A clinical failure of pneumococcal vaccine is reported. A 22 year old African woman was given 23-valent pneumococcal vaccine at her initial presentation with HIV infection. She was asymptomatic and had a CD4+ lymphocyte count above 500 cells/mm3. Eighteen months later she died of meningitis and septicaemia due to Streptococcus pneumoniae type 9 (an antigen included in the 23-valent vaccine). Pn...