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Table 1 Windows of opportunity for policy change (mandatory vaccination of health care workers)

From: Mandating influenza vaccinations for health care workers: analysing opportunities for policy change using Kingdon’s agenda setting framework

  1999–2002 2006–2009 2010–2015
(perception there is a problem that needs to be acted addressed)
▪ ER overcrowding due to heavy flu season resulting in reduced access to care ▪ SARS (severe acute respiratory syndrome) outbreak
▪ H1N1 outbreak/pandemic
▪ Growing calls from experts for mandatory HCW immunization
(events promoting or inhibiting political action)
▪ Heightened media attention pressures government to act
▪ Court challenges in opposition to mandatory HCW vaccination
▪ Production delays, low vaccine supplies and rationing
▪ H1N1 outbreak turns out to be mild (loss of public interest)
▪ Evidence of cost-effectiveness of flu vaccination
▪ Other jurisdictions adopting mandatory policies for HCWs
(availability and feasibility of options)
▪ Wide availability of public vaccination programs ▪ Favorable arbitrator ruling on mandatory HCW vaccinations ▪ Favorable court rulings on mandatory HCW vaccinations