Influenza vaccination of health care workers (HCW) is widely recommended, but immunization rates are low. In order to assess performance among primary HCW and identify barriers, we conducted a survey among the staff of 27 primary care community clinics in Jerusalem. The low rate of vaccination (30.2%) was in contrast with the large proportion of HCW who considered it desirable to immunize primary health clinic staff (72.1%). Physicians reported having been immunized significantly more (p=0.008) than the rest of the staff. They also had better knowledge and more favorable attitude towards immunization. Also associated (independently of profession) with performance of immunization were age (p<0.001), knowledge (that immunization can not cause influenza, p=0.051), attitude (the belief that it is desirable to immunize primary HCW, p<0.001), previous years' performance of immunization (p<0.001) and a physician's recommendation (p=0.042). A media scare which occurred during the vaccination period was reported to have influenced the decision not to get immunized of 34.1% of HCW who had not been immunized. The study results raise hope of prospective increase in vaccination through educational and technical interventions and by increasing physician involvement.