Travel as risk factor for an influenza infection is poorly established among international travellers when regarding the low vaccination coverage as well as the low selfperceived travel-associated risk estimates. Of note, previous influenza vaccinations facilitated receiving an influenza vaccination in the following year by about 13 times. Therefore, easy access to the influenza vaccine is important. High media coverage was not considered sufficient to increase the vaccination rate substantially as is indicated by the low increase of the vaccination coverage between the two surveys in 2009 and 2010 and also by the low pandemic influenza vaccination coverage of only 14.2%. Therefore, multiple efforts need to complement one another including information strategies provided by family physicians and travel medicine practitioners, but also job-and age-related activities need to be considered. Our sample of travellers is comparable to other studies performed at our Centre for Travel' Health [7] with respect to the age distribution, educational level and travel duration. Inherent limitations include a selection bias: Frequently visited destinations such as the Middle East, North Africa and the Caribbean are underrepresented as travellers to those destinations generally do not consider a pre-travel health consultation as indicated [11] but destinations with higher risk for faecal-orally transmitted infectious diseases, such as TD or bacterial meningitis, are well represented, such as e.g. India and Sub-Saharan countries. Therefore, our sample may represent a best practice sample. The fact, that the high proportion of university graduates indicates a health literate population may result in an even overestimated risk perception as well as influenza vaccination coverage. All data collections relied on self-reported information. Hence, the results of the studies might be limited by a potential bias such as disclosure bias, although self-report of influenza vaccination status has been found to be reliable when checked against medical record documentation [13] . Most seasonal influenza activity occurs during November to April on the Northern hemisphere and vaccination is usually administered between October and November. Therefore, travellers visiting the opposite hemisphere have to be counselled accordingly and the seasonal influ-enza vaccine also for the Southern hemisphere has to be available as there is year-round influenza activity in tropical and subtropical areas.