Patients who were candidates for influenza vaccination seen in the primary care center of a community teaching hospital were studied to determine whether there is a differential immunization rate depending on risk level. The immunization rate was as follows: moderate risk group, 44%; high risk group, 59%; and very high risk group, 81%. The immunization rate was also closely associated with the frequency of clinic visits, ranging from 34% for those with low visit frequency to 73% for those with high visit frequency. The highest vaccination rates were thus found in the groups at highest risk for influenza-associated morbidity and mortality. Although influenza complication rates are lower in the healthy elderly, this group is so large that the public health impact of a low vaccination rate will be significant. The healthy elderly should be the special targets of future influenza vaccination campaigns.