Universal childhood influenza vaccination presents challenges and opportunities for health care and public health systems to vaccinate the children who fall under the new recommendation. Advisory Committee on Immunization Practices (ACIP) recommendations and guidelines are helpful, but they do not provide strategies on how to deliver immunization services to the groups affected by their recommendations. Community stakeholders need to develop and sustain new partnerships to achieve the goals of universal childhood immunization recommendations, including expanding the points of access to influenza vaccination. Schools are a key community venue for annual delivery of influenza vaccination. Over the past 2 years, the National Association of County and City Health Officials has examined local health department-school system relationships in regard to delivery of influenza vaccination to identify and document common elements of success, challenges, and key lessons learned.