The number of vaccinations and vaccine boosters that are becoming relevant to delivery among adolescents is growing. For sexually transmitted infections (STIs) in particular, such as HIV, vaccine delivery in this (pre-sexually active) age group is going to be an integral component of the strategy to control these diseases in the future. Currently, however, adolescent vaccination does not routinely occur because the traditional method of delivery is through secondary schools, and in developing countries school attendance has historically been low. But with school attendance growing rapidly throughout the developing world, the cost of vaccines falling over time, and an increasing number of current and future vaccines targeted at adolescents, it is an ideal opportunity to place this route of delivery on the national and international health agenda. Therefore, this paper examines the rationale for adolescent vaccination, looks at the success of other adolescent-targeted health care interventions, and finally, considers the challenges associated with future adolescent vaccination programmes in developing countries.