Our study showed an association between influenza vaccination and influenza-like illness among persons aged 65 years and older. This is a counterintuitive finding as vaccines are known to reduce the burden of influenza. Although our study is crosssectional and we cannot determine a causal pathway, it is possible that individuals with greater susceptibility to influenza infection (e.g., persons with chronic diseases) were more likely to get vaccinated. Indeed, these findings suggest the success of targeted public health messaging regarding the importance of vaccination among high risk individuals.