Thursday, July 30, 2009

Vaccine Priorities are Out

The Advisory Committee on Immunization Practices (ACIP) met today and issued guidelines on who should get the vaccine for H1N1 "swine" flu first.  As you know, I have strong opinions about how these guidelines, or any guidelines, are going to affect people and how they will be received.  So, now that they're out, let's see how we're doing at mitigating the impact up front.

I give Day 1 of this process a C-, max.  Don't get me wrong -- I don't have any problem with what appear to be the new guidelines.  What I have a problem with is that I can find well over 800 articles about them by googling "H1N1 vaccine guidelines," but the guidelines themselves are nowhere to be found. 

All 800 articles have roughly the same information:  the first wave of vaccinations will go to pregnant women, children and young adults 6 months to 24 years, healthcare workers, adult caregivers of infants and adults under 65 with other medical conditions.  If there isn't enough vaccine to accomplish this (since this is about half the U.S. population) they will further pare it down.  This information was apparently delivered in a press conference this afternoon.  As far as I can find, no press release was distributed, and there is nothing on the CDC website, the government flu website or the ACIP website (in fact, the postings to the ACIP website seem to be running at least a month out of date).  You can get the transcript from the Federal News Service -- if you happen to already have a subscription. 

In short, the government is relying solely on the press to get the word out.  This is pretty much what they did in April and May, and I refer you to my post on the 2009 Flu Pandemic to see how that can go really wrong.  You need only look at some of the headlines to see why relying solely on the press is a bad idea.  Most news outlets have fairly low key headlines running, like, whose headline reads "Federal Panel Issues H1N1 Vaccine Guidelines."  On the other hand, we have ABC News, which is running the sensationalist tagline, "Who Gets Swine Flu Vaccine Before You Do?"  The government is managing the facts, but not how those facts are presented. 

It's probably true that they can't control how the story gets spun.  But what they could do,  which they aren't, is put out the guidelines in writing on the web so that people who want more information can get it, and so news organizations can link to it.  They also could, in the same document, discuss not only why they are making these recommendations, but why those who aren't going to get the vaccine in the first wave should still feel calm.  Some detailed, scientific reassurance is in order to frame this as a way of keeping everyone as safe as possible -- after all, an effective vaccination program actually provides some protection for those who have not been immunized, since they are less likely to be exposed.

Once again, the powers that be are failing to understand a basic principle of crisis communication, which is that they not only have to get the information out there, but they also need to anticipate what other information will be out there and where it will come from, as well as how people will react to it.  Yes, it's complicated to put out something in writing at the same time as a press conference that is based on a decision that has just been made.  But it's not impossible.  And they need to get better at it, because with this particular flu, people want their information to be accurate and timely, and timeliness is measured in minutes, not days.  And frankly, they really don't have that much time to start getting this right.

(Don't miss the previous Quarterbacking on H1N1)


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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