Longitudinal investigation of public trust in institutions relative to the 2009 H1N1 pandemic in Switzerland

PLoS One. 2012;7(11):e49806. doi: 10.1371/journal.pone.0049806. Epub 2012 Nov 21.


Background: The 2009 H1N1 pandemic left a legacy of mistrust in the public relative to how outbreaks of emerging infectious diseases are managed. To prepare for future outbreaks, it is crucial to explore the phenomenon of public trust in the institutions responsible for managing disease outbreaks. We investigated the evolution of public trust in institutions during and after the 2009 pandemic in Switzerland. We also explored respondents' perceptions of the prevention campaign and the roles of the government and media.

Methodology/principal findings: A two-wave longitudinal survey was mailed to 2,400 members of the Swiss public. Wave 1 was in Spring 2009. Wave 2 was in Spring 2010. Six hundred and two participants responded in both waves. Participants indicated moderate to high levels of trust in medical organizations, the WHO, the Swiss government, the pharmaceutical industry, and the EU. On the other hand, trust in the media was low. Moreover, trust in almost all institutions decreased over time. Participants were satisfied with the amount of information received and indicated having followed official recommendations, but widespread concerns about the vaccine were evident. A large majority of participants agreed the vaccine might have unknown or undesirable side effects. Perceptions of the government's and the media's role in handling the outbreak were characterized by a substantial degree of skepticism and mistrust.

Conclusions/significance: Results show clear patterns of skepticism and mistrust on the part of the public relative to various institutions and their actions. Results underscore the importance of systematically investigating trust of the public relative to epidemics. Moreover, studies investigating the evolution of the public's memories of the pandemic over the coming years may be important to understand reactions to future pandemics. A systematic research program on trust can inform public health communication campaigns, enabling tailored communication initiatives.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Health
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype / pathogenicity
  • Influenza, Human* / epidemiology
  • Influenza, Human* / prevention & control
  • Influenza, Human* / virology
  • Longitudinal Studies
  • Male
  • Pandemics*
  • Public Opinion*
  • Switzerland
  • Trust*

Grants and funding

Research was supported by grants from the Swiss National Science Foundation ((100014_132023/1 and 100014_122366/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.