PIP: In developing countries, pneumococcus is an important cause of serious infections during the first 3 months of life and the most important cause of meningitis in that age group. A meeting of experts was held January 26-27, 1998, at World Health Organization headquarters to review strategies for the prevention of pneumococcal disease in early infancy. Polysaccharide-protein conjugate vaccines designed for use in young infants have been developed and are currently being evaluated for use at the time of routine DTP immunization. Early pneumococcal infections, however, which may be responsible for up to 30% of infant pneumococcal deaths, may not be preventable by the infant immunization strategies currently under investigation. Additional approaches to preventing pneumococcal disease in early infancy include the immunization of pregnant women. The experts supported efforts to move toward large-scale studies of the safety and efficacy of vaccinating pregnant women with pneumococcal polysaccharide vaccine or one of the pneumococcal polysaccharide-protein conjugate vaccines currently being developed. An alternative approach to controlling pneumococcal disease during the first 3 months of life would be neonatal immunization with pneumococcal conjugate vaccines.