Significant morbidity due to pneumococcal co-infection is associated with viral respiratory infections. Pneumonia is the leading cause of death in children worldwide. The incidence of clinical pneumonia among children in the United States decreased 39% following the introduction of a seven-valent pneumococcal conjugate vaccine (PCV). PCVs have also reduced hospitalisations associated with influenza in children. The majority of the mortality associated with the influenza pandemic of 1918 was attributable to bacterial infections, especially the pneumococcus. Vaccination with PCV for children and pneumococcal polysaccharide vaccine for adults should be considered essential to pandemic influenza preparedness.