This study examines the planning, operations and assessment of a Seniors Vaccination Program in Campinas, São Paulo State, from the standpoint of practices adopted by central, district and local authorities and intended to ensure influenza vaccination coverage. The case study method was used, with work-health process benchmarks. The primary data source was semi-structured interviews, with institutional documents and records serving as secondary sources. The field of study was the municipal coordination of this Program in two Health Districts and one Basic Healthcare Unit. The choice of these Districts was based on differing vaccination coverage, while the Unit choice was guided by its outstanding campaign organization. At the district and local levels, the program was coordinated by nurses who assigned high priority to following routines and rules instead of pursuing the purpose of the campaign. Insufficient analysis capacities were identified, with poorly networked actions, incipient communications methods and ineffective use of information for planning purposes. The results underscore the importance of adopting management practices tailored to the purposes of healthcare efforts, ushering in responsible autonomy among workers and fostering ongoing reflection on these practices.