This study examined adult vaccination rates in Metropolitan Toronto/Peel Region following the implementation of publicly funded adult pneumococcal and universal influenza vaccination programs in Ontario. Community-living adults eligible for pneumococcal vaccines were surveyed regarding vaccination rates, and factors potentially associated with vaccination. Influenza vaccine rates increased over time, but only respondents 65 years of age and older met Canadian targets. Pneumococcal vaccine rates were below target for all respondents. More than 90% of unvaccinated respondents had seen a physician within the past year, and most vaccinations occurred in a physician's office, suggesting a role for physician advocacy to improve immunization rates. Adult vaccination programs may be less successful than pediatric programs in achieving vaccine uptake, and require on-going assessment and promotion.