The heptavalent pneumococcal conjugate vaccine was licensed in the United States in 2000 for use in infants and children. Postlicensure surveillance revealed substantial regional and national decreases in invasive pneumococcal disease. It is not known whether widespread vaccine use has led to a concomitant decrease in invasive pneumococcal disease-associated hospitalization rates.We examined national trends in rates of hospitalization among both children and adults with invasive pneumococcal disease.Data from the 1998-2003 National Hospital Discharge Survey and population estimates from the National Center for Health Statistics were used to calculate rates of hospital discharge for patients admitted with invasive pneumococcal disease, defined as meningitis or bacteremia caused by Streptococcus pneumoniae.Rates of hospital discharge for patients admitted with invasive pneumococcal disease decreased during the study period from a peak of 12.03 discharges per 100,000 population in 1999 to 5.60 discharges per 100,000 population in 2003 (P or = 65 years of age but not for those or = 65 years.