Adult pneumococcal vaccination — 21vPCV (Capvaxive)
Clinician reference for the National Immunisation Program adult pneumococcal schedule. Eligibility, repeat vaccination, co-administration, pregnancy, contraindications. Information only — confirm against the Australian Immunisation Handbook before administering.
From 1 July 2026: The 21-valent pneumococcal conjugate vaccine (21vPCV), Capvaxive®, replaces Prevenar 13® and Pneumovax 23® on the National Immunisation Program for adults. A single dose replaces the former Prevenar 13 + Pneumovax 23 sequence. The funded age for non-Indigenous adults is lowered from 70 to 65, and from 50 to 25 for Aboriginal and Torres Strait Islander adults.
Key points
- From 1 July 2026, Capvaxive® (21vPCV) replaces Prevenar 13® and Pneumovax 23® on the NIP for adults.
- Single dose for all eligible adults — no sequence required.
- NIP-funded for: adults 65+, Aboriginal and Torres Strait Islander adults 25+, adults 18+ with a specified medical risk condition.
- Eligible adults with a prior dose of any other pneumococcal vaccine: a single dose of Capvaxive® at least 12 months after the last dose, NIP-funded.
- Changes lower the age of recommendation, simplify the schedule, and cover more serotypes.
Eligibility — who is recommended a pneumococcal vaccine
Adults 65 and over
A single dose of Capvaxive® — recommended and NIP-funded.
ATSI adults 25 and over
A single dose of Capvaxive® — recommended and NIP-funded.
Repeat vaccination
For patients with prior pneumococcal vaccination, the rules collapse to a small number of scenarios. All Capvaxive® doses below are NIP-funded for the indicated patient group.
| Patient | Recommendation |
|---|
| 65+ with a prior pneumococcal vaccine (any type) | One dose of Capvaxive® at least 12 months after the last dose. |
| ATSI 25+ with a prior pneumococcal vaccine | One dose of Capvaxive® at least 12 months after the last dose. |
| 18+ with a risk condition + prior pneumococcal vaccine | One dose of Capvaxive® at least 12 months after the last dose. |
| 18–64 who already received Capvaxive® for a risk condition | No further dose at 65. |
| ATSI 18–24 who already received Capvaxive® for a risk condition | No further dose at 25. |
| 65+ or ATSI 25+ who had Capvaxive® and then develops a risk condition | No further dose. |
| Child given a dose of Prevenar 20® for a risk condition before 18 | One dose of Capvaxive® at age 18, NIP-funded. |
For complex histories (immunocompromised patients, multiple prior doses, transplant recipients), check the pneumococcal chapter of the Handbook and AIR before administering.
Co-administration with other vaccines
Adults can receive Capvaxive® at the same time as, or separately from, other vaccines — including zoster (Shingrix), seasonal influenza, RSV, and COVID-19. The Department of Health notes potential advantages of co-administration: maximising coverage and timely receipt. Separate injection sites; the Handbook recommends a minimum 2.5 cm gap between sites. See the vaccine co-administration checker for paired-vaccine guidance.
Pregnancy and breastfeeding
Pneumococcal vaccines are not routinely recommended for pregnant women. Women of child-bearing age with a risk condition for pneumococcal disease are normally recommended to receive a vaccine either before a planned pregnancy, or as soon as practicable after delivery. Breastfeeding women can receive pneumococcal vaccines.
Contraindications
The only contraindications to pneumococcal vaccines are anaphylaxis after:
- a previous dose of any pneumococcal vaccine, or
- any component of a pneumococcal vaccine.
Side effects
Common side effects include mild pain at the injection site, fatigue and headaches, typically lasting a few days and resolving without treatment. Serious side effects, such as severe allergic reaction, are rare. Capvaxive® was found to be safe in adults across clinical trials. Source: Department of Health adult pneumococcal program advice, June 2026.
Administration errors and AIR
Check the Australian Immunisation Register (AIR) before administering any pneumococcal vaccine to confirm prior doses. Report all immunisations to AIR. Notify all adverse events and vaccine administration errors through the reporting mechanisms in your state or territory. For Handbook guidance on vaccine administration errors, see the Australian Immunisation Handbook. AIR information for providers: servicesaustralia.gov.au/hpair.
Handbook chapter (updated 30 September 2026) — extra clinical points
- Chapter status: the Handbook notes the pneumococcal chapter is currently undergoing consultation and seeking NHMRC approval — check it for later changes.
- Further doses: the need for further doses has not yet been established.
- No repeat at 65 or 25: adults aged 18–64 who receive 21vPCV because of a risk condition do not need another dose at 65 (Aboriginal and Torres Strait Islander adults 18–24: not at 25). Adults 65+ (or ATSI 25+) who later develop a risk condition do not need an additional dose if they already received 21vPCV on the routine program. Giving an extra dose in these situations is a recognised “additional dose” error — monitor for adverse events.
- Co-administration with influenza vaccine: adults can receive pneumococcal conjugate vaccine at the same time as, or separately from, zoster, influenza, RSV and COVID-19 vaccines. In one co-administration study, 21vPCV given with influenza vaccine produced lower antibody responses to most pneumococcal serotypes and influenza subtypes than when given separately; the clinical significance is uncertain.
- Vaccine administration errors: 20vPCV given to a person 18 or over → give 21vPCV at least 2 months later; 21vPCV given to a person under 18 → give 20vPCV at least 2 months later; a PCV given less than 8 weeks after a previous PCV → repeat at least 8 weeks later; 21vPCV given 2 months or more but under 12 months after 13vPCV → no repeat dose.
- Funded vaccines: the NIP-funded vaccines are 20vPCV for children (aged under 18) and 21vPCV for adults; 20vPCV is funded for all children under 5 and for Aboriginal and Torres Strait Islander children under 18.
- Funding by risk condition: adult NIP funding (18–64) applies only to the specified conditions in the Handbook table — not every recommended condition. For example diabetes and heart disease are recommended but not funded for adults. See vaccines by medical condition.
Source: Australian Immunisation Handbook — Pneumococcal disease (page updated 30 September 2026).
State and territory health department contacts
- ACT: 02 5124 9800
- NSW: 1300 066 055
- NT: 08 8922 8044
- QLD: 13 HEALTH (13 43 25 84), or your local Public Health Unit
- SA: 1300 232 272
- TAS: 1800 671 738
- VIC: immunisation@health.vic.gov.au
- WA: 08 9321 1312
Source: Department of Health adult pneumococcal program advice, June 2026.
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