Despite long-standing recommendations by the Canadian and U.S. national immunization advisory committees that all persons aged 65 or older be vaccinated annually against influenza, vaccination rates among North American seniors remain approximately 20%. This paper reports a study of the effect of computer-generated nurse/physician reminders to offer influenza vaccine to elderly patients seen during the pre-influenza season in a community based group family practice. The study employed a pretest-post-test design strengthened by the use of a no-intervention comparison practice and repeated pretest measures of vaccine coverage. Outcome was measured by clinical records review. The influenza vaccination rate increased by 165% from 10.1% to 26.8% following introduction of the computer-generated reminders. There was no increase in influenza immunization in the comparison practice during the corresponding time period. Over 60% of eligible patients were seen in the practice during the pre-influenza season; 41.6% of those received influenza vaccinations.