The first H1N1 vaccines were licensed in mid-September, and by October 2009 most industrialized countries had rolled out national vaccination programs. The WHO declaration boosted the implementation of various countermeasure programs by national organizations worldwide, and prompted the development and production of vaccines against the H1N1 virus. H1N1 was declared a pandemic by the World Health Organization on June 2009, as soon as infection had shown sustained human-to-human transmission in different geographic regions. In March 2009, the outburst of a novel strain of influenza, linked to swine influenza, was detected in Mexico, and as of January 2010 it had caused nearly 15,000 deaths in 209 countries. The A/H1N1 influenza (hereafter, H1N1) of 2009 is considered one of the most widespread pandemics in recent history. The Israeli population was urged to get vaccinated against the developing H1N1 pandemic influenza, and to acquire gas masks and hoods against a potential future attack by chemical or biological warfare. During a period of several months during 2009–2010, the State of Israel exercised this responsibility by launching two national campaigns. This includes risk communication as well as provision of the appropriate protection measures. The responsibility of the State for the health of its population entails appropriate preparedness against emerging large-scale health hazards. This leaves the policy makers with the complex challenge of interacting with a passive non-involved public or alternatively with an opinionated, reflexive public. Nevertheless, under certain conditions the public may respond in a non-reflective way and delegate this responsibly to authorities in an uncontested 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. The public is not accepting governmental recommendations in an unconditional manner. The newly identified profile of “trusting-reflective-non-complier” individuals should be of concern to policy makers. 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. 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. 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). 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). FindingsĪ 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. Univariate analysis to describe associations of public response and attitude was performed by Chi-square tests. The comparative analysis was based on a telephone survey of 2,018 respondents representing a cross-section of the adult Israeli population. 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. 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. 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.
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