Abstract Immunization among the high risk groups, including the elderly, remains unacceptably low for influenza and pneumococcal vaccines. This study determined the factors which influenced influenza and pneumococcal vaccine compliance in the elderly. A questionnaire developed for this study was mailed to all 300 veterans in west central Florida (≥85 years old) who obtained ambulant medical care at the James A. Haley Veterans' Hospital, Tampa, Florida. They were asked regarding circumstances which influenced their decision for or against accepting either or both the vaccines. Ninetytwo persons responded and data were analyzed six months following mailing date. The single most important factor for not accepting vaccination was lack of information and unawareness that the immunization(s) were necessary (45% and 81% respectively for influenza and pneumococcal vaccines). Fear of “shots” and side effects was the next most important reason for not receiving the vaccines (19% and 15% for influenza and pneumococcal vaccines respectively). Lack of transportation to the doctor's office prevented 12% of the subjects from receiving either of the vaccines. Neither did subjects have interest in prophylactic immunization (11% and 8% for influenza and pneumococcal vaccines respectively). The data suggest that lack of awareness, knowledge, information and motivation about influenza and pneumococcal immunization play major roles in their poor acceptance among the elderly. Health education intervention measures should improve vaccine compliance in this population who suffer from higher death rates and complications from pneumonia.