Patients with systemic autoimmune and/or inflammatory diseases have an increased risk of infections, particularly pneumoccocal invasive infections. Vaccination can prevent these infections. Available data about immunogenicity and safety of pneumococcal polysaccharide vaccine in these patients indicate that, it remains well tolerated and most of the time immunogenic, even if the antibody response is lower compared to healthy controls. These data encourage to vaccinate these patients with pneumococcal vaccine. However, the lack of data confirming the clinical efficacy of this vaccination, the theoretical risk of disease relapse following vaccine administration and the lack of specific recommendations guiding the decision to vaccinate these patients contribute to the low vaccine coverage. More immunogenic vaccine strategy should be evaluated in patients with systemic autoimmune and/or inflammatory diseases to provide better vaccine coverage.