Use of Risk Communication Principles and Audience Research to Guide the Response to the 2009 H1N1 Vaccination Campaign

Background: Communication strategy development to promote 2009 H1N1 influenza vaccination began when the disease was first isolated in April 2009. As more was learned about the disease, the vaccine, and public perceptions of both strategies and tactics evolved.

Setting: Communicating about the 2009 H1N1 vaccine presented unique challenges. These included priority audiences recommended by ACIP which differed substantially from those recommended for the seasonal flu vaccine; a vaccine supply that was out of sync with consumer demand; consumer concerns raised by the rapid development and testing of the vaccine; as well as intense and changing media coverage. These and other factors made for a volatile and unpredictable communication environment.

Population: Campaign efforts focused on parents of children 6 months to 18 years, young adults 19 to 24 years, and persons with risk conditions including pregnant women. Vaccine safety was a concern among many risk groups; others did not perceive 2009 H1N1 to be a threat and/or were unaccustomed to seeking influenza vaccination.

Project Description: CDC held focus groups in June, September, and October to track changes in consumer knowledge, attitudes, and practices related to influenza prevention. The focus groups were used in conjunction with online surveys to quickly test new communication messages and materials. CDC used media monitoring to track coverage of vaccine and safety issues, including traditional and social media, e.g., blogs. Data from all research methods were analyzed from a risk communication perspective to inform changes in strategies and tactics.

Results/Lessons Learned: Notable changes in attitudes toward vaccination, awareness of ACIP recommendations, and intentions to seek vaccination were documented in the months leading up to the flu season. Media coverage was reported as a significant driver of awareness and concerns. The interplay between perceived risk of disease and safety of the 2009 H1N1 vaccine led CDC to clearly differentiate communication about the disease (increasing risk perception) from the vaccine (reassuring concerned consumers).