Many older people who would benefit from influenza vaccine do not get immunised. We carried out a postal questionnaire survey of people aged 65 years and over living in the community to explore views about influenza vaccine and identify ways of improving uptake. Completed questionnaires were returned by 1468/2553 (57.5%). Vaccine coverage for 1998-1999 season was 50.5% (95% confidence interval (CI) 47.9-53.1%). Important predictor variables for non-uptake included absence of medical risk factors, perceived good health, lack of advice from a doctor or nurse, and negative views on vaccine efficacy and safety. Most people had to request vaccination, only one in five got a reminder from their general practitioner. There is scope for improving influenza vaccine coverage in older people by placing more emphasis in patient information materials on vaccine efficacy and safety and by greater use of reminders.