Challenges and opportunities in the Israeli 2009 Pandemic Influenza Vaccination Program

A literature review to identify factors that determine policies for influenza vaccination

“…For example, authors investigating policy-making during annual epidemics rarely mentioned the possible influence of the media and anti-vaccination actions [53]. In contrast, we observed over-declarations of how evidence was used, emphasised by adjectives such as "best" or "solid" [35][36][37][38][39][40]. Moreover, primary documents were more likely to highlight the uncertainty of the process [46,59,78], whereas secondary documents were more likely to mention the influence of experts opinions and ethical issues [33,42].…”

“…In Europe, the strength of the expert opinion, represented by national advisory committees, universities, and national research institutes, was important [28,32,36,47,55,56]. The influence of the WHO was remarkable in India [49,57] and Israel [39], where they seemed to seek expertise. A similar relationship was observed with the PAHO in Latin America [51].…”

“…The evidence used by policy-makers was often associated with adjectives like 'best', 'solid', or 'empirical' in both primary [35,36] and secondary documents [37][38][39][40]. Frequently, the type of evidence used was not explicitly stated; instead, the term 'scientific evidence' was employed [41][42][43].…”

Silent reintroduction of wild-type poliovirus to Israel, 2013 – risk communication challenges in an argumentative atmosphere

“…The first and most important was to achieve consensus amongst the medical community regarding the need for a SIA [9]. During the 2009 pandemic in Israel, vaccination campaigns faced difficulties as a sizeable number of physicians did not support or opposed influenza vaccination [10]. In the presented incident, many opinion-leading physicians employed by health organisations outside the MoH, including paediatricians, family physicians, infectious disease and neurology consultants, were fully engaged in the MoH decision regarding vaccination.…”

“…More research that identifies improved methods for communication and sharing of information between public health and healthcare professionals is needed [10]. Communication with professional staff at all levels is critical, and requires planning and sufficient time intervals between transmitting information to professionals and the public, to keep professionals up-todate in parallel to the process of feeding information to the media.…”