Prevnar (heptavalent pneumococcal conjugate vaccine; PCV7) provides protection against invasive pneumococcal disease (IPD) caused by vaccine serotypes. Indirect protection of non-immunised individuals may be the consequence of decreased transmission of vaccine serotypes, generally carried in the nasopharynx of infants and young children. This review summarises published reports of IPD incidence (1998-2005) among non-immunised individuals in countries with universal PCV7 immunisation. Findings suggest that non-immunised individuals benefit from indirect protection following widespread vaccination, enhancing cost-benefit evaluations of vaccination programs. Continued surveillance will be important, to follow future changes associated with non-vaccine type IPD, particularly among individuals with medical co-morbidities that may put them at higher risk of disease.