Background. Pandemic influenza vaccination rate amongst healthcare workers in England 2009/2010 was suboptimal (40.3%). Targeting medical students before they enter the healthcare workforce is an attractive future option. This study assessed the H1N1 vaccine uptake rate amongst medical students and factors that influenced this. Methods. Anonymised, self-administered questionnaire at a medical school. Results. The uptake rate amongst 126 medical students offered the vaccine was 49.2% and intended uptake amongst 77 students was 63.6%. Amongst those offered the vaccine, the strongest barriers to acceptance were fear of side effects (67.9%), lack of vaccine information (50.9%), lack of perceived risk (45.3%), and inconvenience (35.8%). Having a chronic illness (OR 3.4 (95% CI 1.2–10.2)), 4th/5th year of study (OR 3.0 (95% CI 1.3–7.1)), and correct H1N1 knowledge (OR 2.6 (95% CI 1.1–6.0)) were positively associated with uptake. Non-white ethnicity was an independent negative predictor of uptake (OR 0.4 (95% CI 0.2–0.8)). Students who accepted the H1N1 vaccine were three times more likely (OR 3.1 (95% CI 1.2–7.7)) to accept future seasonal influenza vaccination. Conclusion. Efforts to increase uptake should focus on routine introduction of influenza vaccine and creating a culture of uptake during medical school years, evidence-based education on vaccination, and improving vaccine delivery. 1. Introduction The novel influenza A (H1N1) outbreak was declared a pandemic by the World Health Organisation (WHO) on 11th June 2009 [1]. In the United Kingdom (UK), 474 deaths had occurred by the end of the 2009/10 influenza season with the highest case-fatality rate among the over 65-year age group [1, 2]. Vaccination is one of the intervention strategies used to mitigate an influenza pandemic [3, 4]; therefore, as part of the Department of Health (DH) vaccination policy healthcare workers were recommended to receive the H1N1 vaccine to protect themselves, protect patients, and maintain frontline services during the pandemic [5, 6]. At the University of Birmingham, clinical year (3rd–5th year) medical students were also offered the H1N1 vaccine from November 2009 [7]. Influenza vaccination of health care workers (HCW) is known to be effective in preventing seasonal influenza, reducing absenteeism, and protecting patients against nosocomial infection with a resultant decrease in morbidity and mortality [6, 8]. In spite of these benefits, seasonal influenza vaccine uptake among HCW in the UK has traditionally been disappointingly low with uptake of less than 20% in the
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