Skip to main content

Table 1 Representative participant quotes organized in sub-themes and themes

From: Unintended consequences of communicating rapid COVID-19 vaccine policy changes– a qualitative study of health policy communication in Ontario, Canada

Theme/Sub theme

Representative Quotes

Participant

Successive policy changes complicate

Erratic changes

Sometimes there were some last minute changes that made it challenging. All of a sudden we’re going to make some changes. I didn’t feel there was enough lead time for people to adjust

Non-profit social care enterprise manager

Communicating policy, that's something we struggled with all the time. People need time to prepare. The information is so quick that two or three days after an announcement or NACI comes out with a recommendation almost feels like it's too late so we try to keep up with that in terms of relevance. You have to be constantly evaluating your policy and how you're communicating it. The environment changes very quickly around you

Professional body advocate

When you try and do them all in rapid sequence you've got complexity of what's out of date? How quickly will we able to change online resource? We’re beginning to be out of date and the complexity was because each thing had so much volume. Pivoting to the next one was made more complex because it was almost like you had to unpick the last policy decision. That was the complexity

Director of communication

Disconnect with frontline communication

Even giving a 24 h or 48 h gap in between a change in policy and communication to the public would be very helpful, and it would really help to improve the trust that people have. Then they wouldn't be encountering those situations where policy has changed, but the actual professionals who are responsible for administering that policy don't know about the change

Pharmacy manager

They should have said the vaccine is 95% effective for at least two months. Instead the narrative was so narrow it didn’t allow for the changing reality

Rural community outreach worker

What the public sees is that I’m confused. The messaging changes. Also the consistency with which you are able to deliver on some of those messages is challenging

Urban pharmacist

Information would change rapidly so it became very challenging to have updated information for everybody. Helping them communicate accurately to the community was an exercise in frustration

Non-profit social care organization director

Policy change fuels misunderstanding

Confusion over changes

We come out with one of the first statements from any health professional group to say that we were disappointed with the messaging about changing AZ vaccine policy. Not necessarily disappointed with the science, but the way they had framed it. It was damaging and unclear and caused confusion and caused unnecessary panic

Professional body advocate (Federal)

Initially, priority groups, as to who qualified to get the vaccine, was super confusing. It changes, it’s just never been concrete. It's just confusing

Physician

There are of course going to be those who are really confused and concerned because the news may be different to what we're saying, but it's simply because those students, those patients are not up to date with the most [recent] NACI guidelines or whatnot or Health Canada's recommendation

Nurse practitioner

Emotional discourse

The time between vaccines changed, people were like ‘Why?’ Why are you coming out telling us very strongly this is the vaccine sequence and now you changed it. What am I supposed to believe? Do you actually know what you're doing?

Non-profit social care enterprise manager

Trying to tell people that they had to get one Astra Zeneca and then an mRNA or the mixed mRNA [vaccines]. That was that was brutal. It was so frustrating because people were so against it. I don't know what they were believing. They were just thinking that we were going to try and kill them

Nurse practitioner

The mixed dose regimens and keeping people from travel; change is another thing that has caused a lot of people angst

Vaccine clinic manager

Unintended negative consequences

Complicated implementation

It would be nice to have had a heads up on things prior to press releases. Oh my God, that would have helped us a lot

Community pharmacist

Eligibility criteria were slightly different from province to province. The vaccines were rolled out in pharmacies at different rates in different provinces

Professional body advocate (Federal)

The way the province regulates intervals for the indigenous community was they had urban indigenous and rural Indigenous. They changed the dose interval at one point just for urban Indigenous. Three weeks later, the provincial guidance changed so we had to rework all of our clinics

Vaccine clinic team lead

I would tell you that the vaccine rollout has been challenging because the rules keep changing. It's been that way from the start. Most of that has come down from our provincial government around who is eligible and who can get the vaccine [and] when have been very hard to enact. We never get enough notice so that we can't plan. There's no planning in this and it's incredibly confusing for the general population

Vaccine clinic manager

The poor people, they're probably scrambling to get all this together so that by Monday morning we've got what we need to tell us the new parameters. Another thing was when you get your booster shots, so the change in duration between shots. That policy keeps like flipping out and changing

Rural community pharmacist

When guidance gets announced there’s a catch up. We don't have enough time to plan and to make sure that we are really ready to go when these policy announcements happen…It became chaotic

Professional body advocate (Provincial)

Vaccine passports, how those policies [worked], that was one of the most nerve-wracking times for our team about clarity. That’s a whole thing we continue to navigate

Non-profit social care organisation director

Growing resentment

A lot of people have questions about the vaccine where they feel like they’ve been lied to. It’s because the reality shifted and the communication didn’t shift in lockstep with it. It took a while for communication to catch up and during that period a lot of cracks emerged and people lost trust with a lot of policy in general

Rural community outreach worker

I think when everything is so up in the air, the one thing that we really need is consistent messaging and if NACI, is saying one thing, and healthcare is saying another and then Ontario does its own thing, I think that's going to cause people a lot of confusion and a distrust towards the system as a whole. Waiting for information to filter down is extraordinarily infuriating

Nurse practitioner

Policy communication? Confusion frustration yeah, eventual lack of trust, inconsistency, constantly changing these are more terms, but these are things that I feel like we were hearing from people coming to us, yeah

Public health worker