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OBJECTIVE: To examine patterns of knowledge and attitudes among adults aged > 65 years unvaccinated for influenza. METHODS: Surveyed Medicare beneficiaries in 5 areas; clustered unvaccinated seniors by their immunization related knowledge and attitudes. RESULTS: Identified 4 clusters: Potentials (45%) would receive influenza vaccine to prevent disease; Fearful Uninformeds (9%) were unsure if influenza vaccine causes illness; Doubters (27%) were unsure if vaccine is efficacious; Misinformeds (19%) believed influenza vaccine causes illness. More Potentials (75%) and Misinformeds (70%) ever received influenza vaccine than did Fearful Uninformeds (18%) and Doubters (29%). CONCLUSION: Findings suggest that cluster analyses may be useful in identifying groups for targeted health messages. [ABSTRACT FROM AUTHOR]