The factors with the strongest association with intention to accept pre-pandemic or pandemic vaccine were history of seasonal influenza vaccination and perceived risk of contracting the infection. The strong association between acceptance of seasonal and pre-pandemic vaccination also suggests similar barriers exist for both vaccines. Efforts to improve the uptake of seasonal influenza vaccination by healthcare workers should therefore be a part of the pandemic preparedness plan, as disseminating correct information may be more difficult at time of crisis, and the health belief model could be applied to improve the acceptance of pre-pandemic vaccine as in seasonal influenza vaccination. 19 The major barriers to vaccination we identified were fear of side effects and questions about its efficacy. This suggests that public and hospital health agencies need to provide more information to the staff, especially to those with higher levels of anxiety and doubt.