title: Sociocultural determinants of anticipated acceptance of pandemic influenza vaccine in Pune, India: a community survey using mixed-methods.
abstract: OBJECTIVE
  To investigate community priority and determinants of pandemic influenza vaccine acceptance in Pune, India. Community willingness to accept vaccines is often neglected in pandemic preparedness. Despite an acknowledged need, few such studies have been done in lower income countries.
  
  
  METHODS
  A cross-sectional, mixed-methods study used semi-structured explanatory model interviews to assess anticipated acceptance of nasal and injectable vaccines at different prices among 436 urban and rural residents. Logistic regression models identified sociocultural determinants of vaccine acceptance.
  
  
  RESULTS
  Over 93 % anticipated acceptance at no-cost; 87.8 % for INR 150 nasal vaccine; 74.1 % for INR 500 and 61.7 % for INR 1000 injectable vaccines. Some respondents preferred low-cost over free vaccines. Illness-related concerns about social isolation, contaminants identified as perceived causes, private-hospital or traditional-healer help seeking, and income were positively associated with anticipated acceptance. Humoral imbalances as perceived cause, home remedies for help-seeking and age were negatively associated.
  
  
  CONCLUSIONS
  High acceptability of pandemic influenza vaccines indicates good prospects for mass vaccination. It appeared that confidence was higher in the vaccines than in the health systems delivering them. Vaccination programmes should consider sociocultural determinants influencing vaccine acceptance.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. neisha.sundaram@unibas.ch.|University of Basel, Basel, Switzerland. neisha.sundaram@unibas.ch.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. neisha.sundaram@unibas.ch.
authors.forename: Neisha
authors.initials: N
authors.lastname: Sundaram
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schaetti
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Leticia
authors.initials: L
authors.lastname: Grize
authors.affiliation: Centre for Health Research and Development, The Maharashtra Association of Anthropological Sciences, Pune, India.|Department of Anthropology and Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.
authors.forename: Vidula
authors.initials: V
authors.lastname: Purohit
authors.affiliation: Centre for Health Research and Development, The Maharashtra Association of Anthropological Sciences, Pune, India.|Department of Anthropology and Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.
authors.forename: Saju
authors.initials: S
authors.lastname: Joseph
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Centre for Health Research and Development, The Maharashtra Association of Anthropological Sciences, Pune, India.|Department of Anthropology and Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India.
authors.forename: Abhay
authors.initials: A
authors.lastname: Kudale
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D058873:Pandemics / Q000517:prevention & control*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000379:methods
chemical_list: D007252:Influenza Vaccines
keywords: Cultural characteristics; Influenza; Pandemic; Public participation; Social characteristics; Vaccination