abstract: This qualitative study was carried out in one practice in a socially deprived district of inner-city Manchester. Patients' personal accounts of the factors which caused them to accept or reject the offer of vaccination were studied in order to detect common influences. The three most important factors were identified as trust or mistrust in modern medicine, prior experience of vaccination, and the perceived risk from influenza. Current health promotion initiatives encouraging influenza vaccination were largely regarded in a negative light. The authors suggest that future campaigns should place vaccination in a wider context of health maintenance.