Recent efforts of health authorities to promote vaccination against influenza A/H1N1 were met with low compliance rates in most industrialized countries. Here we analyzed the attitudes of the Israeli public towards A/H1N1 vaccination based on a telephone survey conducted several months after the peak of the outbreak. The findings attest to the low uptake of the A/H1N1 vaccine (17%) in Israel, and identify the socio-demographic characteristics associated with non-compliance. In addition, the survey reveals passiveness, fear and distrust as motives leading to non-compliance. Most importantly, the study identified the substantial weight of reflective assessment in the attitude of lay individuals towards the A/H1N1 vaccine. As many as 30% of the non-vaccinated responders provided reasoned arguments for rejecting the vaccine, based mainly on assessment of threat versus actual risk. These observations highlight the need to consider the opinion of the lay public when implementing new vaccination programs.
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