Same Threat, Different Responses: Experts Steering Politicians and Stakeholders in 2009 H1n1 Vaccination Policy‐making

Why do similar countries facing the same threat respond differently? To throw light on this question, this article analyses Dutch and Danish vaccinations against the 2009 H1N1 ‘swine’ influenza pandemic (most‐similar cases with different outcomes). Policy‐making in the cases intersected the politics of crisis management (including risk management and disaster management), pharmaceuticals and epidemic response. Uncertainty and urgency were basic conditions and reduced the potential for evidence‐based policy. Public health specialists, elected leaders, and organizations in the economy and society contributed to each national response. Related literatures show that such decision‐making can turn on politicians' blame avoidance ( A1 ) or demonstrations of value to swing voters ( A2 ), stakeholders seeking gains (B), or experts following national standards (i.e. norms) for appropriate response (C). While each of these four logics is in evidence to some degree, differences in norms used by national experts advising their governments on pandemic responses best answer the question in the extant cases.