Pneumovax 23 is a pneumococcal polysaccharide vaccine (PPSV23) that protects against serious infections caused by 23 types of Streptococcus pneumoniae bacteria, including pneumonia, meningitis, and bloodstream infections.

What Is Pneumovax 23?

Pneumovax 23, also known as PPSV23 or pneumococcal vaccine polyvalent, is a vaccine manufactured by Merck & Co., Inc. It contains purified capsular polysaccharide antigens from 23 serotypes of pneumococcal bacteria — more serotypes than any other pneumococcal vaccine currently available.

The vaccine has been in use for decades and has a well-established safety record. It is not a controlled substance and does not require a traditional prescription in most settings — pharmacists in most U.S. states can administer it directly.

Pneumovax 23 is available in three formulations:

• 0.5 mL single-dose vial
• 0.5 mL pre-filled syringe
• 2.5 mL multi-dose vial (5 doses)

What Is Pneumovax 23 Used For?

Pneumovax 23 is FDA-approved for the prevention of pneumococcal disease in the following groups:

• Adults aged 50 and older — Routine vaccination is recommended for this age group.
• People aged 2+ with chronic illnesses — Including cardiovascular disease, pulmonary disease (like COPD or asthma), diabetes, liver disease, and alcoholism.
• Immunocompromised people aged 2+ — Including those with HIV, leukemia, lymphoma, Hodgkin disease, multiple myeloma, chronic kidney failure, nephrotic syndrome, organ transplant recipients, and those on immunosuppressive medications.
• People aged 2+ in high-risk environments — Including Alaska Natives, certain Native American populations, and residents of long-term care facilities.

Pneumococcal bacteria can cause life-threatening infections. In the United States, pneumococcal pneumonia alone kills thousands of adults each year, and the bacteria can also cause meningitis (infection of the brain and spinal cord lining) and bacteremia (bloodstream infection).

How Is Pneumovax 23 Given?

Pneumovax 23 is administered as a single 0.5 mL injection, given either intramuscularly (IM) or subcutaneously (under the skin). The injection is typically given in the deltoid muscle of the upper arm by a healthcare provider — you don't self-administer this vaccine.

Common settings where you can receive Pneumovax 23 include:

• Your doctor's office
• Pharmacies (CVS, Walgreens, Walmart, Rite Aid, and others)
• Community health centers
• Local health departments
• Hospitals and clinics

For more on finding a provider, see our guide: How to Find a Doctor Who Can Prescribe Pneumovax 23 Near You.

Revaccination

Some high-risk patients may need a second dose at least 5 years after the first. This includes people who are immunocompromised and those with functional or anatomic asplenia (absence of a working spleen). Your doctor will tell you if revaccination applies to you.

Timing With Other Pneumococcal Vaccines

If your doctor recommends both a pneumococcal conjugate vaccine (PCV15 or PCV20) and Pneumovax 23, the conjugate vaccine should generally be given first, followed by Pneumovax 23 at least 8 weeks to 1 year later, depending on your age and risk factors. This sequencing is based on current ACIP (Advisory Committee on Immunization Practices) guidelines.

Who Should Not Get Pneumovax 23?

You should not receive Pneumovax 23 if you:

• Have had a severe allergic reaction (anaphylaxis) to any component of the vaccine or to a previous dose of any pneumococcal vaccine
• Are a child under 2 years old — the vaccine is not effective in this age group because young children don't respond well to polysaccharide antigens
• Have a moderate or severe acute illness — vaccination should be deferred until you've recovered (a mild cold is usually fine)

Tell your healthcare provider about all your medical conditions and medications before getting vaccinated, especially if you are pregnant, breastfeeding, immunocompromised, or taking blood thinners. For details on drug interactions, see Pneumovax 23 Drug Interactions.

How Much Does Pneumovax 23 Cost?

Here's what you can expect to pay:

• Without insurance: $100–$250 per dose, depending on the pharmacy and your location.
• With Medicare Part B: $0 copay — Medicare Part B covers pneumococcal vaccines at no cost to the patient.
• With private insurance: Typically $0 copay — under the Affordable Care Act, ACIP-recommended vaccines are covered without cost-sharing by most private plans.
• With Medicaid: Covered in most states.

No generic version of Pneumovax 23 is available.

If you're uninsured, the Merck Patient Assistance Program (merckhelps.com) may help eligible patients get the vaccine at no cost. Community health centers and local health departments also often provide vaccines on a sliding-fee scale. For more ways to save, read our guide on how to save money on Pneumovax 23.

Common Side Effects

The most common side effects of Pneumovax 23 include:

• Injection site pain, redness, or swelling (up to 60–80% of recipients)
• Fatigue
• Headache
• Muscle pain
• Low-grade fever
• Joint pain

These are typically mild and resolve within 1–3 days. Serious side effects are rare. For a complete guide, see Pneumovax 23 Side Effects: What to Expect.

How Does Pneumovax 23 Compare to Other Pneumococcal Vaccines?

There are several pneumococcal vaccines available in 2026:

• Prevnar 20 (PCV20) — A conjugate vaccine by Pfizer covering 20 serotypes. Produces a stronger immune response with T-cell memory. Can be given as a single dose for many adults, potentially eliminating the need for Pneumovax 23.
• Vaxneuvance (PCV15) — A conjugate vaccine by Merck covering 15 serotypes. When PCV15 is used, it's typically followed by Pneumovax 23 to broaden coverage.
• Prevnar 13 (PCV13) — An older conjugate vaccine largely replaced by PCV15 and PCV20 in adult recommendations.

Your doctor will recommend the best vaccine or combination based on your age, health conditions, and vaccination history. Learn more in our guide to Pneumovax 23 alternatives.

Final Thoughts

Pneumovax 23 remains an important tool for preventing serious pneumococcal infections, especially for older adults and people with chronic health conditions or weakened immune systems. It's widely available, covered by most insurance plans (including Medicare Part B at $0 copay), and can be administered at pharmacies without a separate doctor's visit in most states.

If you're not sure whether you need Pneumovax 23, talk to your doctor or pharmacist — they can review your vaccination history and medical conditions to help you decide.

Ready to find Pneumovax 23? Search Medfinder to check availability near you.