This study aims at assessing trends in influenza vaccination coverage from 2001 to 2006 in Italy, at understanding the drivers and barriers to vaccination, and to identify vaccination intentions for season 2006/07. We conducted telephone-based household surveys representative of the population from age 14. Total sample size was 10,026 persons. The influenza vaccination coverage rate in Italy increased over the years, reaching 24.1% in season 2005/06. In the elderly (> 65), the vaccination rate reached 63.4% in 2005/06. The increase between seasons 2004/05 and 2005/06 was statistically significant. A recommendation for the doctor/nurse, considering influenza as a serious illness, older age and not being in very good health were the most frequent reasons for getting vaccinated. Four percent of those vaccinated in 2005/06 indicated the threat of avian flu as a reason. For the winter 2006/07, 30% of the population intended to get vaccinated, indicating the potential to increase vaccination coverage next year. The threat of avian influenza may have contributed to a substantial recent increase in season 2005/06 as compared to the year before. Despite of this positive evolution, major effort is still needed to reach WHO objectives for 2010 (75% vaccination coverage rate in the elderly population).