Influenza and pneumococcal disease are major causes of morbidity and mortality in the elderly. In most European countries dual vaccination of persons aged > 65 years is recommended, but the evidence supporting these recommendations is limited. Inadequate immune response in elderly hampers efficacy. Immunogenicity of the influenza vaccine may be improved by adding an adjuvant. Pneumococcal vaccination of children provides herd immunity, but may also result in expansion of non-vaccine strains. Better vaccines with documentation of efficacy in the elderly are needed for both diseases.