PCV20 is recommended for those 65 and above as well as those with certain health conditions.

 

Starting September 1, 2025, the government will include the 20-valent pneumococcal conjugate vaccine (PCV20) under the National Adult Immunisation Schedule (NAIS) and Subsidised Vaccine List (SVL). The vaccine protects against invasive pneumococcal diseases and pneumonia caused by 20 Streptococcus pneumoniae (pneumococcus) serotypes. With this update, PCV20 will become more accessible to Singaporeans, particularly those most vulnerable to severe pneumococcal diseases.

The PCV20 is recommended for all individuals aged 65 years and above, as well as those 18 years and older with certain health conditions including chronic medical conditions (pulmonary, cardiovascular, liver disease and diabetes mellitus), cochlear implants or cerebrospinal fluid leaks, anatomic or functional asplenia, immunocompromising conditions, and chronic kidney disease.

 

What is pneumococcal pneumonia?

So what is pneumococcal pneumonia? Unlike influenza, which is caused by a virus, pneumococcal infection is caused by the bacteria called Streptococcus pneumoniae (also known as pneumococcus). It spreads through droplets produced when an infected person coughs or sneezes, through close contact with the patient, or by touching objects contaminated with the bacteria. The typical incubation period is about one to three days.

The bacteria can invade the body when the immune system is weak, leading to conditions such as otitis media and sinusitis, or more severe forms of infection. Once pneumococcus enters the lungs, it can cause inflammation in the alveoli, leading to what we commonly refer to as “pneumonia”. This condition can result in symptoms such as chest pain, cough, high fever and difficulty breathing.

Streptococcus pneumoniae can also lead to invasive pneumococcal diseases, such as meningitis and sepsis, and may result in severe complications like lung abscess, pleural effusion, pericarditis and respiratory failure, thereby making the condition dangerous.

 

Prevalence in Singapore

Data from 2023 showed that pneumonia was the second leading cause of death in Singapore, accounting for 23.5 percent of all deaths in the country. Pneumococcal pneumonia is the most common type of bacterial pneumonia in adults.

In 2024, pneumococcal pneumonia accounted for 4.6 percent of total hospitalisations, making it the second leading cause of hospitalisation in Singapore. Also, data from the four main public hospitals in Singapore (1997 to 2013) showed that the in-hospital mortality rate due to pneumococcal disease was significantly higher in adults (18.5 percent) than in children (3.1 percent).

 

Different to other PCVs

What makes PCV20 different from the other PCVs? Compared to PCV13 (13-valent pneumococcal conjugate vaccine) and PPSV23 (23-valent pneumococcal polysaccharide vaccine), both of which are recommended to be administered in sequence, PCV20 is recommended as a single dose, which can potentially simplify the vaccination schedule for adults and their families.

 

Cost

According to the Ministry of Health (MOH), at CHAS GP clinics, eligible Singaporeans can expect to pay around S$17 to S$68 for a complete single-dose course of PCV20 depending on their CHAS card status or whether they are a Pioneer Generation or Merdeka Generation senior. Healthier SG Singaporean enrolees will be fully subsidised for PCV20 at their enrolled clinic.

At polyclinics and MOH-funded long-term care institutions, eligible Singaporeans can expect to pay around S$17 to S$68 for a single-dose PCV20, depending on their per capita household income or whether they are a Pioneer Generation or Merdeka Generation senior. Eligible Healthier SG Singaporean enrolees will be fully subsidised at their enrolled polyclinic. Eligible permanent residents can expect to pay around S$102.