Pneumococcal infections are a major cause of morbidity and mortality among the elderly and high-risk groups. There is a concern about the expansion of pneumococcal drug resistance. A pneumococcal polysaccharide vaccine exists, which is epidemiologically adapted and has few side effects. The comparison of vaccine recommendations in six countries shows significant divergence. This can be explained by the scanty scientific evidence for the effectiveness of the current vaccine. While awaiting a more effective vaccine, the current vaccine has a limited place in the strategies of preventive medicine.