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Although influenza vaccination is recognized to be safe and effective, recent studies have confirmed that immunization coverage among health care workers remain generally low, especially among medical residents (MRs). Aim of the present multicenter study was to investigate attitudes and determinants associated with acceptance of influenza vaccination among Italian MRs. A survey was performed in 2012 on MRs attending post-graduate schools of 18 Italian Universities. Each participant was interviewed via an anonymous, self-administered, web-based questionnaire including questions on attitudes regarding influenza vaccination. A total of 2506 MRs were recruited in the survey and 299 (11.9%) of these stated they had accepted influenza vaccination in 2011-2012 season. Vaccinated MRs were older (P = 0.006), working in clinical settings (P = 0.048), and vaccinated in the 2 previous seasons (P<0.001 in both seasons). Moreover, MRs who had recommended influenza vaccination to their patients were significantly more compliant with influenza vaccination uptake in 2011-2012 season (P<0.001). "To avoid spreading influenza among patients" was recognized as the main reason for accepting vaccination by less than 15% of vaccinated MRs. Italian MRs seem to have a very low compliance with influenza vaccination and they seem to accept influenza vaccination as a habit that is unrelated to professional and ethical responsibility. Otherwise, residents who refuse vaccination in the previous seasons usually maintain their behaviors. Promoting correct attitudes and good practice in order to improve the influenza immunization rates of MRs could represent a decisive goal for increasing immunization coverage among health care workers of the future.

Background: The 2009-10 influenza pandemic was a major public health concern. Vaccination was recommended by the health authorities, but compliance was not optimal and perception of the presumed associated risks was high among the public. The Internet is increasingly being used as a source of health information and advice. The aim of the study was to investigate the characteristics of websites providing information about flu vaccine and the quality of the information provided., Methods: Website selection was performed in autumn 2010 by entering eight keywords in two of the most commonly used search engines (Google.com and Yahoo.com). The first three result pages were analysed for each search, giving a total of 480 occurrences. Page rank was evaluated to assess visibility. Websites based on Web 2.0 philosophy, websites merely displaying popular news/articles and single files were excluded from the subsequent analysis. We analysed the selected websites (using WHO criteria) as well as the information provided, using a codebook for pro/neutral websites and a qualitative approach for the adverse ones., Results: Of the 89 websites selected, 54 dealt with seasonal vaccination, three with anti-H1N1 vaccination and 32 with both. Rank analysis showed that only classic websites (ones not falling in any other category) and one social network were provided on the first pages by Yahoo; 21 classic websites, six displaying popular news/articles and one blog by Google. Analysis of the selected websites revealed that the majority of them (88.8%) had a positive/neutral attitude to flu vaccination. Pro/neutral websites distinguished themselves from the adverse ones by some revealing features like greater transparency, credibility and privacy protection., Conclusions: We found that the majority of the websites providing information on flu vaccination were pro/neutral and gave sufficient information. We suggest that antivaccinationist information may have been spread by a different route, such as via Web 2.0 tools, which may be more prone to the dissemination of "viral" information. The page ranking analysis revealed the crucial role of search engines regarding access to information on the Internet.