Medicare Pneumococcal Vaccine Coverage

Medicare Part B provides pneumococcal vaccine coverage. Furthermore, Medicare will pay for two different pneumococcal shots. Each shot protects against different strains of bacteria. You can talk with your doctor or healthcare provider to determine if you need one or both shots.

Moreover, Part B will cover your first pneumococcal shot(s) at any time. Then you can get a different, second shot(s) at least one year after the first shot. To emphasize, you pay nothing for the pneumococcal vaccine when your doctor or other qualified health care provider accepts Medicare assignment.

Please read this article to learn about the pneumococcal disease, transmission, symptoms, and possible vaccine side effects.

Medicare Pneumococcal Vaccine Coverage - Senior Male

Pneumococcal Disease

Pneumococcal disease is an illness caused by Streptococcus pneumoniae bacteria. These illnesses include the following:

  • Pneumonia, infection of the lungs
  • Ear and sinus infections
  • Meningitis, infection of tissues covering the brain and spinal cord
  • Bacteremia, bloodstream infection

These illnesses can become severe, requiring hospital treatment, and may cause death in some cases. According to the CDC, seniors are at increased risk of pneumococcal disease.

Pneumococcal disease bacteria

Pneumococcal Transmission

A kiss on the cheek is safer than the lips.

Similar to COVID-19, pneumococcal bacteria spread from person-to-person by direct contact with respiratory particles. For example, an infected person coughs or sneezes, releasing particles into the air near you. Then these respiratory secretions enter your nose or mouth, and you become infected by the bacteria. 

Moreover, people, especially children, can have the bacteria in their nose or throat without being ill. For example, you can kiss your seemingly healthy grandchild and become infected with pneumococcal bacteria. 

Pneumococcal Symptoms

Pneumococcal symptoms depend on the part of the body infected. The most severe form of pneumococcal disease infects the lungs and include the following symptoms:

  • Fever and chills
  • Cough
  • Rapid breathing or difficulty breathing
  • Chest pain

According to the CDC, seniors “may experience confusion or low alertness, rather than the more common symptoms above.”

Pneumococcal Symptoms - Senior Man
Senior man with pneumococcal symptoms

Meningitis, Bacteremia, and Ear Infections

Pneumococcal meningitis infects your brain and spinal cord, and symptoms include:

  • Stiff neck
  • Fever
  • Headache
  • Photophobia (eye sensitivity to light)
  • Confusion

Pneumococcal bacteremia infects your blood and causes symptoms of fever, chills, and low alertness. The pneumococcus bacteria can also cause middle ear infections with the following symptoms:

  • Ear pain
  • A red, swollen eardrum
  • Fever
  • Sleepiness
Pneumococcal Meningitis - Senior Man Headache

Medicare Pneumococcal Vaccine Coverage

Medicare Pneumococcal Vaccine Coverage - doctor gives senior man a vaccine shot
Doctor gives senior man pneumococcal vaccine

Medicare Part B provides seniors with CDC recommended Pneumococcal Polysaccharide vaccine PPSV23. This vaccine is also called Pneumovax23 and protects seniors “against serious infections caused by 23 pneumococcal bacteria types.” Polysaccharide vaccines look like the surface of certain bacteria to help your body build immunity. So how effective is this vaccine?

Vaccine Effectiveness

CDC reports studies showing that “1 dose of pneumococcal polysaccharide vaccine protects between 50% to 85% of healthy seniors against invasive pneumococcal disease.” For example, the vaccine protects most seniors from pneumococcal meningitis, bacteremia, and ear infections. So what are the possible vaccine side effects?

Possible Vaccine Side Effects

Most seniors who get the Pneumococcal Polysaccharide vaccine do not have any serious problems. However, you may experience the following mild side effects: redness or pain where the shot location, fever, or muscle aches. If these side effects occur, they usually go away within two days.

Other Medicare Vaccine Coverage

In addition to the pneumococcal vaccine, Medicare provides other Medicare vaccine coverage. For example, Medicare Part B provides seniors with Flu Shot and Hepatitis B vaccines. Furthermore, Medicare Part D or Medicare Advantage Plan with drug coverage pays for the Shingles vaccine