In our study, we identified significant patient, physician, and environmental predictors of influenza vaccination.1 Dr. Schattner states that 33.9% of patients were vaccinated in our study. While this is true, it is important to take into consideration the patient sample. We evaluated the first patient visit with a primary care physician for those who were not already vaccinated during influenza season. Prior work has shown that about 23% of patients arrived already vaccinated.2 Patients who have multiple visits are also more likely to receive the vaccination. When evaluating primary care practices at our health system, we found that influenza vaccination rates were closer to 60% in 2019. This included patients who were already vaccinated before their visit and accounted for multiple visits. We do agree with Dr. Schattner that other patient factors that were not included in our study could play an important role and inform intervention design.