Considerable morbidity and mortality are related to pneumococcal disease predominantly in high risk populations: infants and young children, the elderly and the immunocompromised. A recent heptavalent conjugate anti-pneumococcal vaccine, introduced in the routine immunization program in the United States in 2001, has been shown to be spectacularly effective in the prevention of invasive disease in the very young in contrast to the pre-existing polysaccharide vaccine. As a consequence, horizontal transmission throughout the community is decreased with a reduction in disease rates in non-vaccinated adults. Finally the conjugate vaccine also provides an effective tool for reduction of drug-resistant pneumococcal strains. A review of the existing anti-pneumococcal vaccines, their direct and indirect effects and their recommended use in Switzerland.