Background: Since 2010, the Advisory Committee on Immunization Practices (ACIP) has recommended that all persons aged >= 6 months receive annual influenza vaccination. Methods: We analyzed data from the 2015 National Internet Flu Survey (NIFS), to assess knowledge and awareness of the influenza vaccination recommendation and early influenza vaccination coverage during the 2015-16 season among adults. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with adults' knowledge and awareness of the vaccination recommendation and early vaccine uptake during the 2015-16 influenza season. Results: Among the 3301 respondents aged >= 18 years, 19.6% indicated knowing that influenza vaccination is recommended for all persons aged >= 6 months. Of respondents, 62.3% indicated awareness that there was a recommendation for influenza vaccination, but did not indicate correct knowledge of the recommended age group. Overall, 39.9% of adults aged >= 18 years reported having an influenza vaccination. Age 65 years and older, being female, having a college or higher education, not being in work force, having annual household income >=$75,000, reporting having received an influenza vaccination early in the 2015-16 season, having children aged <= 17 years in the household, and having high-risk conditions were independently associated with a higher correct knowledge of the influenza vaccination recommendation. Conclusions: Approximately 1 in 5 had correct knowledge of the recommendation that all persons aged >= 6 months should receive an influenza vaccination annually, with some socio-economic groups being even less aware. Clinic based education in combination with strategies known to increase uptake of recommended vaccines, such as patient reminder/recall systems and other healthcare system-based interventions are needed to improve vaccination, which could also improve awareness. Published by Elsevier Ltd.