The policies, organization and outcome of the influenza vaccination programmes for the elderly were studied in randomly selected general practices in Trent during the winter of 1985-86. Data from 127 practices, covering approximately one-fifth of the 668 800 people in Trent 65 years of age and older, were studied in detail. Altogether 87% of practices offered vaccine to selected elderly patients and 93.5% gave it upon request. However, less than one-fifth of the elderly population covered by the survey were vaccinated against influenza and the number of doses prescribed by individual practitioners and practice immunization rates varied considerably. The higher immunization rates were correlated with certain practice immunization policies and procedures Reasons for non-acceptance of vaccine were also identified. The observations suggest that provision of educational materials about the risks and benefits of influenza vaccine and a re-appraisal of practice strategies relating to the influenza immunization programme may increase the number of elderly people who are immunized.