Pneumococcal Disease and People with Chronic Health Conditions

People who have certain chronic health conditions or other risk factors should get vaccinated against pneumococcal disease.

Pneumococcal disease is a serious infection that causes pneumonia, meningitis, and bloodstream infection, as well as other less severe illnesses.

Pneumococcal pneumonia is a leading bacterial cause of hospitalized pneumonia in the US. Older adults and people with certain health conditions or other risk factors are at increased risk of serious outcomes or death from pneumococcal pneumonia.

Fewer adults get pneumococcal meningitis or bloodstream infection (bacteremia), but the mortality rate for these infections is high, even with proper treatment. Pneumococcal meningitis kills about 1 in 6 older patients  and bacteremia kills about 1 in 8 adults who are infected. Both conditions can also result in lifelong disability including deafness, brain damage, and limb amputation.

People of all ages are at increased risk for pneumococcal disease if they have any of the following conditions or risk factors:

• Chronic health conditions such as heart disease, lung disease, diabetes, kidney disease, or liver disease
• Conditions that weaken the immune system, such as sickle cell disease, HIV/AIDS, cancer, or a damaged or missing spleen
• Cochlear implants or cerebrospinal fluid (CSF) leaks
• Alcoholism
• Smoke cigarettes

Who Should Be Vaccinated?

Children age 6-18 years who have certain chronic conditions or other factors that increase their risk for pneumococcal disease may need PCV20 or pneumococcal polysaccharide vaccine (PPSV23), depending on their pneumococcal vaccination history.

Adults age 19-49 years with risk factors and all adults age 50 years and older who did not previously receive a pneumococcal conjugate vaccine or whose vaccination history is unknown should be vaccinated.

Talk with a healthcare professional about pneumococcal vaccination

For additional information, see the immunization schedules of the American Academy of Pediatrics and the American Academy of Family Physicians.

CDC offers additional guidance for adults who previously received either PPSV23 only or those who received the PCV13 conjugate vaccine.

Updated November 2025

Sources: American Academy of Family Physicians, American Academy of Pediatrics, Centers for Disease Control and Prevention