Pandemic H1N1 Influenza Communication and Media: An Overview Glen Nowak, PhD Director, Division of Media Relations October 19, 2009

Influenza Vaccination Communication Overview Mission Support the broader public health goal of protecting as many people as possible from influenza, with minimum economic and social disruption Primary Objectives Provide timely and accurate information about the federal government’s influenza and pneumococcal vaccination recommendations, vaccine benefits, and risks and availability Communicate in a way that helps people to protect themselves and their families from influenza, including helping them make vaccination choices Primary Audiences and Intermediaries General public Health professionals Public health partners Private sector partners Policy makers Guiding Principles Acknowledge uncertainties and the unpredictable nature of influenza Share challenges and dilemmas Direct fears and concerns (versus minimizing them) Maintain transparency—communicate early and frequently Utilize multiple channels and partners to increase message reach and visibility

Key Tenets of Media Strategy Frequent, regular press briefings Proactive media outreach (e.g., workshop for journalists, inviting journalists to CDC, media tabletops) Proactive messaging – e.g., foreshadowing challenges and issues Utilization of risk communication principles Frequent updates to CDC media relations website Mapping forward events, publications, likely issues and interests

Initial Availability of H1N1 vaccine (i.e., Oct. 1 – Oct. 9) Message Strategy: Show leadership Set expectations Foreshadow likely events in rollout across the nation Provide anticipatory guidance Recognize and address doubts, concerns, including about vaccine timing, availability, and administration plan Address parent concerns and doubts about H1N1 vaccine Promote prevention Message themes include: Embarking on a complex endeavor at a challenging time – virus leaves us no choice Good to provide some access as soon as possible (vs. waiting for more vaccine later) Flu is unpredictable Vaccine best tool for preventing disease Safe and effective vaccine Initial availability and efforts will be limited Learning and modifying We want those in priority groups to get vaccinated Shared responsibility Encourage seasonal flu vaccination

Core Messages included. . . “There are reasons to be worried/concerned when it comes to the pandemic H1N1 influenza virus and the upcoming season” “This novel virus warrants aggressive public health actions (e.g., investment in vaccines and vaccination)” “Strong actions are taken to protect people from seasonal flu (e.g., production and administration of annual vaccines) – and should be taken in response to this pandemic virus”

Build up to H1N1 vaccine availability and provision (e. g Build up to H1N1 vaccine availability and provision (e.g., October 10 – 18) Message Strategy: Continue to show leadership Recognize and address doubts, concerns, skepticism, including about vaccine timing and availability Guide expectations – especially re: variability Provide “progress” reports (vaccine, state efforts) Acknowledge problems and issues, commit to fixing/resolving Foreshadow events or potential issues Updates on influenza activity and disease Promote prevention Message themes include: Expect variability across the country – flu activity, vaccine availability, where and how vaccination is done People at higher risk of medical complications from influenza should get an H1N1 vaccination The vaccination effort is a complex endeavor – shared responsibilities Challenges are not surprising – we will work with partners to address Vaccinations protect from flu, minimize disease spread Vaccination is important, but voluntary

Rolling out much more H1N1 vaccine (e.g., October 20 – Nov. 1) Message Strategy: Promote vaccination (e.g., campaign, PSAs) Demonstrate resiliency, adaptability, responsiveness Recognize and address doubts, concerns, criticism Provide updates and “progress” reports Highlight efforts to engage and assist states, clinicians, others Be ready to address growing interest in vaccine safety Provide regular updates on 1) influenza activity and disease and 2) vaccine distribution and uptake Message themes include: Expect variability across the country – flu activity, vaccine availability, where and how vaccination is done People at higher risk of medical complications from influenza should get an H1N1 vaccination Others should consider, and get H1N1 vaccination as vaccine becomes more widely available Acknowledge problems, identify steps/efforts being taken to assure effective vaccination programs across the country

Wide/Broad Availability of H1N1 and seasonal flu vaccine (e. g. , Nov Wide/Broad Availability of H1N1 and seasonal flu vaccine (e.g., Nov., Dec.) Message Strategy: Promote influenza vaccination (e.g., campaign, PSAs) Show ability to manage in face of much variability, uncertainty Model resiliency, adaptability, and responsiveness Anticipate and address concerns related to vaccine timing and benefit Provide updates and “progress” reports Provide updates on 1) influenza activity and disease and 2) H1N1 vaccine availability and uptake Be ready to address vaccine safety questions and issues Message themes include: H1N1 vaccine is/is becoming widely available Get H1N1 vaccine, especially if in priority group – it’s best protection against H1N1 influenza (In many places) Others interested can also get vaccinated Influenza is unpredictable – don’t know what will happen during this flu season Acknowledge problems, identify steps/efforts being taken to assure effective vaccination programs across the country

H1N1 Vaccine Safety Communications: Overarching Messages “Flu vaccines are very safe. The safety of influenza vaccines is closely monitored. These vaccines are held to the highest standards.” “2009 H1N1 flu vaccines are produced similarly to seasonal flu vaccines that are made every year. There is a long and successful track record of safety and effectives of seasonal flu vaccines using this technology.” “Over the years, millions of Americans have received seasonal flu vaccines. The most common side effects were mild, such as soreness, redness, tenderness or swelling where the shot was given.”

Current Media Interests Vaccine availability and distribution How much What’s happening in the states Vaccine interest/demand vs. supply Is there mismatch (and if so, what’s being done) Vaccine timing (e.g., is it here too late?) H1N1 disease (e.g., prevalence? Severity?) Vaccine safety Any issues? Any reports?

Going Forward . . . Be prepared for public, policy maker, clinician and media: Questions and skepticism regarding operational plans and implementation for H1N1 vaccine efforts (e.g., ability of health depts. to effectively implement without adversely affecting other programs, doses ordered/available). Interest/concern about two influenza-related vaccination efforts taking place simultaneously Interest/concern about H1N1 vaccine and vaccination efforts reaching vulnerable populations, low SES, people at highest risk for complications. Interest in vaccine effectiveness and safety

Likely Ongoing Media Interests Thimerosal-containing H1N1 vaccine Impact of H1N1 vaccination efforts on state and local health departments and local health care systems Consumer interest and demand for H1N1 vaccine – including ones that will suggest initial demand will exceed initial supply as well as subsequent ones that suggest modest or little consumer interest in vaccination. More stories on problems and shortcomings than on successes – especially stories that focus on problems in ordering/receiving, distribution, access, health care provider interest, public and parent interest (or lack of), vaccination program shortcomings and possible adverse reactions to the vaccine.

Thank you