Objective: To investigate influenza vaccination rates and perceptions underlying vaccine noncompliance. Participants: Participants included undergraduate students (N = 365) at a rural, medium-sized university in Texas. Methods: Students were anonymously surveyed in the spring of 2018 on demographics, insurance status, perceived barriers of influenza vaccination, and vaccination status. Results: Nearly 90% of students had health insurance; however, only 30% of them received the influenza vaccination annually. The top two reasons for non-vaccination were the low perceived threat (20.20%) and having a busy schedule (11.10%). Having health insurance [OR: 2.84, CI: (1.16, 7.0)] and being in the younger age group (18-24) [OR: 1.98, CI: (1.11, 3.54)] were both positively associated with the annual vaccination status. Conclusion: Health education efforts should be focused on vaccination initiatives that increase awareness about the health benefits and ease of access, especially among the older age groups (> =25 years). Information on myths versus facts should also be disseminated.