Crisis Communication Related to Vaccine Safety: Technical Guidance

"All good responses to a crisis begin with good preparation."

Vaccine- and vaccination-related crises require a communication response that is different from the communication strategies used to promote the benefits and importance of vaccines in general. Intended for relevant managerial-level actors in the areas of immunisation and vaccine and vaccination safety, this document from the Pan-American Health Organization (PAHO) presents technical guidance for developing a communication plan that is appropriate for managing crises related to vaccine safety. It may also be useful for preparedness and response teams working in safety crises to optimise their communication plans in order to regain, maintain, or strengthen trust in vaccines, vaccination, and immunisation programmes.

Each chapter corresponds to each of the three phases of the communication response and suggests actions and support tools to prepare, implement, and evaluate this response. Links to related resources are provided throughout.

1. Preparation phase: What to do before a crisis: This phase is not an isolated event but, rather, an ongoing process that nourishes the relationships with all relevant actors, keeps the public informed, monitors the media and social media, and regularly updates the crisis communication plan. The main objective of the preparation phase is to carry out ongoing communication activities to develop and maintain confidence in vaccines, vaccination, and the authorities. During this phase, it is necessary to implement ongoing communication efforts to raise awareness and communicate knowledge about the risks of diseases and the benefits of immunisation. Populations that are resilient and well-informed about vaccination are less likely to be affected by vaccine- and vaccination-related fears, disinformation, and rumours. Steps include:
   • Get to know the evidence
     • Determinants of communication about vaccine safety
     • Monitoring perceptions about vaccine safety
   • Work with key actors
   • Establish coordination mechanisms
     • Train personnel
     • Prepare the messages
     • Understand the media
   • Inform the public and build resiliency to address vaccine-related concerns
   • Event monitoring and evaluation
     • Understand the event
     • Classify the event
     • Identify and design a communication response
     • Indicators to measure the development of the communications plan
2. Implementation phase: How to respond to a crisis - The response provided during the first hours and days of a crisis is fundamental and defines the development and final impact that a crisis can have on the population's trust in vaccines. In the initial phase, it is fundamental to maintain a high level of transparency in internal communications (working group) and external communications (with the public). Although not all information is available at this time, it is important to communicate what is known and what actions have been undertaken to obtain more information on the event. Showing transparency demonstrates health authorities' professionalism and dedication and helps to maintain the public's trust in the immunisation programme. Steps include:
   • Coordinate and commit
     • Bring together the response group
     • Share the information among the response group
   • Create the response and implement the communication strategy
     • Identify the target audiences
     • Define communication goals
     • Adapt the messages
     • Select the media outlets
   • Share the information
     • Prepare the spokespeople
     • Inform the public
     • Communicate with the media
   • Monitor and continue the response
     • Monitor public opinion during a crisis
     • Monitor the media
     • Ongoing response
3. Evaluation phase: How to evaluate the response to a crisis - This phase aims to identify lessons learned, assess whether the initially identified targets and goals were met, and analyse which actions could be implemented to obtain better results in the future. To determine whether the objective of maintaining or strengthening trust in vaccines and vaccination was achieved, special attention should be paid to the following: coordination with the crisis response group and other key actors; elements related to transparency and communication with the public; understanding the perspectives of the public and target audiences; and selection and effectiveness of communication channels. During this phase, the preparation phase for a new potential crisis should be initiated, which means that all relevant actors should know their roles and continue monitoring public perceptions of vaccines. Steps include:
   • Evaluate
   • Share the lessons learned
   • Revise and strengthen the crisis communications plan

Annexes:

• Template to develop a crisis communication plan related to vaccine safety
• How to prepare a message map
• Recommendations for being a good spokesperson
• Strategies used by journalists
• Questions that journalists ask in a crisis

The document complements the Manual for the Surveillance of Events Supposedly Attributable to Vaccination or Immunisation (ESAVI) in the Region of the Americas. It was published within the framework of a joint project between PAHO, the World Health Organization Regional Office for Europe (WHO Europe), and the Centers for Disease Control and Prevention (CDC) that aims to promote communication related to safe vaccination in the Region of the Americas. Countries are invited to culturally and contextually adapt the contents when developing both a communication plan and adequate messages for each situation.

Click here for the 76-page document in English in PDF format.
Click here for the 78-page document in Spanish in PDF format.

Click here to download a 60-page PowerPoint presentation in PDF format from a February 18 2021 webinar about this resource (video available below), featuring slides by its authors.