Inclusion Criteria:

• • Able to understand and comply with all study procedures including availability for all study visits and follow up surveys within 6 months following study enrollment.

  • Age 18-49

    • Patients presenting to travel clinic with no exclusion criteria;
    • Household contacts and out-of-home caretakers of infants from 6-23 months of age;
    • Hospital and/or employees providing service to the public who are not eligible for the post-October 5th recommendations for priority immunization;
    • DOD employees eligible for influenza vaccination prior to October 5th but excluded in the post October 5th guidelines;
    • People living in dormitories or under other crowded conditions, to prevent outbreaks;
  • Ages 50-64 years of age who are not eligible for the post-October 5th recommendations for priority immunization and with no standard of care contraindications to vaccination.
  • Eligible in the Department of Defense for influenza vaccination

Exclusion Criteria:

• • all children aged < 18 years (includes children aged 6 months-18 years on chronic aspirin therapy);

  • adults aged >65 years;

  • persons aged 2-64 years with underlying chronic medical conditions:

    • includes persons with chronic cardiac or pulmonary disease, diabetes mellitus, hemoglobinopathy, or immunosuppressive illness;
    • any acute or chronic condition that, in the opinion of the investigator, would render vaccination unsafe or interfere with the evaluation of response.
  • use of experimental vaccines or medications within 30 days of study entry;
  • receipt of parenteral immunoglobulin within 60 days of study entry;
  • all women who will be pregnant during the influenza season;
  • residents of nursing homes and long-term care facilities;
  • health-care workers involved in direct patient care and included in DOD priority 1; and;
  • military recruits;
  • out-of-home caregivers and household contacts of children aged <6 months.
  • Anyone with clinical contraindications for receiving the inactivated influenza vaccine such as a history of severe allergic reaction to prior influenza vaccinations, severe allergy to egg and/or egg proteins and gelatin.
  • DOD Priority 1: Deployed or deploying (with orders) service members and others designated as critical to national defense.
  • DOD Priority 2: Medically high risk in accordance with ACIP guidelines (includes health-care workers with direct patient contact)
  • Any acute or chronic condition that, in the opinion of the investigator or her provider designee would render vaccination unsafe or interfere with the evaluation of the response.