Crying wolf? Impact of the H1N1 2009 influenza pandemic on anticipated public response to a future pandemic

Objective: To determine changes in public threat perception and anticipated compliance with health-protective behaviours in response to a future pandemic; using data collected before and after the H1N1 2009 influenza pandemic. Design, setting and participants: Repeat cross-sectional computer-assisted telephone surveys with representative samples of the general New South Wales population in 2007 (2081 participants) and 2010 (2038 participants). Main outcome measures: Perceived likelihood of a future pandemic in Australia; concern that respondents or their families would be affected; degree of change made to life because of the possibility of a pandemic; and willingness to comply with health-protective behaviours (to be vaccinated, to be isolated if necessary, and to wear a face mask). Results: In 2007, 14.9% of the general population considered that an influenza pandemic would be highly likely to occur in future; this proportion rose to 42.8% in 2010 (odds ratio [OR], 4.96; 95% CI, 3.99-6.16; P<0.001). Conversely, in the same period concern that respondents or their families would be directly affected by a future pandemic dropped from 45.5% to 32.5% (OR, 0.57; 95% CI, 0.44-0.74; P<0.001). Willingness to be vaccinated against influenza in a future pandemic decreased from 75.4% to 64.6% (OR, 0.69; 95% CI, 0.55-0.86; P<0.001). A general decrease in willingness to be vaccinated was noted across all age groups, most notably for those aged 35-44 years. Conclusions: Data collected before and after the H1N1 2009 influenza pandemic indicated significant shifts in public threat perception and anticipated response to a future pandemic. The H1N1 2009 pandemic has altered public perceptions of the probability of a pandemic in the future, but has left the public feeling less vulnerable. Shifts in perception have the potential to reduce future public compliance with health-protective measures, including critical elements of the public health response, such as vaccination.