed.
If you previously received only PCV13 (the 13-strain conjugate vaccine that preceded Prevnar 20), you should also wait at least one year before getting Prevnar 20. Again, one dose finishes the series.
If you received both PCV13 and PPSV23 because of an immunocompromising condition, cochlear implant, or cerebrospinal fluid leak, you can still get Prevnar 20, but the wait is longer: at least five years after your most recent pneumococcal vaccine. If you received both PCV13 and PPSV23 for other risk conditions, no additional vaccine is recommended until you turn 50, at which point your provider will reassess.
The Four-Dose Series for Children
Infants and young children follow a completely different schedule. They receive four doses of Prevnar 20, one at each of the following ages: 2 months, 4 months, 6 months, and 12 through 15 months. This multi-dose series is necessary because young immune systems need repeated exposure to build strong, lasting protection. The adult single-dose approach works because mature immune systems mount a more robust response on the first exposure.
What Prevnar 20 Protects Against
Prevnar 20 is a conjugate vaccine that protects against 20 strains of the bacterium that causes pneumococcal disease. These strains are responsible for serious infections including pneumonia, bloodstream infections, and meningitis. The vaccine covers seven more strains than the older PCV13 vaccine it replaced, which is why a single dose of Prevnar 20 can complete vaccination even for people who previously received PCV13.
Pneumococcal disease is particularly dangerous for older adults and people with weakened immune systems. It kills thousands of adults in the United States each year, and hospitalization rates climb sharply after age 50, which is part of why the recommendation was recently expanded to include that age group.
Cost and Insurance Coverage
Medicare Part B covers pneumococcal vaccines at no cost to you, as long as your provider accepts Medicare assignment. Most private insurance plans also cover recommended vaccines without a copay under the Affordable Care Act’s preventive care provisions. If you’re uninsured, the retail price can be significant, but federally funded programs like the Bridge Access Program may help cover the cost.