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Pneumococcal Conjugate Vaccine

Pneu-C — protects against pneumococcal disease (Vaxneuvance® / Pneu-C-15 for most infants)

Quick Summary

Pneumococcal Conjugate Vaccine

Protects against pneumococcal disease — a common cause of serious infections in young children.

Routine / recommended Publicly funded
Diseases Protected Against
Pneumococcal disease, including some types of pneumonia, meningitis, bloodstream infections, and ear infections.
Ontario Routine Timing
2, 4, and 12 months of age for most healthy infants
Number of Doses
Three doses for most healthy infants; children at higher risk may have a different schedule
Publicly Funded Status
Yes — provided free of charge as part of Ontario's routine schedule
Bottom line: The pneumococcal conjugate vaccine protects babies against a bacterium that can cause serious infections like meningitis and bloodstream infections. It's part of Ontario's routine, publicly funded schedule and is recommended for all infants, though it is not separately named as a required disease under Ontario's school attendance law.
The Disease

What it protects against

The pneumococcal conjugate vaccine protects against disease caused by Streptococcus pneumoniae bacteria, which can range from common ear infections to life-threatening illness.

Form of disease What parents might notice How it spreads Why it can be serious How vaccination helps
Meningitis Fever, irritability, poor feeding, sleepiness, or a stiff neck in an infant. The bacteria spread through coughing, sneezing, and close contact. Infection of the lining of the brain and spinal cord can be life-threatening and may cause lasting effects such as hearing loss or brain injury. The vaccine helps the immune system recognize the bacteria's outer coating and respond quickly.
Bloodstream infection (bacteremia) Fever and a very unwell-seeming child. Coughing, sneezing, and close contact. Infection in the blood can spread through the body and become life-threatening. Vaccination reduces the chance of these invasive infections.
Pneumonia Cough, fever, and difficulty breathing. Coughing, sneezing, and close contact. Lung infection can be serious, especially in young children. The vaccine protects against several of the types most likely to cause serious pneumonia.
Ear infections Ear pain, tugging at the ear, fever, and fussiness. Often follow a cold or other respiratory infection. Usually not dangerous, but common and can be painful and recurrent. The vaccine helps reduce ear infections caused by the pneumococcal types it covers.
There are many types (serotypes) of pneumococcal bacteria. The conjugate vaccine protects against the ones most likely to cause serious illness in children. Because it can't cover every type, it greatly reduces — but doesn't completely eliminate — the chance of pneumococcal disease.
Timing & Schedule

Why it's given at this age

Why so early? Young infants are among those most at risk of serious pneumococcal disease, so the schedule starts early — at 2 months — to build protection during this vulnerable period.

Why more than one dose? Babies' immune systems typically need several doses to build strong, lasting protection. For most healthy infants in Ontario, doses at 2 and 4 months build initial protection, and a dose at 12 months acts as a booster.

What if a dose is late? A delay does not mean restarting. The remaining doses can usually be given following minimum spacing guidelines. A healthcare provider or your local public health unit can confirm the right schedule, which can vary for children at higher risk. See the Catch-Up & Missing Records page.

Can it be given with other vaccines? Yes. At 2 and 4 months it's routinely given with the 5-in-1 and rotavirus vaccines, and at 12 months alongside other scheduled vaccines such as MMR and meningococcal C. These are given at different injection sites during the same visit.

Ontario School & Reporting Status

School and reporting status

Pneumococcal disease is not one of the diseases required for school attendance under Ontario's Immunization of School Pupils Act (ISPA). The pneumococcal conjugate vaccine is part of Ontario's routine, publicly funded schedule and is recommended for all infants — but it is not on the ISPA list, so it is not required for school entry.

This means pneumococcal disease is not an ISPA-designated disease for school attendance, so missing this vaccine does not trigger the ISPA suspension process. It remains strongly recommended because of the protection it offers against serious infections in early childhood, when the risk is highest.

Reporting: As with all vaccines, parents and caregivers are generally responsible for reporting their child's immunizations to their local public health unit, since healthcare providers do not always do this automatically. After each dose, make sure your provider updates your child's immunization record (the "yellow card"), and report the update — for example, through Immunization Connect Ontario (ICON) if your area uses it. Even though it isn't ISPA-required, public health may keep this on file as part of your child's overall record.

Higher-risk children: Children with certain medical conditions may be eligible for additional doses or a different pneumococcal product (such as Prevnar 20). A healthcare provider can advise whether this applies to your child.

Ingredient Transparency

What's in this vaccine

For most healthy infants, Ontario currently uses Vaxneuvance® (Pneu-C-15, Merck), based on its Health Canada product monograph. (Children at higher risk may receive Prevnar 20® instead, which has similar categories of ingredients.) This is not a live vaccine.

Ingredient / Component Category Why it's there Plain-English explanation
Pneumococcal polysaccharides (15 types) linked to CRM197 protein Active ingredients These train the immune system to recognize the outer coating of 15 types of pneumococcal bacteria. The "conjugate" part means the sugars from the bacteria's coating are linked to a harmless carrier protein, which helps a young child's immune system respond well. The sugars and protein are not alive and cannot cause disease.
Aluminum phosphate Adjuvant Helps the immune system respond more strongly to the vaccine. An aluminum-based adjuvant used in small amounts. Aluminum adjuvants have a long track record of safe use in vaccines.
L-histidine Buffer Helps keep the vaccine at a stable acidity (pH). An amino acid (a building block of protein) the body uses normally.
Polysorbate 20 Stabilizer Helps keep the vaccine's ingredients evenly mixed and stable. A stabilizer used in small amounts in many medical and food products.
Sodium chloride Tonicity agent Helps match the vaccine's salt concentration to that of the body. Ordinary salt, so the injection is gentler on the body's tissues.
Water for injection Base The liquid base of the vaccine. Sterile water that makes up most of the injection's volume.
About preservatives and latex: According to the manufacturer, Vaxneuvance does not contain preservatives, and the tip cap and plunger stopper of the prefilled syringe are not made with natural rubber latex. Because the carrier protein is a diphtheria-derived protein (CRM197), this vaccine is not recommended for anyone with a history of severe allergic reaction to a diphtheria toxoid-containing vaccine — discuss this with a healthcare provider if it applies.
Side Effects & Safety

Side effects and safety

Expected / common side effects

  • Soreness, redness, or swelling where the needle was given
  • Mild fever
  • Irritability or fussiness
  • Drowsiness or sleepiness
  • Decreased appetite

Timing and duration: These reactions usually begin within a day of the vaccine and typically resolve within 1–2 days.

Home care: A cool compress can ease injection-site soreness. Acetaminophen or ibuprofen may be used as directed for discomfort or fever — check with a pharmacist or healthcare provider on appropriate dosing for your child's age and weight. Children under 19 should not be given ASA (Aspirin) or salicylate-containing products. For fever or discomfort, speak with your healthcare provider or pharmacist about age-appropriate dosing. Ibuprofen is generally not used in infants under 6 months unless advised by a healthcare provider.

When to call a healthcare provider: If a fever is high or persistent, if your child seems unusually unwell, or if you're unsure — it's always reasonable to call.

Mild side effects can happen as the immune system responds. Many children have no side effects at all, and that does not mean the vaccine didn't work.

Rare but important

  • Severe allergic reaction (anaphylaxis) — reported rarely after vaccination in general; exact frequency varies by source.
  • Apnea (brief pauses in breathing) — has been observed in some infants born prematurely after intramuscular vaccination. For very premature infants, the timing of vaccination is considered individually.

What clinics do to reduce risk: Clinics ask about allergy history before vaccination and are equipped with epinephrine and trained staff in case of a severe allergic reaction.

Observation period: Many clinics recommend staying nearby for about 15 minutes after vaccination, as severe allergic reactions — though rare — typically occur shortly after the injection.

Get urgent help now if your child has:

  • Trouble breathing
  • Swelling of the lips, tongue, throat, or face
  • Widespread hives together with breathing difficulty
  • Severe weakness, limpness, or unresponsiveness
  • A seizure
  • Persistent, inconsolable crying that won't settle, or you are very worried
  • A high or persistent fever, especially in a young infant
  • Any symptom that feels serious or is rapidly getting worse

If any of these occur, go to the nearest emergency department or call 911. Otherwise, contact a healthcare provider and let them know what happened — this information also helps with vaccine safety monitoring.

Before the Appointment

Who should pause or speak with a healthcare provider first

Speak with a healthcare provider before this vaccine if:

  • Your child has had a serious allergic reaction to a previous dose of pneumococcal vaccine, or to any of its components
  • Your child has had a serious allergic reaction to a diphtheria toxoid-containing vaccine (the carrier protein is diphtheria-derived)
  • Your child has a moderate or severe acute illness (it's generally fine to wait until they feel better)
  • Your child was born very prematurely — the timing of the first dose may be considered individually

These usually do NOT require delaying this vaccine:

  • A mild cold or other minor illness without fever
  • Currently breastfeeding
  • Prematurity in a stable infant (premature infants are generally vaccinated on schedule, with timing considered for the very premature)
  • A stable, ongoing chronic health condition
  • Currently taking antibiotics for an unrelated condition
Common Questions

Questions parents often ask

Yes. At 2 and 4 months it's routinely given with the 5-in-1 and rotavirus vaccines, and at 12 months with vaccines like MMR and meningococcal C. These are given at different injection sites during the same visit.
Ontario's publicly funded pneumococcal program has shifted which products it uses. Most healthy infants now receive Vaxneuvance (Pneu-C-15), while children at higher risk of invasive pneumococcal disease receive Prevnar 20 (Pneu-C-20). Both protect against pneumococcal disease; they cover slightly different numbers of pneumococcal types. Your provider or public health unit uses the one appropriate for your child.
Being behind does not mean starting the series over. The remaining doses can generally be given following minimum spacing guidelines. Visit the Catch-Up & Missing Records page, or speak with a healthcare provider to confirm the right plan for your child.
Generally, no. A mild cold without fever is usually not a reason to delay. If your child has a fever or seems more unwell, it's reasonable to mention this to the clinic — they can advise whether to proceed or reschedule.
A mild fever after a previous dose is common and is not usually a reason to avoid future doses. Let the clinic know about the previous reaction — they can advise on any precautions, such as giving acetaminophen proactively, and will watch for any pattern.
This is common and manageable. Gather whatever records you have, and contact your local public health unit or healthcare provider — they can often help locate or reconstruct records, or advise on next steps if records truly cannot be found. See the Catch-Up & Missing Records page.
This vaccine is typically given by a family doctor or nurse practitioner as part of routine infant well-child visits. Some public health units also offer immunization clinics. See the Resources page for links to find services in your area.
Parents and caregivers are generally responsible for reporting vaccines to their local public health unit — healthcare providers do not always do this automatically. Many areas use Immunization Connect Ontario (ICON) for this. See the Resources page for links.
Mild soreness, redness, fussiness, or a low fever for a day or two are common and expected. Review the "Get urgent help now" list above — if any of those signs occur, seek urgent care. Otherwise, contact a healthcare provider with any concerns.
What the Evidence Shows

What we know about pneumococcal vaccination

Fact Since pneumococcal conjugate vaccines were introduced into routine childhood programs, rates of serious (invasive) pneumococcal disease in young children have fallen substantially.
Concern Some parents wonder whether this vaccine is necessary, since they may not have heard of pneumococcal disease the way they've heard of measles or whooping cough.
Evidence Before the vaccine, pneumococcal bacteria were a leading cause of bacterial meningitis and serious bloodstream infections in young children. The drop in these infections following vaccination programs is one of the clearer demonstrations of a vaccine's impact at the population level.
Takeaway Pneumococcal disease is less visible precisely because vaccination has made it less common — but the bacteria are still around, which is why protection in early childhood remains valuable.
Ontario Next Steps

What to do next

Where to get it

Typically given by a family doctor or nurse practitioner during routine well-child visits. Some public health units also offer clinics.

What to bring

Your child's immunization record (the "yellow card"), health card if available, and a list of any allergies or previous reactions.

If you're behind

Catching up does not mean restarting. Visit the Catch-Up & Missing Records page or ask your provider for a review.

If records are missing

Contact your local public health unit — they may have records on file, or can advise on next steps.

If vaccinated outside Ontario

Bring any available records to a healthcare provider for review — products and schedules elsewhere may differ slightly from Ontario's.

Contact public health

For record reporting, school requirements, or general questions, see the Resources page for your local public health unit's contact details.

Sources

Where this information comes from

This page is based on:

Last reviewed: June 2026  ·  Next review due: December 2026
Schedules, products, and eligibility can change. Always confirm current details with your healthcare provider, your local public health unit, or official Ontario sources.

Please note: This is an independent website. It is not affiliated with, endorsed by, or operated by the Government of Ontario, the Ministry of Health, or any public health unit. The information here is for general education only and is not medical advice — always consult a licensed healthcare provider about your or your child's immunizations.