Influenza, also known as the "flu", is a contagious respiratory illness with the potential to cause serious illness and death. In the United States, annual epidemics of influenza occur from late fall to early spring with the peak of activity often occurring in the winter months and frequently in February. The aim of this study was to identify individual and practice characteristics associated with receiving an influenza vaccination. This study used baseline data from a multi year intervention study, San Diego Influenza Coverage Extension (SDICE). The cross sectional study of nine medical practices across San Diego County used a convenience sample of patients 50 years and older. Patient intercept surveys and key informant interviews were used to gather information on individual characteristics and strategies to improve coverage rates that might influence a person to be vaccinated against influenza. Analysis included multivariate regression modeling to assess the associations between receiving an influenza vaccination and selected individual and medical practice characteristics. The baseline influenza coverage rate from the 2008-2009 was 63%. This study found age, having a high risk health condition, gender, receiving a reminder and attending a practice that used electronic medical records (EMR) to be positively associated with receiving an influenza vaccination while controlling for other variables in the model. Education and race/ethnicity were found to be not significantly associated with receiving an influenza vaccination, contradicting previous literature. Interventions should focus on medical practice organizational strategies, such as EMR's. Influenza vaccines need to be continually offered at every visit based on the recommendations made by the ACIP and offered beyond the months of the typical vaccination season. Utilizing strategies to improve coverage rates have been shown in the literature to increase coverage rates and could potentially assist in increasing access, and improving quality of care.