title: Risk communication during the 2009 influenza A (H1N1) pandemic: stakeholder experiences from eight European countries.
abstract: OBJECTIVE
  We aimed to assess professional stakeholders' perceptions of the risk-communication difficulties faced during the 2009 influenza A (H1N1) pandemic in Europe.
  
  
  METHODS
  Semi-structured interviews were conducted with experts involved in the management of the 2009 swine flu pandemic from different European countries. The interviews were recorded, transcribed, and coded.
  
  
  RESULTS
  A total of 25 experts from 8 European countries were interviewed: 9 from the micro-level, 10 from the meso-level, and 6 from the macro-level of employment. The interviews revealed 3 main themes: vaccine issues, communication issues, and general problems. As reasons for the low vaccination coverage, stakeholders mentioned the late arrival of the vaccines, the moderate character of the pandemic, vaccine safety concerns, and a general skepticism toward vaccination. Communication needs varied between the different levels of employment: macro- and meso-level stakeholders preferred fast information but from multiple sources; the micro-level stakeholders preferred one credible source. Throughout Europe, collaboration with the media was perceived as poor and professionals felt misunderstood.
  
  
  CONCLUSIONS
  Professional stakeholders should be enabled to access reliable information rapidly through preestablished channels; emphasis should be placed on establishing sustainable cooperations between experts and the media; and measures to improve trust in health authorities, such as the transparent communication of uncertainties, should be encouraged.
authors.affiliation: Department of Life Sciences,HAW Hamburg,Hamburg,Germany.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Cloes
authors.affiliation: Department of Life Sciences,HAW Hamburg,Hamburg,Germany.
authors.forename: Amena
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of Life Sciences,HAW Hamburg,Hamburg,Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Reintjes
mesh_terms: D003142:Communication; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D032541:Mass Vaccination / Q000379:methods / Q000706:statistics & numerical data*; D058873:Pandemics; D012308:Risk Management / Q000379:methods*
keywords: human