Background : Vaccination policies in EU Member States (MS) are mainly focused on at-risk groups i.e. children and elderly above 65 years, especially susceptible to vaccine-preventable diseases (VPDs) such as influenza, while adult vaccination remains underused; age of ≥65 is the predominant target group for recommended influenza vaccination, being adopted in 22 MS while the age of 50+ is set in Austria and Ireland only. A life-course approach to immunisation is a proposed means for the improved epidemiological control of VPDs.   Discussion : A wide variability in the recommended target groups for VPDs is seen in MS which could exacerbate inequalities at international level. Vaccination schedules targeted at adults aged ≥50 in merely a few MS pose a missed opportunity to promote healthy ageing given that this group is characterized by a sizable prevalence of risk factors. In the light of recognized benefits of vaccination beyond solely at-risk groups, life-course approach to immunization has been partly put in place in some MS. However, vaccination coverage rate (VCR) for influenza did not reach expected threshold of 75% by the 2014-2015 winter season in most of the MS from a number of reasons (e.g. lack of awareness among health-care workers). Sub-optimal uptake of routinely recommended adult immunisations is reported which entails great burden associated with VPDs. An approach targeted at healthy adults and promoted throughout the life-course is expected to reduce risk of VPDs and contain health-care costs while increasing the economic productivity.   Conclusions : Life-course approach to vaccination could become the future EU vaccination policy upon an important prerequisite being the systematic evaluation of its benefits and (cost-)effectiveness in different VPDs to determine its added-value over the current approach. This could mean a switch in the understanding and the implementation of vaccination policies from “risk-based” to “age-based” and improve VCRs.