Every year for the last few decades, the health authorities of most countries throughout the world have issued specific recommendations for the prevention and treatment of pediatric influenza, including recommendations concerning the use of vaccines. However, different evaluations of the importance of the disease and the efficacy of influenza vaccination frequently lead to conflicting recommendations. This is clearly demonstrated not only by the differences in the subjects for whom the vaccine is recommended, but also by the inaccurate manner in which subjects at risk of influenza-related complications are defined. Only further studies that consider the burden of the disease and vaccine efficacy in adequate numbers of healthy children and high-risk children with different chronic underlying diseases can overcome all of the current limitations and significantly improve vaccination coverage in both categories.