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To compare influenza vaccine effectiveness in the general practice and hospital settings. Victorian sentinel hospitals and general practices, — Patients presenting to general practitioners, or those admitted to hospital with an influenza-like illness who were tested for influenza using a polymerase chain reaction assay. Cases were patients with a positive test result for influenza; non-cases controls had a negative test result. Main outcome measures: Vaccine effectiveness against laboratory-confirmed influenza. Hospitalised patients were on average older and reported a higher proportion of comorbidities than general practice patients. Influenza vaccines appeared to be similarly modestly effective in the general practice and hospital settings. Influenza vaccination appears to prevent hospital admission by preventing symptomatic infection rather than by attenuating the severity of illness. Although not explicitly stated in the handbooks, these estimates referred to efficacy in protecting against influenza infections managed in the community, the majority of which are relatively mild. While protection against the mild disease seen in primary care might be modest, it is nevertheless possible that the protection provided against more serious disease, including confirmed influenza infections requiring admission to hospital, might be greater. In Victoria, two surveillance schemes make it possible to investigate whether there was any major difference in vaccine effectiveness estimates in community and hospital patients. The Victorian Sentinel Practice Influenza Network VicSPIN is a group of sentinel general practitioners in Melbourne and regional Victoria, operating since , that has provided estimates of influenza vaccine effectiveness for protection against laboratory-confirmed influenza since