The purpose of this study was to understand the reasons why some UK military personnel refused the anthrax vaccination. Data were collected from 5,302 members of the UK Armed Forces who had been deployed to Iraq since 2003 and had been offered the anthrax vaccination. As part of a larger questionnaire, information was collected on acceptance or refusal of the vaccination. Twenty-eight percent of participants refused the anthrax vaccination; of these 51% indicated that they refused vaccination because of concern that it was being offered voluntarily. Reasons differed between those deployed during the war-fighting phase in Iraq, who were concerned about being supplied with insufficient or unclear information (75% vs. 66%), and those involved on subsequent deployments, who felt that there was no longer a risk that biological weapons would be used against them (61% vs. 43%). Thus, refusal rates were related to perception of the threat. In addition, our results indicated the importance of providing individuals with relevant information to aid them in making decisions to receive the anthrax vaccination or not. The findings provide evidence that for some people, the policy to increase confidence in the anthrax vaccination program may have led to a decrease in levels of trust.