OBJECTIVES: The purpose was to identify motivating factors and barriers on influenza vaccination. METHODS: An employer site conducting an annual influenza vaccination program was selected for the study. Subjects were recruited on-site to participate in the 5-month study. The vaccinated group (VG) included subjects presenting for vaccination over a 3-week vaccination schedule in October 1998. During a subsequent 3-week period, volunteers not receiving vaccination (NVG) were recruited into the study. Health Belief surveys were administered at the time of recruitment, which included questions specifically inquiring about health beliefs. The Health Belief Model (HBM) was utilized to derive motivators, barriers, threats, and expectations regarding influenza vaccination and their influence on getting vaccinated. The influence of the motivating factors and barriers were rated on a 4-point rating scale (1=none, 4=a great deal). RESULTS: Preliminary results of motivating factors and barriers on 1065 subjects (663 VG and 402 NVG) who completed the surveys are presented. "Avoid influenza" was reported most often as having a great deal of influence on getting vaccinated (86%, 524/606 subjects) followed by "transmit influenza" (53%, 307/575 subjects). Fear of injection and site pain (32%, 96/298 subjects) and inconvenience (32%, 96/297 subjects) were reported most often as having a great deal of influence as barriers to vaccination. Additional multivariate analyses incorporating all aspects of HBM are ongoing. CONCLUSIONS: Perception of contracting and/or transmitting influenza were primary motivators for seeking vaccination. In the survey, there appears to be multiple barriers to vaccination. Communication strategies and noninvasive formulations of influenza vaccines may diminish these barriers and enhance vaccination rates.