EDITOR,—Martin Wiselka points out that the rate of uptake of influenza vaccine is surprisingly poor.1 In Grampian three factors contribute to this.

Firstly, analysis of all prescriptions for influenza vaccine in Grampian last autumn found that practice prescribing rates varied from 0.01 per 100 patients to 12.72 per 100 (data supplied by pharmacy practice division, Edinburgh). This variation did not correlate with the proportion of elderly patients in each practice, but small practices tended to have higher rates than larger practices. There was an appreciable difference between …