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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
Problems (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
Politics (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
Policies (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