[Pandemic influenza A (H1N1)v vaccination status and factors affecting vaccination: Ankara and Diyarbakır 2009 data from Turkey].

In this study, it was aimed to determine the frequency of the symptoms of influenza-like illness during influenza A (H1N1)v pandemic in two provinces where sentinel influenza surveillance was conducted and also to obtain opinions about H1N1 influenza and vaccination, H1N1 vaccination status and factors affecting vaccination. This cross-sectional study was conducted in the provinces of Ankara (capital city, located at Central Anatolia) and Diyarbakır (located at southeastern Anatolia). It was planned to include 455 houses in Ankara and 276 houses in Diyarbakır. The household participation rate in the study was 78.9% and 53.6% for Ankara and Diyarbakır, respectively. Our study was carried out between January-February 2010, with 1164 participants from Ankara and 804 from Diyarbakır, including every household subjects except for infants younger than 11 months and patients with primary/secondary immunodeficiency diseases. Data was collected by site teams consisting of a physician and a healthcare staff with informed consent. Of the participants 45.5% from Ankara and 35.3% from Diyarbakır stated that they had gone through an influenza-like illness. The most frequently indicated clinical symptoms were fatigue/weakness, rhinitis, sore throat and cough. The rates of admission to a physician with influenza like illness complaints were 50.6% and 58.7%; rates of hospitalization due to influenza-like illness were 1% and 1.5%, and rates of antiviral drug use were 3.8% and 1.9%, in Ankara ve Diyarbakır participants, respectively. The rate of personal precautions taken by the subjects for prevention from pandemic influenza were 59% and 53.3%, in Ankara and Diyarbakır, respectively. These precautions most frequently were "hand washing" and "avoiding crowded public areas". H1N1 influenza vaccine was applied in 9.3% of the participants in Ankara and in 3.7% of the participants in Diyarbakır. Vaccination rate was higher in both of the provinces in adults over 25 years old than children and adolescents and in patients with chronic underlying disease. None of the 25 pregnant participants were vaccinated against pandemic influenza. The educational background, employment status and quality of the job have been detected as factors affecting the status of being vaccinated with H1N1 influenza vaccine in both provinces. In addition, the percentage of having H1N1 influenza vaccination was found to be higher in subjects who had seasonal influenza vaccination previously and in 2009, than those who had not, and this difference was statistically significant in both provinces (Ankara p< 0.001, Diyarbakır p< 0.001). The mostly indicated post-vaccination adverse reactions reported by vaccinated participants were local sensitivity, muscle and joint pains, headache and malaise. The most frequent rationale for not being vaccinated against H1N1 were "I do not consider it necessary/I do not want" (Ankara 33.4%, Diyarbakır 27.4%) and "I do not believe/trust its efficacy" (Ankara 25.6%, Diyarbakır 22.6%). Those data emphasized the insufficient awareness of our population about the importance of pandemic influenza and vaccine. It is also believed that possible case definition in H1N1 case management scheme should be revised. In conclusion an important part of pandemic preparation plans is risk communication with the public to increase awareness and to prevent the missed opportunities.