Implementation of a systematic pneumococcal vaccination campaign in over 65s and at-risk groups is described for Dumfries and Galloway, South West Scotland. A successful programme is achievable in health boards and health authorities with a modes degree of effort. Problems are few, costs are manageable if the campaign is combined with the flu vaccination campaign, and acceptability to and uptake by the population is high. The lessons learned have implications for all regions of the United Kingdom as pneumococcal vaccination programmes are scheduled for introduction over the next three years.