What the Public Was Saying about the H1N1 Vaccine: Perceptions and Issues Discussed in On-Line Comments during the 2009 H1N1 Pandemic

Natalie Henrich,Bev Holmes,Vladimir Brusic

doi:10.1371/journal.pone.0018479

Abstract

During the 2009 H1N1 pandemic, a vaccine was made available to all Canadians. Despite efforts to promote vaccination, the public's intent to vaccinate remained low. In order to better understand the public's resistance to getting vaccinated, this study addressed factors that influenced the public's decision making about uptake. To do this, we used a relatively novel source of qualitative data – comments posted on-line in response to news articles on a particular topic. This study analysed 1,796 comments posted in response to 12 articles dealing with H1N1 vaccine on websites of three major Canadian news sources. Articles were selected based on topic and number of comments. A second objective was to assess the extent to which on-line comments can be used as a reliable data source to capture public attitudes during a health crisis. The following seven themes were mentioned in at least 5% of the comments (% indicates the percentage of comments that included the theme): fear of H1N1 (18.8%); responsibility of media (17.8%); government competency (17.7%); government trustworthiness (10.7%); fear of H1N1 vaccine (8.1%); pharmaceutical companies (7.6%); and personal protective measures (5.8%). It is assumed that the more frequently a theme was mentioned, the more that theme influenced decision making about vaccination. These key themes for the public were often not aligned with the issues and information officials perceived, and conveyed, as relevant in the decision making process. The main themes from the comments were consistent with results from surveys and focus groups addressing similar issues, which suggest that on-line comments do provide a reliable source of qualitative data on attitudes and perceptions of issues that emerge in a health crisis. The insights derived from the comments can contribute to improved communication and policy decisions about vaccination in health crises that incorporate the public's views.

Highlights

In March 2009 the first cases of H1N1 influenza were reported in Mexico
As health officials struggled to convince the public of the safety and value of vaccination against H1N1, the question loomed large: how could such a mismatch exist between the officials’ expectations about the public’s acceptance of the vaccine and the intentions to vaccinate voiced by the public? It appeared that the factors that officials perceived as relevant in the decision making process differed from those perceived by large segments of the Canadian public
Our findings identified and provided context for understanding public perceptions and concerns about the H1N1 vaccine and suggest that online comments are a valuable source of qualitative data

Summary

Introduction

In June 2009, the World Health Organization (WHO) declared a pandemic [1] and discussions commenced worldwide among public health officials, governments and pharmaceutical companies about development of an H1N1 vaccine. While health and political officials hoped that demand for the vaccine would be high, polls indicated that as much as 50% of Canadians did not intend to get vaccinated [2]; actual vaccination rates during the pandemic were estimated at approximately 41% of Canadians [3]. As health officials struggled to convince the public of the safety and value of vaccination against H1N1, the question loomed large: how could such a mismatch exist between the officials’ expectations about the public’s acceptance of the vaccine and the intentions to vaccinate voiced by the public? The information provided to the public about the vaccine did not resonate with them and in many cases was being rejected

Methods

Results

Conclusion