Streptococcus pneumoniae remains the most common cause of community-acquired pneumonia and bacterial meningitis in older adults. Current recommendations from CDC's Advisory Committee on Immunization Practices suggest providing pneumococcal polysaccharide vaccine to all adults age 65 and older and to persons age 2 to 64 with chronic illnesses that place them at higher risk for pneumococcal disease. In addition, vaccination status should be assessed for residents of nursing homes and long-term care facilities on admission and vaccine administered as needed. Although the polysaccharide vaccine is safe, effective against invasive disease, and cost-effective, many older adults have not yet received the vaccine. Use of standing orders is encouraged as a way to improve vaccine delivery. Research into new vaccines to prevent pneumococcal disease in older adults is ongoing.