The reference pneumococcal vaccine for babies is changing. Since 30 July 2026, the Haute Autorité de santé (HAS, France's national health authority) has recommended Prevenar 20 for all infants, premature babies included, in four doses at 2, 4, 6 and 11 months. It replaces Prevenar 13 and Vaxneuvance, and adds one dose to the current schedule. As of 1 October 2026, this recommendation had not yet been added to the French vaccination schedule, nor was it reimbursed for children.
This article explains what the HAS decided, why, and what it changes compared with the 2026 schedule. It sets out catch-up vaccination for a baby who has already had some doses and where implementation stands. As the HAS pages could not be accessed from our working environment, we read the recommendation in two reports by Vidal dated 30 and 31 July 2026. The implementation status comes from the InfoVac bulletin of 1 October 2026.
Pneumococcal vaccine for babies: what has the HAS recommended since July 2026?
The HAS Board adopted a revised vaccination strategy against invasive pneumococcal infections on 23 July 2026 and published it on 30 July. For infants, the decision comes down to three points.
- A single vaccine: Prevenar 20, a 20-valent conjugate vaccine (PCV20), for all infants, including those born before 37 weeks. The HAS recommends stopping Prevenar 13 (PCV13) and Vaxneuvance (PCV15).
- Four doses: three primary doses at 2, 4 and 6 months, then a booster at 11 months, known as a ‘3 + 1’ schedule.
- Can be given at the same time as the other vaccines recommended at these ages, notably the 6-in-1 vaccine.
For infants vaccinated late, the HAS advises two doses at least four weeks apart between 7 and 11 months, followed by a booster in the second year. Between 12 and 23 months, it is two doses at least eight weeks apart.
Why change vaccine?
Invasive pneumococcal infections, mainly meningitis and sepsis, have been rising steadily in France since 2015 and in 2024 exceeded their pre-Covid-19 pandemic level. Babies under one year old have the highest rate among children, 26.3 cases per 100,000 according to data cited by the HAS. Pneumococcus is also the leading bacterial cause of community-acquired pneumonia, responsible for at least 60,000 cases a year across all ages.
The main reason is serotype coverage. According to the 2024 data reported by the HAS, the serotypes in Prevenar 13 accounted for 16.2% of invasive infections in children, and those in Vaxneuvance for 22.6%. Prevenar 20 additionally covers 21.5% of cases that current vaccines do not. As Vidal sums it up: PCV20 would protect against 41% of cases in children, compared with 18% at most for the vaccines recommended until now. Serotype 24F, which none of these vaccines contains, remains one of the main culprits in young children.
What changes compared with the 2026 vaccination schedule
The French vaccination schedule published in April 2026 provides, for a baby born at term, two doses at 2 and 4 months then a booster at 11 months, with Vaxneuvance or Prevenar 13. Premature and high-risk infants already receive a reinforced schedule at 2, 3, 4 and 11 months. Pneumococcal vaccination is compulsory in France for children born since 1 January 2018. The HAS recommendation does not change this requirement: it changes the product and the number of doses.
In practice, for a baby born at term, the new element is one extra dose, at 6 months, and a different vaccine. For a premature baby, the number of doses stays the same, only the product changes, and the third dose moves from 3 to 6 months. Our article on baby vaccinations in France sets out the full 0-3 years schedule as it applies today.
My baby has already had Prevenar 13 or Vaxneuvance: do we need to start again?
No. The HAS recommends continuing the schedule with Prevenar 20, without repeating the doses already given. The InfoVac bulletin of 1 October 2026 details the transition as the HAS plans it.
- One dose received at 2 months: Prevenar 20 at 4, 6 and 11 months.
- Two doses received at 2 and 4 months: Prevenar 20 at 6 and 11 months.
- Two doses received at 2 and 4 months, and baby is already 11 months old: Prevenar 20 as a booster at 11 months.
- No doses between 12 and 23 months: two doses of Prevenar 20 at least eight weeks apart.
The same bulletin notes that InfoVac, a group of experts in paediatric vaccinology, proposes its own schedule, different from the HAS one, with three doses. That debate is a matter for professionals. For parents, the rule is to follow what the doctor writes in the health record book, without delaying a dose while waiting for a vaccine that is unavailable.
What about children at risk?
The HAS extends Prevenar 20 to children at risk of invasive infection, those who are immunocompromised, have sickle cell disease, have no spleen or have certain chronic conditions, and lowers the starting age from 24 to 15 months. For them, it replaces Prevenar 13, Vaxneuvance and Pneumovax. Between 15 months and 5 years, a single dose at least eight weeks after the last dose of conjugate vaccine is enough when the schedule is complete. From 5 to 17 years, it is a single dose whatever the history. Children born prematurely, for their part, follow the schedule for all infants. The HAS is also assessing the place of a 21-valent vaccine, Capvaxive, in children at risk, with conclusions expected before the end of 2026.
Where does implementation stand on 20 October 2026?
An HAS recommendation does not come into force by itself. Three steps are still needed: inclusion in the vaccination schedule by the Ministry of Health, the opinion of the Commission de la transparence (the HAS drug appraisal committee) on the paediatric indication, then the decree setting reimbursement. As of 1 October 2026, according to InfoVac, the paediatric file had not yet been reviewed by the Commission de la transparence and Prevenar 20 was still reimbursed at 65% for its adult use only. Vidal noted for its part, on 31 July, that the new recommendations had not yet been added to the vaccination schedule.
In the meantime, the official schedule remains that of the 2026 calendar: Vaxneuvance or Prevenar 13 at 2, 4 and 11 months. InfoVac also reports supply difficulties with these vaccines, flagged by its subscribers, and expects things to change in the coming weeks or months. We will update this article when the decree is published.
What it changes for parents, in practice
- A planned vaccination appointment does not need to be moved: the vaccine available today protects your baby, and the switch to Prevenar 20 will happen without starting again.
- The 6-month appointment may include one more injection than planned once the new schedule is in place.
- The expected effects after a dose are the same as with current vaccines: mild fever, redness at the injection site, irritability for one to two days. Our article on fever in babies and the one on paracetamol dosage for babies give you the key points.
- Pneumococcus is also behind some ear infections and pneumonias: our article on antibiotics for babies explains why vaccination matters for using them wisely.
This revision is part of a series of recent HAS decisions on vaccinating young children, following the scoping note on the chickenpox vaccine. It goes hand in hand with progress in vaccination during pregnancy, which protects the baby before their first injections.
Key points to remember
- Since 30 July 2026, the HAS has recommended Prevenar 20 for all infants, at 2, 4, 6 and 11 months.
- It replaces Prevenar 13 and Vaxneuvance, whose serotypes covered less than a quarter of invasive infections in children in 2024.
- A baby who has already been vaccinated continues with Prevenar 20, without starting again.
- As of 1 October 2026, neither the vaccination schedule nor paediatric reimbursement had been updated: the 2, 4, 11-month schedule remains the rule in the meantime.
Sources
- Haute Autorité de santé, “Révision de la stratégie de vaccination contre les infections invasives à pneumocoques”, place of the high-valency vaccines Prevenar 20 and Capvaxive. Recommendation adopted on 23 July 2026, published online on 30 July 2026. HAS pages not accessible from our environment: content read via the two Vidal articles below.
- Vidal, “Stratégie vaccinale contre le pneumocoque : la HAS recommande Prevenar 20 chez l'enfant et Capvaxive chez les adultes”, 30 July 2026.
- Vidal, “Avis de la HAS : évolution des recommandations vaccinales contre le pneumocoque avec Prevenar 20 et Capvaxive”, 31 July 2026.
- Ministère chargé de la Santé (French Ministry of Health), “Calendrier des vaccinations et recommandations vaccinales 2026”, April 2026 edition.
- InfoVac-France, bulletin no. 9, September 2026, published on 1 October 2026: implementation status and transition table.
