How Well do You Know Pneumococcal Immunization? – Interactive Quiz

Adult Pneumococcal Immunization

Pneumococcal immunization is a recommended adult vaccine.  There are two different vaccine options that could be considered in adults.  These include:

  • Pneu-P-23 (Pneumovax-23(R))  which is a 23-valent polysaccharide pneumococcal vaccine
  • Pneu-C-13 (Prevnar-13 (R)) which is a 13-valent conjugate pneumococcal vaccine

Many people in primary care are unsure of the specific pneumococcal vaccine recommendations for a specific patient.  Two great references to learn more about this infection and the vaccines include:

I thought I would develop an interactive quiz on this topic.  I hope you like it.

Interactive Quiz (20 T/F Questions)

1. A child (5 years old) was just diagnosed with asthma.  He has a full series of Pneu-C-13 doses.  The child should receive 1 dose of Pneu-P-23 vaccine.

2. A patient with chronic kidney disease received a dose of both Pneu-C-13 and Pneu-P-23 when he was diagnosed at 25 years.  He should receive a booster of Pneu-P-23 after the age of 30 years.

3. An immunocompromised patient received a dose of Pneu-C-13 at age 50, a dose of Pneu-P-23 10 weeks later.  They had a booster dose of Pneu-P-23 at age 55 years. She should receive another dose of Pneu-P-23 at age 65 years.

4. Pneu-C-13 vaccine can be safely administered to a senior at the same time as high-dose influenza vaccine (Fluzone HD(R)) and a dose of inactivated herpes zoster vaccine (Shingrix(R))

5. A patient presents with a prescription for both Pneu-P-23 and Pneu-C-13. She has not received either vaccine before.  Ideally the Pneu-P-23 first.

6. Pneu-C-13 vaccine has been shown to reduce the risk of vaccine-type community acquire pneumonia by 45% in people 65 years of age and older

7. Pneumococcal infections are more common in late spring and early fall

8. The Pneu-P-23 is 90% effective against IPD in the elderly.

9. A patient is going to be started on a biologic for inflammatory bowel disease, the Canadian Immunization Guide recommends a dose of Pneu-C-13 followed by a dose Pneu-P-23 at least 8 weeks later

10. All healthy seniors who received a dose of Pneu-P-23 at the age of 65 years, should receive a booster 5 years later.

11. A patient presents with a prescription for Pneu-C-13.  She has received a dose of Pneu-P-23 8 months ago.  She could receive the Pneu-C-13 today.

12. The most common manifestation of S. pneumoniae infection is invasive pneumococcal disease.

13. Invasive pneumococcal disease is most common in young children, adolescents and young adults.

14. Heart disease and diabetes increase the risk of invasive pneumococcal disease

15. S. pneumoniae infection and invasive pneumococcal disease is increased in smokers, persons with alcoholism and illicit drug users

16. Following immunization with Pneu-P-23, antibody concentrations decline after 25 years.

17. Pneumococcal polysaccharide vaccine is less immunogenic in children than pneumococcal conjugate vaccine

18. Pneu-P-23 has been consistently shown to reduce the risk of community acquired pneumonia

19. All healthy adults should receive a dose of Pneu-P-23 vaccine at 65 years of age.

20. If a person received a Pneu-P-23 vaccine dose at the age of 28 years they should receive a dose at 65 years of age.



  1. Public Health Agency of Canada Government of Canada. “Pneumococcal Vaccine – Part 4 – Active Vaccines – Canadian Immunization Guide – Public Health Agency of Canada.” Accessed February 17, 2020.
  2. Center for Disease Control. “Pinkbook | Pneumococcal | Epidemiology of Vaccine Preventable Diseases | CDC.” Accessed February 17, 2020.