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Pneumococcal 20-valent conjugate vaccine Side Effects

Medically reviewed by Last updated on Jun 12, 2023.

Applies to pneumococcal 20-valent conjugate vaccine: intramuscular suspension.

Serious side effects

Along with its needed effects, pneumococcal 20-valent conjugate vaccine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking pneumococcal 20-valent conjugate vaccine:

More common

Incidence not known

Other side effects

Some side effects of pneumococcal 20-valent conjugate vaccine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

For Healthcare Professionals

Applies to pneumococcal 20-valent conjugate vaccine: intramuscular suspension.


The most common adverse reactions reported for most adults were pain at the injection site, muscle pain, fatigue, headache, arthralgia, and injection site swelling.[Ref]


Postmarketing reports: Pediatric cyanosis, pediatric pallor[Ref]


Uncommon (0.1% to 1%): Angioedema, rash

Postmarketing reports: Angioneurotic edema, erythema multiforme[Ref]


Uncommon (0.1% to 1%): Diarrhea, nausea, vomiting[Ref]


Postmarketing reports: Lymphadenopathy at injection site[Ref]


Uncommon (0.1% to 1%): Hypersensitivity reaction

Postmarketing reports: Anaphylactic/anaphylactoid reaction (including shock)[Ref]


Very common (10% or more): Injection site pain (up to 81.2%), injection site swelling (up to 16.4%), injection site redness (up to 25.5%)

Postmarketing reports: Vaccination-site dermatitis, vaccination-site pruritus, vaccination-site urticaria[Ref]


Very common (10% or more): Decreased appetite among infants (up to 26.4%)[Ref]


Very common (10% or more): Muscle pain (up to 66.6%), joint pain (up to 13.4%)

Frequency not reported: Limitation of arm movement, arthralgia[Ref]

Nervous system

Very common (10% or more): Headache (up to 38.8%), drowsiness among infants (up to 67.2%)

Frequency not reported: Seizures

Postmarketing reports: Pediatric hypotonia[Ref]


Very common (10% or more): Fatigue (up to 42.7%), fever in infants (up to 17.3%)

Common (1% to 10%): Pyrexia

Uncommon (0.1% to 1%): Chills[Ref]


Very common (10% or more): Irritability among infants (up to 70.9%)[Ref]


Uncommon (0.1% to 1%): Bronchospasm, dyspnea

Postmarketing reports: Pediatric apnea[Ref]


1. Product Information. Prevnar 20 (pneumococcal 20-valent conjugate vaccine). Pfizer Inc. 2023.

2. Product Information. Prevenar-20 (pneumococcal 20-valent conjugate vaccine). Pfizer Australia Pty Ltd. 2022;pfpprvni11222.

3. Product Information. Apexxnar (pneumococcal 20-valent conjugate vaccine). Pfizer Ltd. 2023.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.