Explaining science-led policy-making: pandemic deaths, epistemic deliberation and ideational trajectories

What logics steer policy-making when science really leads? Answering this question is a core question for contemporary policy improvement doctrines such as innovative governance, evidence-based policy and experimental governance. In particular, the paper reviews two ideal-type logics of the impact of new information on policy, based on epistemic community, policy learning, neoinstitutional and philosophy of science literature. One logic emphasizes shared epistemic community where uncertainty creates differences in expert judgments, but accruing information pushes toward consensus. The alternative logic emphasizes nationally established ideas that place policies on trajectories, where countervailing new information is ignored until overwhelming, and polities stay different. It then assesses these logics for their ability to explain an empirical puzzle from real-world science-led policy-making: the actual impact of developing pandemic influenza mortality information on 2009 H1N1 flu vaccination policies in three most-similar polities—the Netherlands, Sweden and Denmark. The comparative case studies employ in-depth interviews with each country’s leading government-appointed experts and archival evidence, in addition to national statistics. The evidence best supports the second, ideational trajectories logic. In face of the same growing certainty about low 2009 H1N1 mortality, Dutch policy shifted from general mass to targeted vaccination, Swedish policy remained general mass vaccination, and Danish policy remained targeted vaccination. In addition, looking closely at the Dutch policy shift reveals it to have been a switch from national pandemic to seasonal flu response trajectories, rather than a skip from ‘Swedish’ to ‘Danish’ style policy.