title: Influenza vaccine refusal in Israeli young adults.
abstract: OBJECTIVE
  The purpose of this study was to identify correlates of noncompliance with influenza immunization among young adults and to determine the reasons leading to immunization refusal.
  
  
  METHODS
  Self-administered questionnaires were distributed in 10 military bases during two consecutive annual Israel Defense Force influenza vaccination campaigns. Multivariate logistic regression was performed to identify independent correlates.
  
  
  RESULTS
  Of 2,000 questionnaires distributed over two seasons, 942 were completed and returned. Of those, 401 respondents were not vaccinated either because of medical contraindication or for administrative reasons. The remaining 541 respondents who reported either receiving the vaccine or refusing to receive it were analyzed. Risk groups for vaccine refusal included older age (17.9% vs. 3.5% refusal rate) and officer rank (25.9% vs. 13.8% refusal rate). The main reasons for vaccine refusal differed significantly between officers and nonofficers (chi2 = 7.587, p = 0.023). Officers refused mainly (60%) because of fear of possible vaccine adverse effects, whereas nonofficers refused mainly (44.2%) because of disbelief in the vaccine's efficacy in preventing illness.
  
  
  CONCLUSIONS
  Officers serve as a negative role model in this case, and efforts directed toward dissemination of evidence-based information regarding vaccine-related adverse effects should be introduced to increase vaccination rates in this group.
authors.affiliation: Army Health Branch, Medical Corps, Israel Defense Force, Tel Hashomer, Israel 02149.
authors.forename: Ran D
authors.initials: RD
authors.lastname: Balicer
authors.forename: Itamar
authors.initials: I
authors.lastname: Grotto
authors.forename: Michael
authors.initials: M
authors.lastname: Huerta
authors.forename: Yardena
authors.initials: Y
authors.lastname: Levian
authors.forename: Nadav
authors.initials: N
authors.lastname: Davidovitch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control*; D007557:Israel; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012306:Risk; D011795:Surveys and Questionnaires; D016312:Treatment Refusal
chemical_list: D007252:Influenza Vaccines