Abstract: Objective To understand the effect of 23-valent pneumococcal polysaccharide vaccine (PPV23) immunization among people aged 60 years in Jing'an district, Shanghai. Methods A retrospective cohort study was conducted among 500 elders receiving PPV23 immunization and 500 elders receiving no PPV23 immunization to compare the incidence on respiratory tract infection between two groups. Results The protective rate of PPV23 was 53% to respiratory tract infection (95% CI: 11.00%-77.00%) and 87.00% to pneumonia (95% CI:1.00%-99.80%). Conclusion PPV23 immunization showed the effect in protecting the elders in Jing'an against respiratory tract infection and pneumonia. It is necessary to further strengthen the PPV immunization in old population.