This study has three primary aims: 1) to estimate the relative vaccine effectiveness of Flucelvax versus inactivated influenza vaccine (IIV) in vaccinated Kaiser Permanente Northern California members aged 4 to 64 years against all PCR-confirmed influenza A5; 2) to estimate the vaccine effectiveness of Flucelvax against all PCR-confirmed influenza A, comparing Flucelvax vaccinees versus unvaccinated in Kaiser Permanente Northern California members aged 4 to 64 years; and 3) to estimate the vaccine effectiveness of IIV (not including Flucelvax) against all PCR-confirmed influenza A, comparing IIV vaccinees versus unvaccinated Kaiser Permanente Northern California members aged 4 to 64 years. Secondary aims are 1) to estimate the relative vaccine effectiveness of Flucelvax versus trivalent influenza vaccine (TIV) in vaccinated Kaiser Permanente Northern California members aged 4 to 64 years against all PCR-confirmed influenza B; and 2) to estimate the relative vaccine effectiveness of Flucelvax versus IIV in vaccinated Kaiser Permanente Northern California members aged 4 to 64 years against PCR-confirmed hospitalized influenza A.