Streptococcus pneumoniae community-acquired pneumonia (CAP) results in 40,000 deaths each year (Atkinson, 1997), making it the leading cause of death secondary to infection. Of these deaths, 50% could be prevented with the use of the pneumococcal vaccine. Developed 20 years ago, only 28% of patients 65 years and older receive the vaccine despite a prevention rate of invasive pneumococcal infections of 56-81% in immunocompetent adults. The overall cost for treating patients with CAP is more than $23 billion per year. More than $3.5 billion was spent on Medicare patients alone. Immunizing identified high-risk patients for CAP can improve morbidity and mortality rates for this group and ultimately reduce the amount of health care dollars spent on this preventable disease. Guidelines for identifying high-risk groups, a description of the vaccine, vaccination recommendations, and the signs and symptoms of CAP are discussed.