Pneumococcal vaccine in Belgium: price and reimbursement
11 October 2026 · 14 min read
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In Belgium the Superior Health Council recommends a single dose of conjugate pneumococcal vaccine for all adults from 65, and from 18 for people with a risk condition. At the pharmacy, Prevenar 20 and Capvaxive cost 67,78 € (public price listed by CBIP/BCFI, consulted on 10 October 2026).
Reimbursement is narrower than the recommendation: you need to be at least 65, have a listed comorbidity and, with one exception, never have been vaccinated against pneumococcus. For babies, three doses are free in the basic schedule, with a change on 1 November 2026 on the French-speaking side.
- The Superior Health Council (advice 9842, 10 December 2025) recommends a single dose of conjugate vaccine, PCV20 or PCV21 depending on age, for all adults from 65 and from 18 with a risk condition.
- Prevenar 20 and Capvaxive cost 67,78 € at the pharmacy (CBIP/BCFI, consulted on 10 October 2026); your pharmacy confirms the amount at the counter.
- Reimbursement (12,80 €, or 8,50 € with increased reimbursement) requires that you are at least 65 (and at most 80 for Prevenar 20), have a listed comorbidity and were never vaccinated, or only with PPV23 more than five years ago: age alone is not enough.
- Pneumovax 23 costs 33,66 €, is not reimbursed, and the Council no longer gives it a place in its current advice.
- Babies: three free doses of Prevenar 13, at 8 weeks, 16 weeks and 12 months. In the Wallonia-Brussels Federation, for babies under 12 months on 1 November 2026, the last one moves to 15 months (13 months for babies born before 37 weeks); on the Flemish pages read on 11 October 2026, no change and no date.
Who should get the pneumococcal vaccine as an adult in Belgium?
The reference is advice no. 9842 of the Superior Health Council on pneumococcal vaccination for adults (2025 revision), published on 10 December 2025. It replaces advice 9674 from 2022 and exists in English only.
The Council recommends the vaccine for all adults aged 65 and over, regardless of other risk factors and with no upper age limit. It also recommends it for adults aged 18 to 64 with a risk condition. The table lists the categories from the advice.
| Category (adults aged 18 to 64) | Conditions named by the Council |
|---|---|
| Immunocompromising conditions | Primary immunodeficiency, HIV infection, haematopoietic malignancy, active chemotherapy or radiation therapy, immunosuppressive medications, anatomical or functional asplenia, sickle cell disease, haemoglobinopathies. |
| Anatomical risk factors | Cochlear implant, cerebrospinal fluid leak. |
| Chronic heart disease | Congestive heart failure, coronary artery disease, cardiomyopathies. |
| Chronic lung disease | COPD, asthma, chronic bronchitis, emphysema, current smoking, cystic fibrosis and bronchiectasis (including primary ciliary dyskinesia). |
| Chronic liver disease | Cirrhosis, chronic hepatitis, alcoholism. |
| Chronic kidney disease | Stage 3 to 5 chronic kidney disease, end-stage renal disease, nephrotic syndrome. |
| Neurological conditions | Chronic neurological disorders with aspiration risk, neuromuscular disorders, seizure disorders. |
| Metabolic disorders | Diabetes mellitus. |
| Environmental and occupational | Homelessness, working as a welder. |
This list says who the vaccine is recommended for, not who it is reimbursed for. CBIP/BCFI points this out: the Council does not take the cost of vaccination into account, and some vaccines it recommends for older patients are not reimbursed.
CBIP/BCFI is also more reserved about healthy people aged 65 and over: it writes that the benefit/risk balance is not sufficiently documented in that group, and that the vaccine’s efficacy is not documented beyond the age of 85. Your doctor is the one who assesses your situation.
Source : Superior Health Council: advice 9842, pneumococcal vaccination for adults (FR page) ↗vaccination-info.be: pneumococcal meningitis, pneumonia and septicaemia (FR) ↗The vaccination schedule in Belgium ↗
One dose: Prevenar 20 or Capvaxive, and do you need a booster?
The Council opts for a single dose of a conjugate vaccine: PCV20 (Prevenar 20, by Pfizer, formerly Apexxnar) or PCV21 (Capvaxive, by MSD, marketed in Belgium in March 2026 according to CBIP/BCFI). No revaccination is required after either of these two vaccines, the Council writes, with an individual assessment for immunocompromised patients (see below the table).
The advice also removes the non-conjugate vaccine PPV23 (Pneumovax 23) from routine vaccination. CBIP/BCFI sums it up: the Council no longer gives PPV23 a place.
The choice between the two vaccines depends on age, as in the table below. CBIP/BCFI adds one reservation about PCV21: there are no studies with clinical endpoints for that vaccine.
| Age | Who | Vaccine chosen by the Council |
|---|---|---|
| 18 to 49 | Adults with a risk condition | PCV20 |
| 50 to 64 | Adults with a risk condition | PCV20 or PCV21 |
| 65 and over | All adults | PCV20 or PCV21 |
| 85 and over | All adults | PCV21 preferred. The Council names PCV20 as an acceptable alternative if PCV21 is unavailable. |
If you already had an older vaccine, the Council’s catch-up table provides one dose of PCV20 or PCV21 at least 1 year after PPV23 alone (whatever the number of doses), and at least 1 year after PCV13 or PCV15 alone. After PCV13 or PCV15 followed by PPV23, a dose is to be considered, at least 5 years after the PPV23.
After PCV20 or PCV21, the Council provides none. If your vaccination history is unknown, the Council says to vaccinate as for someone never vaccinated. That recommended catch-up dose is not always reimbursed: the conditions are set out further down.
The advice attaches one reservation to these intervals and to the absence of revaccination: for immunocompromised patients the Council asks for an individual assessment, and earlier revaccination may be considered case by case for those who are severely immunocompromised. That is for the doctor to assess.
No season is imposed: an older page of the Council (2023) says this vaccination is feasible all year round. Advice 9842 calls co-administration with other age-appropriate vaccines acceptable; the studies it cites concern the flu vaccine.
The Flemish Departement Zorg writes that vaccines against covid, flu, RSV and pneumococcus can be given at the same time. For the RSV vaccine Arexvy, however, the Council’s RSV advice (December 2024) notes that co-administration with COVID-19 and pneumococcal vaccines has not been studied.
Source : CBIP/BCFI: Repertoire, vaccine against pneumococcal infections (FR) ↗CBIP/BCFI: Folia March 2026, pneumococcal vaccination for adults (FR) ↗Flu vaccine in Belgium ↗
Prevenar 20, Capvaxive, Pneumovax 23: what do they cost at the pharmacy in 2026?
The prices below are the public prices in the CBIP/BCFI Repertoire, consulted on 10 October 2026, for one 0.5 ml pre-filled syringe in a public pharmacy. All of these vaccines are prescription-only.
| Vaccine | Type | Public price | INAMI/RIZIV reimbursement | Consulted on |
|---|---|---|---|---|
| Prevenar 20 (Pfizer) | PCV20, conjugate | 67,78 € | Category b, under conditions | 10 October 2026 |
| Capvaxive (MSD) | PCV21, conjugate | 67,78 € | Category b, under conditions | 10 October 2026 |
| Pneumovax 23 (MSD) | PPV23, non-conjugate | 33,66 € | Not reimbursed. The Council no longer gives it a place in its current advice. | 10 October 2026 |
| Prevenar 13 (Pfizer) | PCV13, conjugate | 74,55 € | Not reimbursed at the pharmacy. Free for infants through the Communities. | 10 October 2026 |
| Vaxneuvance (MSD) | PCV15, conjugate | 74,55 € | Not reimbursed | 10 October 2026 |
These prices can change: your pharmacy confirms the exact amount at the counter. According to CBIP/BCFI, Prevenar 20 cost for example 66,91 € on 1 September 2023 and 67,51 € on 1 July 2025.
Pneumovax 23 is still listed at 33,66 € (CBIP/BCFI, 10 October 2026), but it is not reimbursed and the Council no longer gives it a place in its current advice. Its lower price does not make it the vaccine the Council has chosen, and your doctor is the one who prescribes in any case.
This overview covers the public pharmacy circuit only.
Pneumovax 23 is still listed at 33,66 € (CBIP/BCFI, 10 October 2026), but it is not reimbursed and the Council no longer gives it a place in its current advice.
Source : Vaccine prices in Belgium: the full table ↗CBIP/BCFI: Repertoire, vaccine against pneumococcal infections (FR) ↗
Is the pneumococcal vaccine reimbursed at 65?
Not automatically: age alone gives no entitlement. Under the INAMI/RIZIV rules published by CBIP/BCFI, three conditions have to be met together. You are in the age range set for the product, you have at least one listed comorbidity, and you were never vaccinated against pneumococcus, or only with PPV23 (Pneumovax 23) more than five years ago.
The list of comorbidities is the same for both vaccines:
- Chronic heart condition with NYHA class II to IV.
- Chronic lung disease: asthma, COPD, pulmonary fibrosis, interstitial lung disease, restrictive lung disease, after-effects of a pulmonary embolism, cystic fibrosis.
- Active smoking.
- Chronic liver condition (Child-Pugh score B or C).
- Chronic kidney condition with a KDOQI score of 3 to 5.
- Chronic neurological or neuromuscular disease with a high aspiration risk.
- Diabetes mellitus.
| Vaccine | Age | Conditions | What you pay | Since when |
|---|---|---|---|---|
| Prevenar 20 (PCV20) | 65 to 80 | At least one listed comorbidity. Never vaccinated, or PPV23 alone more than 5 years ago. One pack per beneficiary. | 12,80 €, or 8,50 € with increased reimbursement | 1 September 2023 |
| Capvaxive (PCV21) | 65 or over, no upper limit | The same as for Prevenar 20. | 12,80 €, or 8,50 € with increased reimbursement | Announced by CBIP/BCFI in August 2026 (situation at 24 July 2026). Exact first day not published. |
So the following are not reimbursed: healthy people aged 65 and over, even though the Council’s recommendation covers them; adults under 65, whatever their risk, including immunocompromised adults aged 18 to 64; people over 80 with Prevenar 20 (Capvaxive remains possible, with no upper age limit).
People who already had an earlier conjugate vaccine (PCV13, PCV15) are not reimbursed either: the Council recommends a catch-up dose for them, which the INAMI/RIZIV rules do not cover. Immunodeficiency is not in the list of comorbidities for either vaccine.
The 12,80 € and 8,50 € are the co-payment ceilings for category b in force since 1 January 2026, according to INAMI/RIZIV, which adds that they can be indexed every year.
No Community provides this vaccine free of charge to adults. The Flemish page on vaccinations from 65 says so too: not free, but partly reimbursed for people aged 65 and over at increased risk of a pneumococcal infection.
Age alone gives no entitlement: you also need a listed comorbidity, and you were never vaccinated against pneumococcus or only with PPV23 more than five years ago.
Source : CBIP/BCFI: Prevenar 20, reimbursement conditions (FR) ↗CBIP/BCFI: Capvaxive, reimbursement conditions (FR) ↗INAMI/RIZIV: minimum and maximum amounts paid by the patient (FR) ↗
What must the prescription say, and can a pharmacist vaccinate?
Reimbursement of Prevenar 20 and Capvaxive needs no authorisation from the advisory physician, and you have no form to send to your mutuality. It all happens on the prescription and at the counter.
According to vaccination-info.be, pharmacists are allowed to prescribe and administer the flu and COVID-19 vaccines only: for pneumococcus, you need a prescription from a doctor. The pages consulted at the medicines agency AFMPS/FAGG and at INAMI/RIZIV point the same way: they cover flu (AFMPS/FAGG) and flu and COVID-19 (INAMI/RIZIV), and neither mentions the pneumococcal vaccine. The site for professionals notes that this role may be extended in the future.
According to vaccination-info.be, pharmacists are allowed to prescribe and administer the flu and COVID-19 vaccines only: for pneumococcus, you need a prescription from a doctor.
Source : vaccination-info.be: who vaccinates and where (FR) ↗Find your vaccination history in Belgium ↗
What is the schedule in Belgium for the pneumococcal baby and toddler vaccine, and what changes on 1 November 2026?
For infants, both Communities provide Prevenar 13 (PCV13) free of charge, in three doses. Until 31 October 2026 the schedule is the same in the north and the south: 8 weeks, 16 weeks and 12 months. Preterm babies (born before 37 weeks) get an extra dose at 12 weeks.
In the Wallonia-Brussels Federation, the last dose moves from 12 to 15 months from 1 November 2026: until 31 October 2026 it stays at 12 months. For babies born before 37 weeks, an extra dose stays planned at 3 months and the last dose is given at 13 months. On the Flemish pages (Departement Zorg, Kind en Gezin) read on 11 October 2026, there is no change and no date.
According to the dossier that the Wallonia-Brussels Federation’s vaccination programme published for professionals in September 2026, the last dose is planned at 15 months instead of 12 for all babies who are under 12 months on 1 November 2026. For children over 12 months who have already had the planned dose, no further action is required.
| Dose | Flanders | Wallonia-Brussels Federation |
|---|---|---|
| 1st dose | 8 weeks | 8 weeks (2 months) |
| Extra dose for preterm babies | 12 weeks | 12 weeks (3 months) |
| 2nd dose | 16 weeks | 16 weeks (4 months) |
| Last dose | 12 months. On the Flemish pages read on 11 October 2026: no change, no date. | 12 months until 31 October 2026. From 1 November 2026: 15 months, or 13 months for babies born before 37 weeks. |
| Where | Kind en Gezin, GP, paediatrician | ONE consultation, your regular doctor, a paediatrician outside hospital, the hospital paediatrics department |
The dossier says nothing about a child who is already 12 months or older on 1 November 2026 and has not yet had the 12-month dose. If that is your child’s case, ask your ONE consultation or your doctor when that dose is planned.
For parents, the article on the public site vaccination-info.be (updated on 21 September 2026) says in substance that they have nothing to do themselves: doses already given stay valid, the professional adapts the calendar and planned appointments are to be kept. In case of doubt, it advises bringing the vaccination booklet to the next appointment.
On 11 October 2026, the dossier for professionals, the 2026-2027 calendar and the documents for parents are on the vaccination programme’s site for professionals. The public site announces the change in a news article, but its calendar page still shows the 2025-2026 calendar as the one in force.
In the Wallonia-Brussels Federation, the free supply depends on two conditions: the dose is given at the times set by the calendar, and the vaccine is ordered by the professional through the programme. A catch-up with the free vaccine is provided up to 24 months for children who are not up to date.
The Council recommends a broader vaccine for children: its advice no. 9836 (24 April 2025) opts for PCV20 in a 3+1 schedule, which according to CBIP/BCFI means a dose at 8, 16 and 24 weeks and then one at 13-15 months. That vaccine is in no free programme.
In the Wallonia-Brussels Federation, the September 2026 dossier states that PCV13 remains the programme’s vaccine: the move to PCV20 is not implemented at this stage and is under analysis. The article on the public site adds that a doctor can prescribe Prevenar 20, at the parents’ expense. Flanders writes that it does not offer this vaccine free of charge for now.
Parents who choose it pay for it themselves: PCV20 is not reimbursed for children, according to CBIP/BCFI. The Flemish Departement Zorg speaks of about 270 € for 4 doses. In Flanders it is given on prescription from the GP or paediatrician, bought at the pharmacy and not administered by Kind en Gezin.
For a child at increased risk, specific schedules exist, according to vaccination-info.be: ask the doctor who follows your child.
According to the dossier that the Wallonia-Brussels Federation’s vaccination programme published for professionals in September 2026, the last dose is planned at 15 months instead of 12 for all babies who are under 12 months on 1 November 2026.
Source : The child vaccination schedule in Belgium ↗vaccination-info.be: the infant vaccination calendar changes on 1 November 2026 (FR) ↗vaccination-info.be (professionals): guide to the new 2026 infant calendar (FR) ↗vaccination-info.be (professionals): vaccination calendar and Council recommendations (FR) ↗Departement Zorg: pneumococcal vaccination, what parents need to know (NL) ↗Tool: the Belgian vaccination calendar ↗
What does your mutuality reimburse on top?
Several mutualities publish a general yearly allowance for vaccines. None of the pages consulted names Prevenar 20 or Capvaxive: it is a general benefit, not a reimbursement specific to the pneumococcal vaccine.
These are the amounts read on the official pages on 10 October 2026. They differ from one mutuality to another: check the page of your own before counting on it.
| Mutuality | Published allowance | Conditions read on the page |
|---|---|---|
| Mutualité chrétienne (MC) | Up to 15 € per item, up to 75 € per year and per person | Ceiling shared with alternative therapies and other prevention benefits, valid since 1 January 2025. Products on the CBIP/BCFI list, bought in Belgium or a neighbouring country, BVAC certificate. |
| Solidaris Wallonie | The page shows two figures: 25 € per year for anti-infectious vaccines, and up to 30 € per year and per beneficiary | BVAC certificate, vaccine recognised by Solidaris. Have the amount confirmed. |
| Mutualité Libérale (ML MUTPLUS.be) | 50 % of the price actually paid, maximum 30 € per calendar year | All vaccines recognised in Belgium. Nothing if the vaccine is free in a public programme. |
| Helan | Maximum 25 € per year | Only vaccines not reimbursed by the compulsory insurance. |
| Partenamut | Up to 35 € per year | All vaccines registered in Belgium. |
| Mutualia | 35 € per year and per beneficiary | All vaccines recognised in Belgium, capped at the amount left after the compulsory insurance. |
| La Mutualité Neutre | Up to 35 € per calendar year | Any type of vaccine, BVAC certificate. |
| CM (Dutch-language page) | Not read | The page could not be opened on 10 October 2026: check it directly. |
At Helan, the benefit excludes vaccines that received an INAMI/RIZIV reimbursement: so it only applies if you do not meet the conditions described above.
For the medical recommendation and the INAMI/RIZIV reimbursement, the Council’s advice and the rules described above remain the reference. The mutuality pages are used here for the amount of their benefit only.
What the official sources do not say
Several common questions had no official answer in the sources consulted on 10 and 11 October 2026. They are listed here as they stand, without filling them in.
- The exact first day of the Capvaxive reimbursement: CBIP/BCFI announces it in its August 2026 update (situation at 24 July 2026), with no precise date.
- The future of the 80-year limit for Prevenar 20: no source says whether it will be kept or lifted. The two rules simply differ today.
- The date of a switch to PCV20 in the infant programmes: the Wallonia-Brussels Federation says it is under analysis, Flanders that the vaccine is not free for now.
- A Flemish date for moving the last dose for babies (none on the pages read on 11 October 2026), and, in the Wallonia-Brussels Federation, the rule for a child aged 12 months or more on 1 November 2026 who has not yet had the 12-month dose.
- A reimbursement for immunocompromised adults under 65: none was found.
- Whether a pharmacist may administer this vaccine: no official page says yes.
- The future availability of Pneumovax 23: CBIP/BCFI still lists it with a price, nothing was found about its supply.
- An arrangement specific to Brussels or the German-speaking Community: the Vivalis page only says the schedule will be adapted for at-risk seniors.
For each of these points, your doctor, your pharmacist or your mutuality will give you the answer that applies to your situation.
Frequently asked questions
What is the price of Pneumovax 23 at the pharmacy in 2026?
The CBIP/BCFI Repertoire lists 33,66 € for one syringe (consulted on 10 October 2026), but this vaccine is not reimbursed and the Superior Health Council no longer gives it a place in its current advice. Your pharmacy confirms the amount at the counter.
What is the price of Prevenar 20 in Belgium?
67,78 € in the CBIP/BCFI Repertoire, consulted on 10 October 2026, the same as Capvaxive. If you meet the reimbursement conditions, you pay 12,80 €, or 8,50 € with increased reimbursement. Your pharmacy confirms the amount at the counter.
Is the pneumococcal vaccine reimbursed at 65?
Only under conditions: being in the age range (65 to 80 for Prevenar 20, 65 or over for Capvaxive), having a listed comorbidity, and never having been vaccinated against pneumococcus or only with PPV23 more than five years ago. A healthy 65-year-old is not reimbursed.
Do you need to repeat the vaccine after a few years?
According to advice 9842 of the Superior Health Council, no revaccination is required after PCV20 or PCV21. If you had an older vaccine, the Council provides or considers a catch-up dose, depending on the vaccine you had. For severely immunocompromised patients it asks for an individual assessment by the doctor, who may consider earlier revaccination. Your doctor will tell you whether that applies to you.
Can a pharmacist give the pneumococcal vaccine?
According to vaccination-info.be, pharmacists are allowed to prescribe and administer the flu and COVID-19 vaccines only. For pneumococcus, you need a prescription from a doctor.
At what age do babies get the pneumococcal vaccine in Belgium?
At 8 weeks, 16 weeks and 12 months, free of charge, with Prevenar 13. In the Wallonia-Brussels Federation, from 1 November 2026, the last dose moves to 15 months for babies who are under 12 months on that date (13 months for babies born before 37 weeks). On the Flemish pages read on 11 October 2026, there is no change and no date.
Official sources
- CSS/HGR : avis 9842, vaccination antipneumococcique pour les adultes (révision 2025) ↗
- CSS/HGR : avis 9842, texte complet (PDF, anglais) ↗
- CSS/HGR : avis 9836, vaccination anti-pneumococcique pour les enfants (révision 2025) ↗
- CSS/HGR : avis 9837, vaccination contre le VRS chez les adultes (PDF, anglais) ↗
- CSS/HGR : pluri-vaccination respiratoire pour les plus de 65 ans (page de 2023) ↗
- CBIP/BCFI : Répertoire, vaccin contre les infections à pneumocoques ↗
- CBIP/BCFI : Répertoire, vaccins (texte général, tableaux 12a et 12b) ↗
- CBIP/BCFI : prix de Prevenar 20 (PCV20) ↗
- CBIP/BCFI : prix de Capvaxive (PCV21) ↗
- CBIP/BCFI : prix de Pneumovax 23 (PPV23) ↗
- CBIP/BCFI : prix de Prevenar 13 (PCV13) ↗
- CBIP/BCFI : prix de Vaxneuvance (PCV15) ↗
- CBIP/BCFI : Prevenar 20, conditions de remboursement (source INAMI) ↗
- CBIP/BCFI : Capvaxive, conditions de remboursement (source INAMI) ↗
- CBIP/BCFI : Folia mars 2026, vaccination antipneumococcique de l’adulte ↗
- CBIP/BCFI : nouveautés septembre 2023, remboursement du PCV20 ↗
- CBIP/BCFI : nouveautés août 2026, remboursement de Capvaxive ↗
- CBIP/BCFI : Folia août 2025, vaccin antipneumococcique chez l’enfant ↗
- INAMI/RIZIV : montants minimum et maximum à payer par le patient ↗
- INAMI/RIZIV : honoraires pour la vaccination contre la grippe ou la COVID-19 ↗
- AFMPS/FAGG : campagne de vaccination contre la grippe saisonnière 2026-2027 ↗
- vaccination-info.be : méningites, pneumonies et septicémies à pneumocoque ↗
- vaccination-info.be : gratuité et remboursements des vaccins ↗
- vaccination-info.be : par qui et où se faire vacciner ↗
- vaccination-info.be : calendrier de vaccination ↗
- vaccination-info.be : le calendrier de vaccination des nourrissons change le 1er novembre 2026 ↗
- vaccination-info.be (pros) : repères pour le nouveau calendrier nourrissons 2026 (dossier, septembre 2026) ↗
- vaccination-info.be (pros) : calendrier de vaccination effectif à partir du 1er novembre 2026 ↗
- vaccination-info.be (pros) : calendrier de vaccination et recommandations du CSS ↗
- vaccination-info.be (pros) : pneumocoques chez les nourrissons ↗
- vaccination-info.be (pros) : le pharmacien vaccinateur ↗
- Departement Zorg : vaccinaties vanaf 65 jaar (NL) ↗
- Departement Zorg : vaccinaties voor kinderen (NL) ↗
- Departement Zorg : pneumokokkenvaccinatie, wat moet je als ouder weten (NL) ↗
- Departement Zorg : vaccinaties in het najaar, griep en covid (NL) ↗
- Kind en Gezin : het basisvaccinatieschema (NL) ↗
- Kind en Gezin : vaccineren in specifieke situaties (NL) ↗
- Vivalis : quel vaccin à quel âge ↗
- Mutualité chrétienne : vaccination ↗
- Solidaris Wallonie : vaccins ↗
- ML MUTPLUS.be : remboursement de vaccins ↗
- Helan : vaccines (EN) ↗
- Partenamut : vaccination ↗
- Mutualia : vaccins ↗
- La Mutualité Neutre : vaccination ↗