Understandings of influenza and influenza vaccination among high-risk urban dwelling Thai adults: a qualitative study.

BACKGROUND The 2004 outbreak of influenza A H5N1 and the WHO's recommendation for national pandemic plans has led the Thai Ministry of Public Health to develop an influenza vaccination programme for high-risk adults. To date there is no available information to guide this intervention, and how to maximize the uptake of the vaccine by the Thai population. To address this knowledge gap, this study explored factors influencing urban-dwelling Thai adults' decisions whether or not to have the vaccine. It explored their beliefs about influenza and influenza vaccination, and other influences on their decisions. METHODS In-depth interviews were conducted among 20 high-risk individuals who were aged 65 and over or under 65 years with chronic diseases requiring influenza vaccination. Interviews were tape recorded and analysed following using grounded theory. RESULTS Most participants had insufficient knowledge about influenza and influenza vaccination. Their decisions in relation to vaccination were based on a number of factors, including salience of risk, influence of others, perception of the need for preventive health care and the availability of influenza vaccine. CONCLUSION These findings underscore the need to consider and understand factors underlying people's vaccination decisions to create an effective influenza vaccination programme.