Correspondence

Change of vaccine for the routine adult pneumococcal vaccination programme and individuals at increased clinical risk letter

Published 16 December 2025

16 December 2025

Dear colleagues,

A change of vaccine for the routine pneumococcal vaccination programme for adults, for those aged 2 years and above in clinical risk groups for pneumococcal disease, and for children aged less than 2 years of age with asplenia, splenic dysfunction, complement disorder and severe immunosuppression.

This letter should be read by those responsible for commissioning and running the national NHS routine vaccination programme. Please share this guidance with all those involved in delivering the programme in your area.

Currently, the pneumococcal polysaccharide vaccine which protects against 23 serotypes of the pneumococcus bacterium PPV23 (Pneumovax 23) is used in the pneumococcal vaccination programmes for those aged 65 years and over, and from 2 years of age for those with underlying medical conditions. The pneumococcal conjugate vaccine, PCV13 (Prevenar 13), which covers 13 serotypes is used in the routine national childhood immunisation programme. Additional doses of PCV13 are given to children aged less than 2 years of age with asplenia, splenic dysfunction, complement disorder and severe immunosuppression.

In June 2023, the Joint Committee on Vaccination and Immunisation (JCVI) advised that either PCV20 (Prevenar 20) - the pneumococcal conjugate vaccine that covers 20 serotypes - or PPV23 could be used for the adult pneumococcal programme and for individuals over 2 years in a clinical risk group. This advice was accepted by ministers and enabled a competitive tender for vaccine supply. The outcome was a contract for PCV20.

In June 2025, the Green Book was updated to reflect the clinical advice to use PCV20 in children under 2 years of age with asplenia, splenic dysfunction, complement disorder or severe immunocompromise.

Key points

Key points about the vaccine change:

• in January and February 2026, PPV23 central supply will be run down and PCV20 will become available to order for the programme. Further supply information will be provided on ImmForm and in Vaccine Update closer to the time
• once central supply and local PPV23 stocks have been used up, PCV20 should be used for the routine adult pneumococcal vaccination programme, and for those aged 2 years and above in clinical risk groups
• when PCV20 is available to order from ImmForm, children less than 2 years of age with asplenia, splenic dysfunction, complement disorder and severe immunosuppression, and individuals aged 2 years and over with severe immunosuppression, can be offered PCV20 in place of PCV13. The number of doses required will depend upon the age at presentation and is outlined in table 25.3 in the Pneumococcal Green Book chapter
• the vaccine for the routine childhood pneumococcal vaccination programme (PCV13) remains unchanged, and should continue to be offered to all children at 16 weeks and one year of age

Providers are expected to deliver a 100% offer to eligible groups. Providers should also ensure they have robust plans in place to identify and address health inequalities for all underserved groups, and it is expected that progress will be made on reducing unwarranted variation and improving uptake.

Further information

Annexe A provides information and resources to support implementation of the vaccine change.

For any operational queries, please contact your NHS England Regional Public Health Commissioning Team. For clinical queries or queries about programme resources, please email immunisation@ukhsa.gov.uk

We would like to take this opportunity to thank everyone involved in the commissioning and operational delivery of the national immunisation programme in England.

Yours sincerely,

Caroline Temmink, Director of Vaccination, NHS England

Dr Mary Ramsay CBE, Director of Public Health Programmes (including immunisation), UK Health Security Agency