Pneumococcal Vaccine for Adults in Malaysia

Pneumonia is consistently among the leading causes of death in Malaysia, according to the Department of Statistics. One of its most common bacterial causes, Streptococcus pneumoniae (pneumococcus), can be prevented with a vaccine. Yet many adults who would benefit have never been offered it. This guide explains who should get the pneumococcal vaccine, the differences between the vaccines available in Malaysia, and how many doses you need.

What is pneumococcal disease?

Pneumococcus lives harmlessly in the nose and throat of many people and spreads through coughs, sneezes and close contact. When it invades other parts of the body, it causes:

• pneumonia (lung infection), the most common serious form in adults
• bacteraemia (infection of the bloodstream)
• meningitis (infection of the lining of the brain and spinal cord)
• milder infections such as sinusitis and middle-ear infections

Pneumonia, bloodstream infection and meningitis are called invasive pneumococcal disease. They can be life-threatening, and the risk climbs with age and with long-term illnesses. Pneumococcal pneumonia can also follow a bout of influenza, which is why doctors often recommend the flu vaccine alongside it.

Pneumococcal vaccines available in Malaysia

There are two kinds of pneumococcal vaccine. Conjugate vaccines (PCV) join the bacterial sugar coat to a protein, which trains the immune system to remember it and works well in older adults. Polysaccharide vaccines (PPSV) cover more strains, but the protection is weaker and shorter-lived.

Vaccine	Type	Strains covered	Typical use in adults
Prevenar 20 (PCV20)	Conjugate	20	A single dose for adults who need protection. Approved in Malaysia in 2025 for children and adults.
Prevenar 13 (PCV13)	Conjugate	13	Used in the older two-vaccine plan: PCV13 first, then PPSV23 later.
Pneumovax 23 (PPSV23)	Polysaccharide	23	Given after a conjugate vaccine to broaden coverage, mainly for people at higher risk.

A 21-strain vaccine (PCV21) is used in some countries but is not yet available in Malaysia. For babies, a pneumococcal conjugate vaccine has been part of Malaysia’s National Immunisation Programme since late 2020.

Who should get the pneumococcal vaccine?

Talk to your doctor about it if you are:

• 65 or older. Some countries now start at 50. The US CDC lowered its age to 50 in 2024 because risk rises sharply in the 50s.
• a smoker, because smoking damages the lungs’ defences.
• an older adult going on Umrah or Hajj, where crowded conditions raise the risk of respiratory infections.
• an adult of any age with one of the conditions below.

Conditions that raise your risk

• diabetes
• chronic heart disease, including heart failure
• chronic lung disease such as COPD, emphysema or asthma
• chronic kidney disease or nephrotic syndrome
• chronic liver disease or long-term heavy alcohol use
• a weakened immune system (for example HIV, cancer treatment, an organ transplant or long-term steroids)
• no spleen, or a spleen that doesn’t work properly (including sickle cell disease)
• a cochlear implant or a leak of cerebrospinal fluid

How many doses do adults need?

For adults, most current guidance follows this pattern:

Your history	What’s usually recommended
Never had a pneumococcal vaccine	One dose of PCV20. For most people that’s it. The older alternative is PCV13 followed by PPSV23 at least a year later (8 weeks later if your immunity is weak).
Had PCV13 before	One dose of PCV20, or PPSV23, at least one year after the PCV13. Your doctor will choose.
Had PPSV23 only	One dose of PCV20 at least one year after the PPSV23.

The Malaysian Society of Infectious Diseases and Chemotherapy notes that a conjugate vaccine only needs a single dose, and boosters are not routinely recommended. Where PPSV23 is used, a repeat dose may be advised after five years, up to three doses in a lifetime. Bring any old vaccination cards so the doctor doesn’t repeat what you’ve already had.

Side effects and safety

Pneumococcal vaccines don’t contain live bacteria and cannot cause pneumonia. Common side effects last a day or two:

• pain, redness or swelling where the injection was given
• tiredness, headache or muscle aches
• a mild fever or chills

Severe allergic reactions are rare. Tell the doctor if you’ve reacted badly to a vaccine before, or if you’re pregnant or unwell. The pneumococcal vaccine can be given at the same visit as the flu vaccine, one in each arm.

Frequently asked questions

Which pneumococcal vaccine is recommended for adults?

For most adults who have never had a pneumococcal vaccine, a single dose of the 20-strain conjugate vaccine (PCV20, Prevenar 20) is recommended. An older alternative is PCV13 followed by PPSV23 (Pneumovax 23) at least a year later. Your doctor will choose based on your age, health and past vaccines.

Is the pneumonia vaccine the same as the pneumococcal vaccine?

Yes. “Pneumonia vaccine” usually means the pneumococcal vaccine, which protects against Streptococcus pneumoniae, the most common bacterial cause of pneumonia. It doesn’t protect against pneumonia caused by viruses or other bacteria.

How many doses of Pneumovax 23 are needed?

Usually one, given after a conjugate vaccine. Some people at high risk may be advised a repeat dose after five years. The Malaysian Society of Infectious Diseases and Chemotherapy advises no more than three doses in a lifetime.

Do adults need a pneumococcal booster?

After a conjugate vaccine such as PCV20, boosters are not routinely recommended. Your doctor will check your records, particularly if you’ve had PCV13 or PPSV23 before.

Is Prevenar 20 available in Malaysia?

Yes. The 20-strain pneumococcal conjugate vaccine (Prevenar 20) was approved in Malaysia in 2025 for children and adults.

Can I get the pneumococcal and flu vaccines at the same time?

Yes. Both can be given at the same visit, one in each arm. Getting both makes sense, because pneumococcal pneumonia often follows influenza.

Who should get the pneumococcal vaccine?

Adults aged 65 and above (some guidelines now start at 50), smokers, and adults of any age with diabetes, heart, lung, kidney or liver disease, a weakened immune system, or no working spleen.