Pneumococcal vaccine (conjugate) Pregnancy: eMC §4.6: there are no data from the use of the 13-valent pneumococcal conjugate vaccine in pregnant women, therefore use should be AVOIDED during pregnancy. It is unknown whether the vaccine is excreted in human milk. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity.

Pneumococcal polysaccharide conjugate vaccine (adsorbed)

Brand names: Prevenar 13, Vaxneuvance, Apexxnar

A conjugate vaccine that provides active immunisation against invasive disease and pneumonia caused by the Streptococcus pneumoniae serotypes it covers, used in the childhood programme and for at-risk groups.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One single dose of 0.5 mL

Route: Intramuscular injection - preferred site is the deltoid muscle of the upper arm in adults and children (anterolateral thigh, vastus lateralis, in infants)

Frequency: Single dose; the need for revaccination with a subsequent dose has not been established

eMC §4.2 (Prevenar 13 suspension for injection, 13-valent pneumococcal conjugate vaccine). Immunisation schedules should be based on official national recommendations. ADULTS 18 YEARS AND OVER AND THE ELDERLY: one single 0.5 mL dose. Regardless of prior pneumococcal vaccination status, if use of the 23-valent pneumococcal polysaccharide vaccine is considered appropriate, Prevenar 13 should be given FIRST. SPECIAL POPULATIONS: individuals with underlying conditions predisposing to invasive pneumococcal disease (e.g. sickle cell disease, HIV infection), including those previously given one or more doses of 23-valent polysaccharide vaccine, may receive at least one dose. Haematopoietic stem cell transplant (HSCT) recipients: four doses of 0.5 mL - a primary series of three doses with the first given 3 to 6 months after HSCT and at least 1 month between doses, and a fourth (booster) dose 6 months after the third. PAEDIATRIC SCHEDULES (all doses 0.5 mL; not weight-based): infants 6 weeks to 6 months - three-dose primary series plus booster (four doses total; first dose usually at 2 months, may be given as early as 6 weeks, at least 1 month between doses, booster at 11-15 months), or alternatively within a routine programme a two-dose primary series plus booster (three doses total; first from 2 months, second 2 months later, booster at 11-15 months). Preterm infants (under 37 weeks gestation): four doses (three-dose primary series plus booster at 11-15 months). Unvaccinated infants 7-11 months: two doses at least 1 month apart, plus a third dose in the second year of life. Children 12-23 months: two doses at least 2 months apart. Children and adolescents 2-17 years: one single 0.5 mL dose. Children previously immunised with the 7-valent vaccine may switch at any point; young children 12-59 months completely immunised with the 7-valent vaccine should receive one 0.5 mL dose at least 8 weeks after their final 7-valent dose, and children 5-17 years may receive a single dose at least 8 weeks after their final 7-valent dose. ADMINISTRATION SAFETY (eMC §4.4): must NOT be administered intravascularly; should not be given intramuscularly to individuals with thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injection, but may be given subcutaneously if the potential benefit clearly outweighs the risks.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances, to any of the excipients, or to diphtheria toxoid (eMC §4.3)
Administration should be postponed in subjects suffering from acute, severe febrile illness; a minor infection such as a cold should not result in deferral (eMC §4.3)

Side effects

Vaccination-site reactions - erythema, induration/swelling, pain or tenderness (very common in children 6 weeks to 5 years) (eMC §4.8)
Pyrexia and irritability (very common); fever rates were higher when given concomitantly with Infanrix hexa, mostly moderate (39 degrees C or less) and transient
Decreased appetite (very common); vomiting and diarrhoea (common)
Somnolence and poor quality sleep (very common); rash (common), urticaria or urticaria-like rash (uncommon)
Convulsions including febrile convulsions (uncommon); hypotonic-hyporesponsive episode and hypersensitivity reactions including face oedema, dyspnoea and bronchospasm (rare)
Note: the captured §4.8 extract covers infants and children aged 6 weeks to 5 years only - the adult and older-age-group adverse reaction tables were not retrieved; clinician to review the full SPC

Interactions

23-valent pneumococcal polysaccharide vaccine (eMC §4.2) - where its use is considered appropriate, Prevenar 13 should be given first
Infanrix hexa (eMC §4.8) - analysis of post-marketing reporting rates suggests a potential increased risk of convulsions, with or without fever, and of hypotonic-hyporesponsive episodes, when Prevenar 13 is reported with Infanrix hexa compared with Prevenar 13 alone
Immunosuppressive therapy and other causes of impaired immune responsiveness (eMC §4.4) - may result in a reduced antibody response to active immunisation
The eMC §4.5 interaction section was not captured in this bundle - clinician to review it in the full SPC for co-administration with other routine vaccines

Clinical monograph

How it works

Pneumococcal capsular polysaccharides are conjugated to a carrier protein, generating a T-cell-dependent immune response that produces immunological memory and protection in infants, which plain polysaccharide vaccines cannot achieve.

Prescribing in practice

As with all vaccines, it is contraindicated in those with confirmed anaphylaxis to a previous dose or to a vaccine component, and administration should be deferred during acute severe febrile illness.
It should be given by intramuscular injection according to the national immunisation schedule, with timing and number of doses determined by age and risk group as set out in current immunisation guidance.
Facilities for managing a rare anaphylactic reaction must be available, and the conjugate and polysaccharide pneumococcal vaccines have distinct roles that should not be confused.

Monitoring

No laboratory monitoring is required; observe for immediate hypersensitivity after administration and record the dose in the immunisation record.

Counselling the patient

Soreness at the injection site, mild fever or irritability for a day or two is common and expected.
This vaccine protects against several types of pneumococcal bacteria but not all causes of chest infection.
Tell the immuniser about any serious reaction to a previous vaccine dose.

Evidence & guidelines

The pneumococcal conjugate vaccine is part of the UK routine childhood immunisation schedule, supported by Public Health guidance demonstrating reductions in invasive pneumococcal disease.

Reference: UKHSA Green Book Ch.25; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways