INTRODUCTIONAs preparation against a possible avian flu pandemic, international and local health authorities have recommended seasonal influenza vaccination for all healthcare workers at geographical risk. This strategy not only reduces "background noise", but also chance of genetic shifts in avian influenza viruses when co-infection occurs. We evaluate the response of healthcare workers, stratified by professional groups, to a non-compulsory annual vaccination call, and make international comparisons with countries not at geographical risk.

MATERIALS AND METHODSA cross-sectional study was performed over the window period for vaccination for the 2004 to 2005 influenza season (northern hemisphere winter). The study population included all adult healthcare workers (aged < or =21 years) employed by a large acute care tertiary hospital.

RESULTSThe uptake rates among frontline caregivers--doctors >50%, nurses >65% and ancillary staff >70%--markedly exceeded many of our international counterparts results.

CONCLUSIONGiven its close proximity in time and space to the avian flu pandemic threat, Singapore healthcare workers responded seriously and positively to calls for preventive measures. Other factors, such as the removal of financial, physical and mental barriers, may have played important facilitative roles as well.