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Some factors affecting the decision on non-mandatory vaccination in an influenza pandemic: comparison of pandemic (H1N1) and seasonal influenza vaccination

Background: The 2009 influenza pandemic caused by the influenza A (H1N1) 2009 virus was accompanied by a debate about whether or not to be vaccinated. The percentage of people who decided to be vaccinated was lower than in the case of seasonal influenza vaccination. We therefore compared factors influencing the decision on pandemic and seasonal influenza vaccination.

Method: Slovene inhabitants aged 18 and over (N=1383) completed an internet based survey on socio-demographic and health behaviour-related characteristics, personality traits, and characteristics of decision-making. Two stepwise logistic regression analyses were performed, one with an uptake of the pandemic influenza vaccine and the other with an uptake of the seasonal influenza vaccine as a dependent variable.

Results: In addition to common predictors of a decision in favour of the two vaccinations (age, gender, chronic illnesses, working in healthcare, trust in media news and vaccination side-effects in someone close), deciding in favour of vaccination against the pandemic virus was related to living with children and thoroughness in decision-making. It was also related to being vaccinated against seasonal influenza, trust in pandemic vaccine safety and professional information in favour of vaccination, and the decision of someone close.

Conclusions: In the face of the pandemic threat and lack of information, people behaved as they had in previous similar situations and according to the behaviour of people close to them and information from trusted sources. Concern for children and decision-making characteristics also became important. These factors should be considered in future crisis interventions.



The first large outbreak of SARS-CoV-2 in Europe occurred in Northern Italy in February 2020. The relatively fast spread of the infection to Slovenia was expected, and preventive measures for its suppression were widely discussed.


An online questionnaire was designed to evaluate adherence to preventive measures and the extent to which the taking of preventive measures was associated with people’s anxiety level, psychological burden, their perceived vulnerability to disease, germ aversion and a number of demographic characteristics in the early stage of Covid-19 spread. The survey was active for 24 hours (13–14 March 2020). There were 12,307 responses and 7,764 questionnaires were completed in full.


Higher preventive behaviour was found in individuals who experienced greater psychological distress, were more anxious, and expressed greater perceived infectability and germ aversion. Greater compliance with preventive behaviour was found among women, those sharing a household with people aged over 65, the elderly and those who knew somebody who had been infected. These groups also showed higher anxiety levels, which appeared to be significantly increased in general as a result of the specific situation. Quarantine was evaluated as the most efficient preventive measure, and was respected relatively strictly even before it became an officially announced protective measure.


This research reveals a strong association between preventive behaviour and anxiety. Anxiety, together with social distancing, may affect physical and psychological health in the population in the long term. Other aspects of public health might therefore be influenced by the measures currently being enforced to prevent the spread of SARS-CoV-2.


Mycotoxicoses are acute or chronic diseases of humans and animals caused by mycotoxins, toxic compounds produced by moulds. Of about 400 known mycotoxins only a small number are known to cause mycotoxicoses in humans. Organs that are most targeted are those in which mycotoxins are metabolised, that is, the liver and kidneys, but the lesions may affect the neurological, respiratory, digestive, haematological, endocrine, and immune systems as well.

The epidemics of mycotoxicoses are often connected with times of famine, when population consumes food that would not be consumed in normal circumstances. Mycotoxicoses have influenced human history, causing demographic changes, migrations, or even influencing the outcomes of wars. Fortunately, epidemics affecting so many persons and with so many fatalities belong to the past. Today they only appear in small communities such as schools and factory canteens. This paper presents epidemics and pandemics of mycotoxicoses that influenced human history.


This paper deals with historical aspects of the development of dermatovenereology in Serbia in the period of liberation wars against Turkey until gaining complete independence (1804 - 1878). Communicable diseases were a major health problem of that time. One of the most important infectious diseases was syphilis, and the development of dermatovenereology in Serbia began with fighting this disease. Special emphasis was put on the origin of the first hearth of the disease and prevalence of syphilis in the country. In this period, two dates were associated with eradication of syphilis: in 1846, the true nature of “frenga” (the term people used for syphilis) was established, and in 1851, the first hospital for venereal diseases was founded in Knjazevac. Another disease important for the development of dermatovenereology was scabies, which was also rather spread and required organized eradication. “Instructions on Scabies” were published in 1845, its treatment was mandatory, whereas people had a legal duty to report the disease. In both cases, the western medical doctrine was applied. The study also deals with a number of other skin and venereal diseases, which points to good professional knowledge of health professionals of that time.

fitness, menstrual cycle disorders and smoking habit in Croatian national ballet and national folk dance ensembles. Coll Antropol 2006;30:279-83. Lenček-Kružić V. Osteoporoza tiha epidemija. U: Pezelj T, Genz G, urednici. Hrvatska i Europa: mozak, znanost i umjetnost. Zagreb: Hrvatski odbor europskog udruženja Medicine umjetnosti; 2007. str. 113-20. Miletić A, Grgantov Z, Krstulović S. Pojava mišićno-koštane boli u trenažnom procesu kod plesača i plesačica u sportskom plesu. U: Mekić M, Smajlović N, Talović M, Mahmutović I, Kapo S, Jelešković E, urednici. IV Međunarodni

of Ancona, Italy Eur. J. Epidemiol 16 1023 1026 10.1023/a:1010853124085 Gvozdenović, E., Mitrović, M., Dakić, Z., Stojković-Švirtlih, N., Dulović, O. (2012): Porodična epidemija kriptosporidijaze u Srbiji – prikaz slučaja. [Family Outbreak of Cryptosporidiosis in Serbia: Case Report]. Srp. Arh. Celok. Lek 140 (9–10): 653–657. DOI: 10.2298/SARH1210653G Gvozdenović E. Mitrović M. Dakić Z. Stojković-Švirtlih N. Dulović O. 2012 Porodična epidemija kriptosporidijaze u Srbiji – prikaz slučaja [Family Outbreak of Cryptosporidiosis in Serbia: Case Report]. Srp. Arh