Introduction <p>Worldwide, pneumococci are the most common cause of morbidity and mortality from lower respiratory tract infections. Despite recommendations of the Standing Committee on Vaccination (STIKO), the vaccination rate against pneumococci in over 60-year-olds in Germany remains low. This study therefore investigates the associations between psychological reasons for (non-) vaccination, knowledge about pneumococci, age and gender, previous vaccination decisions, and pneumococcal vaccination intention in over 60-year-olds.</p> Methods <p>The analysis is based on data from the study “ALtersspezifische Impfinanspruchnahme VErbessern,” in which 1117 patients aged&#xa0;60 and over were surveyed in 2022. In addition to the descriptive evaluation of the cross-sectional data, a&#xa0;Spearman correlation analysis was carried out. Predictive variables were also identified in a&#xa0;linear regression analysis.</p> Results <p>Confidence in the safety of vaccination (β = 0.514, <i>p</i> &lt; 0.001) and receiving the influenza vaccination (β = 0.153, <i>p</i> &lt; 0.001) in the last season are the strongest predictors of pneumococcal vaccination intention. In addition, the perceived risk of pneumococcal infection (β = 0.086, <i>p</i> = 0.002) showed a&#xa0;significant positive correlation with vaccination intention. The regression analysis performed was able to explain 48.8% of the variance in vaccination intention (R² = 0.488).</p> Discussion <p>Confidence and risk perception appear to be decisive factors in the decision to get vaccinated. Measures that address these aspects could increase vaccination intention. A&#xa0;joint administration of the influenza and pneumococcal vaccination could be useful, as receiving an influenza vaccination in the previous season showed a&#xa0;positive effect on the intention to get the pneumococcal vaccination.</p>