Analysis of public responses to preparedness policies: the cases of H1N1 influenza vaccination and gas mask distribution

Israel Journal of Health Policy Research

Giora Kaplan²  Liat Lerner-Geva⁴  Gilead Shenhar¹  Valentina Boyko³  Baruch Velan⁵ 

[1] Trauma & Emergency Medicine Research Center, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat Gan, Israel;Psychosocial Aspects of Health, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat Gan, Israel;Women and Children’s Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Ramat Gan, Israel;Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel;Genetic Policy and Bioethics Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer 52621, Israel

关键词: Preparedness;    Gas-Masks;    Public-trust;    Acceptance;    H1N1-influenza;   

Others  :  804873
DOI  :  10.1186/2045-4015-2-11

 received in 2012-09-19, accepted in 2013-02-28,  发布年份 2013

【 摘 要 】

Background

During several months in 2009–2010, the Israeli population was asked to take part in two preparedness programs: Acquisition of gas masks against a potential chemical-warfare attack, and vaccination against the A/H1N1 influenza pandemics. Compliance with the first request was moderate and did not attract much attention, whereas compliance with the second request was very low and was accompanied by significant controversy. The aims of this study are to compare the public’s attitudes towards these two preparedness campaigns, and to explore the roles of trust, reasoned assessment, and reflexive reactions in the public’s response to governmental preparedness policies.

Methods

The comparative analysis was based on a telephone survey of 2,018 respondents representing a cross-section of the adult Israeli population. Univariate analysis to describe associations of public response and attitude was performed by Chi-square tests.

Findings

A set of queries related to actual compliance, trust in credibility of authorities, personal opinions, reasons for non-compliance, and attitudes towards uncertainties was used to characterize the response to mask-acquisition and vaccination. In the case of mask-acquisition, the dominant response profile was of trusting compliance based on non-conditional belief in the need to adhere to the recommendation (35.6% of respondents). In the case of vaccination, the dominant response profile was of trusting non-compliance based on a reflective belief in the need for adherence (34.8% of respondents). Among the variables examined in the study, passivity was found to be the major reason for non-compliance with mask-acquisition, whereas reasoned assessment of risk played a major role in non-compliance with vaccination. Realization of the complexity in dealing with uncertainty related to developing epidemics and to newly-developed vaccines was identified in the public’s response to the H1N1 vaccination campaign.

Conclusions

The newly identified profile of “trusting-reflective-non-complier” individuals should be of concern to policy makers. The public is not accepting governmental recommendations in an unconditional manner. This is not driven by lack of trust in authorities, but rather by the perception of the responsibility of individuals in confronting forthcoming risks. Nevertheless, under certain conditions the public may respond in a non-reflective way and delegate this responsibly to authorities in an uncontested manner. This leaves the policy makers with the complex challenge of interacting with a passive non-involved public or alternatively with an opinionated, reflexive public.

【 授权许可】

   
2013 Velan et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Michaelis M, Doerr HW, Cinatl J: An influenza A H1N1 virus revival - pandemic H1N1/09 virus. Infection 2009, 37:381-389.
• [2]Peiris JS, Tu WW, Yen HL: A novel H1N1 virus causes the first pandemic of the 21st century. Eur J Immunol 2009, 39:2946-2954.
• [3]Girard MP, Tam JS, Assossou OM, Kieny MP: The 2009 A (H1N1) influenza virus pandemic: A review. Vaccine 2009, 2010(28):566-574.
• [4]Tosh PK, Jacobson RM, Poland GA: Influenza vaccines: from surveillance through production to protection. Mayo Clin Proc 2010, 85:257-273.
• [5]Levine H, Balicer RD, Laor D, Grotto I: Challenges and opportunities in the Israeli 2009 pandemic influenza vaccination program. Hum Vaccin 2011, 7:1077-1082.
• [6]Roll U, Yaari R, Katriel G, Barnea O, Stone L, Mendelson E, Mandelboim M, Huppert A: Onset of a pandemic: characterizing the initial phase of the swine flu (H1N1) epidemic in Israel. BMC Infect Dis 2011, 11:92. BioMed Central Full Text
• [7]Velan B, Kaplan G, Ziv A, Boyko V, Lerner-Geva L: Major motives in non-acceptance of A/H1N1 flu vaccination: the weight of rational assessment. Vaccine 2011, 29:1173-1179.
• [8]Barach P, Rivkind A, Israeli A, Berdugo M, Richter ED: Emergency preparedness and response in Israel during the Gulf War. Ann Emerg Med 1998, 32:224-233.
• [9]The State Comptroller of Israel. Report A59 2008. http://www.mevaker.gov.il/serve/contentTree.asp?bookid=532&id=57&contentid=9890&parentcid=undefined&bctype=9887&sw=1366&hw=698 webcite
• [10]Command Delivers Refurbished Gas Masks to Residents. News Bulletin 28 February 2010. http://dover.idf.il/IDF/English/News/today/10/02/2801.htm webcite
• [11]Israel Central Bureau of Statistics: Income survey. 2010. http://www1.cbs.gov.il/publications12/1479/pdf/t01.pdf webcite
• [12]Israel Central Bureau of Statistics: Selected Data from the New Statistical Abstract of Israel No. 62. 2011. http://fmx.sagepub.com/content/23/2/188 webcite
• [13]Raffensperger C, Tickner JA, Wes J (Eds): Protecting public health & the environment: implementing the precautionary principle. Washington, DC: Island Press; 1999.
• [14]Renn O, Levine D: Credibility and Trust in Risk Communication. In Communicating Risks to the Public. International Perspectives. Edited by Kasperson R, Stallen JM. Norwell, MA: Kluwer Academic Publishers; 1991.
• [15]Covello VT, Peters RG, Wojtecki JG, Richard C, Hyde RC: Risk Communication, the West Nile Virus Epidemic, and Bioterrorism: Responding to the Communication Challenges Posed by the Intentional or Unintentional Release of a Pathogen in an Urban Setting. J Urban Health 2001, 78:382-391.
• [16]O’Leary A: Self-efficacy and health. Behav Res Ther 1985, 23(4):437-451.
• [17]Griffith S: A review of the factors associated with patient compliance and the taking of prescribed medicines. Br J Gen Pract 1990, 40:114-116.
• [18]Efrat E: The geography of a population mass-escape from the Tel Aviv area during the Gulf War. Geogr J 1992, 158:199-206.
• [19]Shenhar G, Jaffe D, Gidron D, Peleg K: Evacuation Patterns of Ethnic Groups under Fire. J Homel Secur 2012, 9:1547-7355.
• [20]Velan B, Boyko V, Lerner-Geva L, Ziv A, Yagar Y, Kaplan G: Individualism, acceptance and differentiation as attitude traits in the public’s response to vaccination. Human Vaccines & Immunotherapeutics 2012, 9(8):1272-1282.
• [21]Porter B, Rosen B, Rishpon S: Development and implementation of vaccine policy. Survey No 14. Health Policy Monitor 2009. http://www.hpm.org/is/a14/4.pdf webcite
• [22]Vigoda-Gadot E, Mizrahi S: The Performance of the Israeli Public Sector: A Citizens Survey and National Assessment (research paper #9). A working paper. Haifa, Israel: The Division of Public Administration and Policy, School of Political Sciences, University of Haifa; 2009.
• [23]Brien S, Kwong JC, Buckeridge DL: The determinants of 2009 pandemic A/H1N1 influenza vaccination: a systematic review. Vaccine 2012, 30:1255-1264.
• [24]Velan B: Acceptance on the move: public reaction to shifting vaccination realities. Hum Vaccin 2011, 7:1261-1267.
• [25]Casiday R, Cresswell T, Wilson D, Panter-Brick C: A survey of UK parental attitudes to the MMR vaccine and trust in medical authority. Vaccine 2006, 24:177-184.
• [26]Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES: Qualitative analysis of mothers’ decision-making about vaccines for infants: the importance of trust. Pediatrics 2006, 117:1532-1541.
• [27]Haug C: The Risks and Benefits of HPV Vaccination. J Am Med Assoc 2009, 302:795-796.
• [28]Brewer NT, Chapman GB, Gibbons FX, Gerrard M, McCaul KD, Weinstein ND: Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination. Health Psychol 2007, 26:136-145.
• [29]Teitler-Regev S, Shahrabani S, Benzion U: Factors affecting intention among students to Be vaccinated against a/H1N1 influenza: a health belief model approach. Adv Prev Med 2011, 2011:353207.
• [30]Giddens A: Risk and responsibility. Mod L Rev 1999, 62:1-10.
• [31]Beck U, Giddens A, Lash S: Reflexive Modernization: Politics, Tradition and Aesthetics in the Modern Social Order. Stanford, CA: Stanford University Press; 1994.
• [32]Velan B: Personal and State Responsibilities in Vaccination: A Two-Way Road. In Accountability and Responsibility in Healthcare. Edited by Rosen B, Israeli A, Shortell S. Singapore: World Scientific; 2012:513.