Influenza infection leads to on average 3000-49,0000 deaths and 150,000 hospitalizations annually. While vaccination is the cornerstone of preventing influenza infection, vaccination coverage in adults is low. Latino adults have the lowest coverage rates. Text message reminders have been used successfully for improving influenza vaccination for children. This study will assess the use of text messaging to improve influenza vaccination coverage rates in a largely minority, publicly insured adult population. We will also assess if the patient having received a text message makes the patient more likely to accept vaccination when their provider has received in electronic alert regarding need for influenza vaccination in the electronic health record.

Inclusion Criteria:

• > or = 18 years of age
• at least one visit to the AIM clinic during previous 6 months
• a cell phone number in the registration system
• fluent in English or Spanish

Exclusion Criteria:

- Receipt of influenza vaccination during the 2014-2015 influenza season prior to randomization