In the United States, influenza causes an average of 20,000 deaths per year; 90% of these death are among persons aged > or =65 years. Pneumococcal disease accounts for more deaths than any other vaccine-preventable bacterial disease (2). Annual influenza vaccination and one dose of pneumococcal polysaccharide vaccine can prevent complications from these infections among persons aged > or =65 years. In 1997, 65% of adults aged > or =65 years reported receiving influenza vaccination during the previous 12 months and 45% reported ever receiving pneumococcal vaccination. This report presents an analysis of responses to the 1996 Medicare Current Beneficiary Survey (MCBS) to describe self-reported vaccination status and reasons for not receiving influenza and pneumococcal vaccinations reported by Medicare beneficiaries aged > or =65 years; the findings indicate that most persons who had never received pneumococcal vaccination did not think they needed it, and those who had not received influenza vaccine did not know of the need for influenza vaccination and had misconceptions about its safety and efficacy.