Background, Each year Streptococcus pneumoniae causes similar to 1.2 million deaths worldwide from pneumonia, in the United States S, pneumoniae is estimated to cause 500 000 cases of pneumonia and 7 million episodes of acute otitis media annually. Conjugate vaccines. The current pneumococcal polysaccharide vaccine is ineffective in children <2 years old and may not produce an adequate antibody response until children reach the age of 5 years. Pneumococcal conjugate vaccines are immunogenic after primary and booster vaccination in young children and in children and adults with immunodeficiencies. Immunization with conjugate vaccines also induces a strong and rapid anamnestic response and enhanced functional activity of antibodies. Two large scale field trials of pneumococcal conjugate vaccines were, initiated in 1995, 1 in California and 1 in Finland, The California trial, involving 37 868 children, evaluated the efficacy of a 7-valent conjugate for the prevention of invasive pneumococcal disease and secondarily evaluated its efficacy for acute otitis media and pneumonia, Results. Preliminary results indicate 94% efficacy against invasive pneumococcal disease caused by serotypes included in the vaccine int fully or partially vaccinated children, Preliminary evidence from large scale field trials indicates that; pneumococcal conjugate vaccines are effective in reducing invasive pneumococcal disease as well as acute otitis media and pneumonia in children and. represents a significant advance in the prevention. of childhood infectious diseases.