The CDC recommends a pneumococcal vaccine — often called the pneumonia vaccine — for all adults 50 and older, and for adults 19 to 49 with certain health conditions. For most people it is a single shot. You can walk in for it at Mega Health Rx in Forest Hills.
What it protects against
Pneumococcal bacteria cause pneumonia, bloodstream infections and meningitis. Older adults and people with chronic illnesses are at the highest risk of serious illness.
Who should get it
According to the CDC, a pneumococcal conjugate vaccine (PCV15, PCV20 or PCV21) is recommended for adults who have never received one and are:
- 50 years or older, or
- 19 to 49 years old with certain risk conditions, such as diabetes, chronic heart, lung, liver or kidney disease, a weakened immune system, or smoking
The age for routine vaccination dropped from 65 to 50, so many people in their 50s and early 60s are newly recommended.
Which vaccine?
The newer vaccines — PCV20 (Prevnar 20) and PCV21 (Capvaxive) — are usually a single dose. If PCV15 (Vaxneuvance) is used, a dose of PPSV23 (Pneumovax 23) follows later.
What if I already had a pneumonia shot?
It depends on which one and when. Some people who got older vaccines years ago are recommended to get one of the newer conjugate vaccines. Our pharmacist can check the New York State immunization registry and tell you whether you need another dose.
Does Medicare cover Prevnar 20?
Yes. Prevnar 20 (PCV20), Capvaxive (PCV21) and the other pneumococcal vaccines are covered under Medicare Part B as a preventive service. According to Medicare.gov, you pay nothing when the pharmacy or provider giving the shot accepts Medicare assignment. There is no copay and no Part B deductible for it.
- Original Medicare: covered under Part B, not your Part D drug plan. Bring your red-white-and-blue Medicare card.
- Medicare Advantage: your plan must cover it at no cost as well. Bring your plan card.
- Medicaid: New York Medicaid covers recommended adult vaccines, including the pneumonia vaccine.
- Commercial insurance: most plans cover it at no cost as preventive care.
Not sure which card to bring? Bring every insurance card you have, and we will check your coverage before giving the shot.
Getting your pneumonia vaccine here
Stop by 64-51 108th Street, Forest Hills with your Medicare or insurance card and a photo ID; no appointment is needed. If you’re not sure whether you had a pneumococcal shot before, we can usually look up your record in the New York State immunization registry first, and we add today’s dose to it with your consent. Call (516) 304-5038 to confirm which pneumococcal vaccine we have in stock.
Frequently asked questions
Who should get the pneumonia vaccine?
The CDC recommends a pneumococcal conjugate vaccine for all adults 50 and older and adults 19 to 49 with certain risk conditions who have not received one.
Is the pneumonia vaccine a one-time shot?
For most people using PCV20 or PCV21, yes. If PCV15 is used, a dose of PPSV23 follows.
I had a pneumonia shot years ago. Do I need another?
Possibly. It depends on which vaccine you received and when. Your pharmacist can check your record.
Does Medicare cover the pneumonia vaccine?
Yes. Medicare Part B covers pneumococcal vaccines as a preventive service, and you pay nothing when the pharmacy or provider accepts Medicare assignment.
Does Medicare cover Prevnar 20?
Yes. Prevnar 20 is covered under Medicare Part B, not Part D, with no copay or deductible at a pharmacy that accepts Medicare assignment. Medicare Advantage plans must cover it at no cost too.
Does Medicare cover Capvaxive?
Yes. Capvaxive (PCV21) is covered under Part B the same way as Prevnar 20.
Does Medicaid cover the pneumonia vaccine in New York?
Yes. New York Medicaid covers recommended adult vaccines, including pneumococcal vaccines.
This article is for general educational purposes and does not replace individualized medical advice. Speak with your pharmacist, physician or other healthcare professional about what is right for you.
Walk in for your pneumonia vaccine
We check your record and coverage first. No appointment needed.