Annual vaccination with trivalent inactivated vaccines has been proven as safe and efficacious in preventing influenza and its complications. It is recommended especially to the elderly (>65) and other people at high risk for influenza complications and death such as patients with chronic medical conditions. Healthcare workers, who are considered to transmit infection to patients, or reciprocally, can be infected during encounters with patients, are also strongly advised to regularly receive vaccines. In order to improve influenza vaccination rates in countries in Europe, health authorities set targets for vaccination coverage by 2010. Despite the substantial efforts done, coverage rates maintain low. It is considered that informed decisions, based on existing evidence, are likely to cope with improving vaccination rates. Intention of this manuscript is to address some important issues connected with influenza vaccination which, to be able to aid the evidence, need to be further clearified. To support the debate, the author presented some dubious facts from the own practice experiences. As a long-lasting solution to improve vaccination practice strategies, strengthening programed vaccination is suggested. This concept would include implementation of nationwide vaccination protocols and their harmonization by the common logistics, and standardized data collection based on installation of E-health records. This strategy would allow data comparison among different populations. As based on this debate, improving influenza vaccination rates is not likely to be easy to perform straightforward task, but a multifaceted, long term challenge.