WEDNESDAY, Aug. 26 (HealthDay News) -- Despite fears of an impending swine flu pandemic this fall and winter, more than half of all health-care workers surveyed in Hong Kong said they will not get vaccinated.

Their reason: fear of possible side effects and doubts about the vaccine's efficacy, according to Chinese research reported online Aug. 26 by the journal BMJ.

"To our knowledge, this is the largest study conducted to assess the willingness of health-care workers to accept pre-pandemic influenza vaccination, and it provides important information on barriers to vaccination," according to the study, which was led by the Chinese University of Hong Kong. "Campaigns to promote vaccination should consider addressing the knowledge gap of staff and the specific target groups for intervention."

More than 8,500 healthcare workers, including doctors and nurses, were surveyed twice this year -- once when the World Health Organization (WHO) pandemic alert was at phase 3 and again when WHO raised the alert to 5. Even at phase 5 -- the highest alert -- less than half (47.9 percent) said they would be vaccinated for the H1N1 swine flu virus.

Health-care workers are among the priority groups that public health officials want to vaccinate first. Others include pregnant women, the elderly and those who have certain chronic health problems.

The study's authors were surprised and concerned that so many health-care workers were not considering vaccination. In addition, Hong Kong was the epicenter of the SARS outbreak a few years ago, suggesting that health-care workers there would be especially motivated to seek vaccination.

In the United States, officials predict that as much as 50 percent of the U.S. population could be infected, with a possible death toll of 90,000 or more -- triple the number lost to seasonal flu every year.

Paul Chan, lead author and a professor of microbiology at the Chinese University of Hong Kong, advocated more education to encourage health-care workers to seek vaccinations.

In an accompanying BMJ editorial, Rachel Jordan, a lecturer in public health at England's University of Birmingham, and Andrew Hayward, senior lecturer at the UCL Centre for Infectious Disease Epidemiology in England, stressed that vaccination of health-care workers is important for their own protection and the protection of their patients.
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