In three children with fever, two girls aged 8 and almost 10 months and one boy aged 5 months, invasive pneumococcal disease was present. The youngest girl presented with pneumococcal sepsis which was complicated by haemolytic uraemic syndrome--she recovered--and the boy developed fulminant fatal pneumococcal sepsis/meningitis. The oldest girl was admitted for pneumococcal cellulitis and recovered. More than 80% of the cases of childhood invasive pneumococcal disease occur in children less than 2 years of age. However, the long available 23-valent pneumococcal polysaccharide vaccine is not effective in this age group. Recently, a 7-valent pneumococcal conjugate vaccine was registered in the Netherlands. This conjugate vaccine is effective in protecting infants and children from invasive pneumococcal disease. The Health Council of the Netherlands has recommended inclusion of the conjugate vaccine in the standard vaccine schedule. In the absence of a universal vaccination, the 7-valent pneumococcal conjugate vaccine is recommended for children at high risk of invasive disease.