Introduction The benefits of influenza vaccination among the elderly and people with chronic conditions have been shown in several studies. The aim this study was to assess the influenza vaccination coverage in the elderly, identifying associated factors and reasons for non-compliance.

Methods This was a cross-sectional population-based study with stratified clustered two-stage sampling in Campinas, São Paulo, Brazil in 2008–2009.

Results Among the 1517 elderly, 62.6% reported influenza vaccination during the previous year. Physical activity in leisure, self-reported diabetes and recommendation from a healthcare worker were positively associated with the vaccination, while occupational activity and hospitalisation were negatively statistically related. Except for diabetics, the vaccination didn't reach adequate levels in elderly with chronic diseases. Reasons for non-compliance were: not find it necessary and belief that the vaccine causes reaction.

Conclusion Socioeconomic conditions, life style and physical mobility did not restrict adherence to vaccination, but the coverage was below the target of 80% established by the Ministry of Health. Campaigns focused on the elderly aged 60–69 years and on patients with chronic conditions, beyond the guidance of health professionals can expand coverage to groups with low adherence to the campaigns.