The median influenza vaccination rate for Toronto acute care facilities in 2013/14 was only 44%, well below the target rate of 90%. While many Toronto hospitals adopted a vaccinate-or-mask policy, Trillium Health Partners (THP) opted to create a multimodal incentives-based flu campaign entitled GET POKED. This campaign, which required significant additional resourcing, only increased our vaccination rate by 10%. While having some modest success, we believe it is unlikely that non-policy based interventions will efficiently and sustainably raise flu vaccine rates. Vaccinate-or-mask policies, while having some inherent challenges, may be worth exploring as part of THP's larger flu-prevention strategy.