The uptake rate for seasonal influenza vaccine in Hong Kong varies among the target groups. A previous study on patients attending a general outpatient clinic, of whom half had chronic illnesses, found a vaccination rate of 27%, but without correlation with sex, occupation, or household income. 20 The uptake rate among elderly people aged >65 years living in the community was also low (26.9%-36.4%). 21 In contrast, more than 90% of elderly people living in institutions received influenza vaccine, which was delivered on site. 22 The overall vaccination rate for elderly people in Hong Kong could be within the range reported from surveys in the UK, Italy, France, Germany, and Spain conducted from 2003 to 2007 (41.3%-78.1%). 23 As for healthcare workers, both Hong Kong and European countries face a low uptake rate. The 32.9% vaccination recorded in the current study is close to the ranges reported for the UK (15.9%-25.2%), Italy (13.3%-23.2%), Spain (20.5%-28.9%), Germany (22.0%-27.5%), and France (15.8%-22.2%). 23 The Department of Health in Hong Kong provides a comprehensive immunisation programme from birth to 12 years old. There seems to be no major generic barrier to vaccination in Hong Kong, as the uptake for childhood immunisation programmes is high (84.7%-99.6%), 24 and a recent survey indicates a high level of willingness (88%) to accept human papillomavirus vaccine, 25 similar to that recorded in the UK (89%). 26 While cultural differences could affect the acceptance of vaccines in general, we believe there are common barriers to influenza vaccination that exist across geographical regions and racial groups. 27 The findings of this study can therefore serve as a reference for other countries that are planning to offer the H1N1 vaccine to their healthcare workers.