1. Using Short-Duration Opinion Surveys to Track the Public’s Response to an H1N1 Outbreak
Robert J. Blendon, Sc.D. Harvard Opinion Research Program Harvard School of Public Health Harvard Kennedy School of Government
Presented at NPHIC, October 19, 2009
Funded as part of a cooperative agreement between
HSPH/National Preparedness Leadership Institute and the CDC

2. Harvard Opinion Research Program’s Focus on Public Health Emergencies
Baseline Polls on Possible Public Response to Threats
Crisis Polls during Threat (2-5 day results)
Crisis Aftermath Polls (impact of events and communications)
Analysis of Historic Polling Data for Trends/Perceptions
AIDS – J. Osborn, “What ever happened to AIDS?”
what some people consider to be panic flight is a RATIONAL response given the information the people have on the threat and risks
Knowledge is a huge factor – saw this especially with AIDS. A 1985 ABC/WP survey found that 36% of the public believed that AIDS was just as contagious or more contagious as the common cold. These beliefs led to controversies over HIV positive children in school.

3. Understanding the Public’s Response to H1N1
Knowledge and Concern
Level of concern
Awareness of alerts and advisories
Beliefs about threats
Beliefs about prevention or treatment
Response to Public Health Emergencies
Following recommendations
Other non-recommended behavior
Support for public health policies
Experiencing serious problems
Information-seeking Behavior
Sources of information sought
Trust in spokespeople
Usefulness of information
Rating of authorities’ response
AIDS – J. Osborn, “What ever happened to AIDS?”
what some people consider to be panic flight is a RATIONAL response given the information the people have on the threat and risks
Knowledge is a huge factor – saw this especially with AIDS. A 1985 ABC/WP survey found that 36% of the public believed that AIDS was just as contagious or more contagious as the common cold. These beliefs led to controversies over HIV positive children in school.

4. Concerns about H1N1/Swine Flu Among Hispanics and White Non-Hispanics
% saying concerned they or an immediate family member may get sick from H1N1/swine flu in the next 12 months
Concerned
Not concerned
Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

5. % saying they/member of household
Steps Taken in Response to Outbreak Among Hispanics and White Non-Hispanics
% saying they/member of household
Washed hands or used hand sanitizer more frequently
Avoided places where many people are gathered together, like sporting events, malls, or public transportation
Avoided Mexican restaurants or grocery stores
Avoided people you think may have recently visited Mexico
Talked with your doctor about health issues related to swine flu
Worn a face mask
Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

6. % saying in response to reports of H1N1/swine flu, have personally…
Steps Taken to Avoid Contact with Others, Among Hispanics and White Non-Hispanics
% saying in response to reports of H1N1/swine flu, have personally…
Taken any steps to avoid being near someone who has flu-like symptoms
Stopped shaking hands with people
Stopped hugging/kissing close friends/relatives
Harvard Opinion Research Program, Harvard School of Public Health, May 5-6, 2009.

7. H1N1 Vaccine and the Public

8. Methods Summary Telephone poll Conducted September 14-20, 2009
Nationally representative random sample of adults in the United States
1,042 respondents—includes 357 parents
Data weighted to match U.S. Census on: gender, age, race, education, region, and number adults in household 8

9. Americans’ Views of the Likelihood of a Major Outbreak of Influenza A – H1N1
% saying they think widespread cases with people getting very sick are…
Very likely
Somewhat likely
Not too likely
Not at all likely
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009; May 5-6, 2009. .

10. Americans’ Concerns That They or Someone in Their Family May Get Sick from Influenza A – H1N1 During Next 12 Months
Concerned
Not concerned
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

11. Americans’ Views of Public Health Officials’ Concerns about a Possible Outbreak of Influenza A-H1N1
Justified
Overblown
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

12. Americans’ Attitudes about Getting the H1N1 Vaccine
Adults absolutely certain will get for themselves
Parents absolutely certain will get for their children
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

13. Not Absolutely Certain They Will Get Vaccine Includes those not sure, plan to get vaccine but may change mind, do not plan to get vaccine but will get if outbreak becomes severe, or absolutely certain NOT to get vaccine
Gender *
Men
Women
Age **
18-29
30-49 **
50-64 **
65+
Income
<$25,000
***
$25,000-50,000
***
$50,000-75,000
>$75,000
Education
High school graduate or less
****
Some college
College graduate
* Statistically significantly different than women
** Statistically significantly different than 65+ age group
*** Statistically significantly different than <$25,000
**** Statistically significantly different than high school graduate or less/college graduate 13
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

14. Parents Not Absolutely Certain They Will Get Vaccine for Their Children
Includes those not sure, plan to get vaccine but may change mind, do not plan to get vaccine but will get if outbreak becomes severe, or absolutely certain NOT to get vaccine
Racial/Ethnic Groups
African American
Hispanic *
White
Income
<$25,000 **
>$25,000 **
>$75,000
Education
High school graduate or less
***
Some college
***
College graduate
* Statistically significantly different than Hispanic
** Statistically significantly different than <$25,000
*** Statistically significantly different than those with high school diploma or less 14
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

15. Major Reasons Adults Will Not/Are Not Sure/May Change Their Mind About Getting H1N1 Vaccine
% Who Said Was Major Reason
Concern about side effects
Don’t think at risk for serious case
Can get medication to treat H1N1
Concern about getting H1N1 from vaccine
Getting vaccine would be too expensive
Concern about getting another serious illness from vaccine
Don’t trust public health officials to provide correct information about vaccine safety
Don’t think vaccine would be effective
Don’t like shots/injections
Plan on getting seasonal flu vaccine and believe will protect against H1N1 too
Healthcare provider said should not get the vaccine
Too hard to get to location for vaccine
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

16. Citing Concern about Safety of Vaccine Among those who say they will NOT get the vaccine
Race
African American *
Hispanic
White
Age
18-29 **
30-49
50-64 **
65+
Income
<$25,000
***
>$25,000
>$75,000
Education
****
High school graduate or less
****
Some college
College graduate
Metro Status
*****
Urban
Suburban
Rural
* Statistically significantly different than whites
** Statistically significantly different than 18-29
*** Statistically significantly different than >$25,000, >$75,000
**** Statistically significantly different than college graduates
***** Statistically significantly different than suburban 16
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

17. Major Reasons Parents Will Not/Are Not Sure/May Change Their Mind About Getting H1N1 Vaccine
% Parents Who Said Was Major Reason
Concern about side effects
Concern about child getting another serious illness from vaccine
Don’t trust public health officials to provide correct info about vaccine safety
Don’t think child at risk for serious case
Concern about child getting H1N1 from vaccine
Don’t think vaccine would be effective
Child doesn’t like shots/injections
Getting vaccine would be too expensive
Plan on getting seasonal flu vaccine for child and believe will protect against H1N1 too
Healthcare provider told you not to get it for child
Too hard to get to location for vaccine
Child is less than 6 months old and cannot get vaccine
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

18. American Public Views: Safety of H1N1 vs. Seasonal Flu Vaccine
Very Safe Generally for Most People to Take
Very Safe for Children 6 Months to 2 Years to Take
Very Safe for Pregnant Women to Take
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

19. Parents’ Attitudes about What Would Make Them More or Less Likely to Get H1N1 Vaccine for Their Children
More likely
Makes no difference
Less likely
Vaccine contains small amount of mercury, aka thimerosal
Makes no difference
Less likely
More likely
Vaccine can be taken as a nasal spray rather than shot
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

20. Americans’ Trust in Groups Giving Advice about H1N1 Vaccine
% saying trust a great deal
Your personal doctor
Your child’s pediatrician
The Centers for Disease Control (CDC)
The American Medical Association (AMA)
Friends or family members employed in the field of health care
The Surgeon General
The Department of Health and Human Services (HHS)
The Food and Drug Administration (FDA)
The Department of Homeland Security (DHS)
Websites from other health organizations, like WebMD
Harvard Opinion Research Program, Harvard School of Public Health, September 14-20, 2009.

21. Public Support for Government’s Swine Flu Policy
October 19761
March 19772
1 Roper Organization poll, October Harris poll, March 1977.