Age-related changes in the immune system are associated with increased susceptibility to infections, greater disease severity and poorer outcomes in the elderly compared with young adults. Both influenza and pneumonia are important causes of morbidity and mortality in the elderly, and herpes zoster also represents an important disease burden in this population. Vaccinations against influenza and Streptococcus pneumoniae (pneumococcus) have been shown to reduce the incidence of influenza and invasive pneumococcal disease, respectively, in the elderly. In addition, as is the case with diphtheria/tetanus and herpes zoster vaccines, they can help to reduce the associated burden of disease in vaccinated individuals. Despite the evidence of these benefits, there are considerable variations among the countries of Western Europe in their policies for vaccination in the elderly. Western European countries face the prospect of a population in which the proportion of elderly people is increasing, with a consequent increase in demand on the healthcare system. Acknowledgement of the benefits of vaccination in the elderly, together with comprehensive vaccination policies for this age group, could help to reduce some of these demands.