Brazil expands free pneumococcal vaccination for people 85 and older

Brazil has begun offering the 20-valent conjugate pneumococcal vaccine free through its Unified Health System, known as SUS, to people aged 85 and older. The nationwide target group is estimated at more than 2.3 million people, and the Health Ministry aims to reach 90%. Distribution to states began in September.

Known as Pneumo 20, the vaccine protects against 20 serotypes of Streptococcus pneumoniae, a bacterium that can cause pneumonia and meningitis. Its conjugate design links an antigen to a carrier protein, helping the immune system recognize the threat and develop a stronger response than non-conjugate vaccines such as Pneumo 23.

The expansion focuses on an age group with a particularly high risk of complications. In 2025, pneumonia hospitalizations among Brazilians aged 80 and older were about 2,902 per 100,000 people. Among those aged 85 and older, the pneumonia death rate was about 743 per 100,000.

People need proof of age, but no medical prescription, to seek vaccination. The schedule depends on previous pneumococcal vaccines: someone never vaccinated generally receives one dose, while prior doses may require a waiting interval or mean Pneumo 20 is not currently indicated. The vaccine remains available to other groups, including children under five and people aged 60 to 84 who are bedridden or live in institutions.