There is a high burden of infectious diseases in the older population, which is associated with increased morbidity and mortality compared with younger age groups. Too many of these diseases are vaccine preventable yet there is a low vaccine coverage rate across Europe. These findings led the European Union Geriatric Medicine Society and the International Association of Gerontology and Geriatrics-European Region to convene an expert Working Group to address the issue of why vaccination programs have failed to provide adequate protection in older European populations and to recommend immunization guidelines to ensure that they contribute to a healthy aging strategy. This review addresses some of the main issues relating to poor vaccine uptake in older adults and presents the recommendations of the joint Working Group regarding the optimal use of the following vaccines: tetanus-diphtheria-pertussis, influenza, pneumococcal (PV23) and herpes zoster. To improve vaccine coverage, communication and awareness of vaccine preventable diseases in the general community is an important starting point, and all healthcare professionals and public health/social workers can play a key role in this regard.