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Influenza: knowledge and risk perception among Finnish conscripts beginning military service
Julkaistu 02.10.2009 00.01


This study investigated knowledge about influenza, perception of riski and vaccination acceptance among Finnish conscripts. In Finland, approximately 90% of men enter obligatory military service at the age of 18–28 years and 80% complete this 6–12 month period. The military environment presents a high risk environment for infectious disease outbreaks due to the large numbers of soldiers living in close proximity.


A total of 1000 military conscripts from the Mechanized Brigade were recruited to the study during their initial health inspection in July 2007. A written questionnaire was used to survey influenza related knowledge, risk perception and vaccination acceptance. The survey was modified from the Psychosocial SARS Research Consortium study survey.

Knowledge: 46 items on Influenza (spreading, symptoms and general questions), avian influenza (spreading) and routes of transmission of communicable diseases in general were presented using yes/no questions. Respondents were asked to tick the items they thought were correct and a sum score was obtained (theoretical range 0–46).

Risk perception: Respondents were asked to rate their comparative risk (compared to that of another person of the same gender, age and living in the same country) of contracting communicable diseases on a scale from 1 (much lower) to 5 (much higher). Personal beliefs about the ability to prevent influenza during military service were studied (efficacy beliefs). Using four scenarios, participants were asked to estimate the probability of contracting influenza during conscription on a scale from 1 (very low) to 5 (very high). Scenarios were: 1) vaccinated: a) no outbreak occurs, b) an outbreak occurs; and 2) not vaccinated: a) no outbreak occurs, and b) an outbreak occurs.

Vaccination acceptance: Participants were asked whether they would like to receive the vaccination during military service and possible reasons influencing this decision.

A total of 950 male conscripts returned the questionnaire. Females (N=25) in voluntary military service were excluded from the analysis due to their low number. A total of 25 males were excluded from the analysis due to incomplete questionnaire data. The average age of the respondents was 19.5 years (range 18–27), 89% were single and 45% had received at least high school education. Of the respondents, 42% were living in large cities (>20,000 citizens), 26% in small cities (<20,000) and 32% in the countryside.


The average number of correct answers was 56%. (26/46). A total of 39% of the respondents perceived hygiene as an important element to health, 52% as a very important element to health, with more of those with higher education holding this belief than those with lower education (61% vs 48%).

Estimation of the risk of contracting influenza during military service varied among the four scenarios from 2.0 to 3.6. Altogether, 2/3 of participants indicated trust in their own ability to prevent influenza during military service.

Asked about influenza vaccination, 27% replied that they did not want it, 31% wanted vaccination and 41 were undecided. The most common reasons given for not wanting the vaccination were already having adequate immunity, not needing it and disliking injections. The participant’s background did not influence this decision although it did appear to influence the reasons for (not) wanting vaccination.

Conclusions The results of the study suggest that conscripts need education about influenza and communicable diseases. The conscript’s belief in their own ability to prevent infection can be utilized in infection control. Both strengthening conscripts` sense of self-empowerment and increasing their knowledge about influenza are important factors in preventing respiratory infection outbreaks.

Anne-Marie Vartti, M.Sc. Researcher, The Finnish Defence Forces, Centre of Military Medicine, E-mail:

Ilkka Mäkitie, Arja R. Aro, Markus Henriksson, Vesa Jormanainen, Simo Nikkari

Finnish Medical Journal 2009;64:3303–10.


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