In January 2003, smallpox vaccinations were offered to health care workers to create hospital-based teams prepared to care for patients with smallpox as part of national bioterrorism preparedness activities. A 2002 survey of pediatric emergency health care workers (HCWs) in the weeks before the start of the national vaccination program found that 72 percent of those surveyed were willing to receive the smallpox vaccine. Researchers from the University of Pennsylvania and two Philadelphia hospitals sent the survey to physicians, nurses, and ancillary staff at five pediatric emergency departments in major U.S. cities. Their work was supported in part by the Agency for Healthcare Research and Quality (HS10399) through the Agency's Centers for Education and Research on Therapeutics (CERTs) program.
Pediatric emergency HCWs who were willing to receive the smallpox vaccine were 29 percent more likely than those who were unwilling to receive the vaccine to believe that a local smallpox outbreak was likely to occur in their city during the next 12 months. One-fifth of those surveyed reported a contraindication to smallpox vaccine. Nevertheless, more than half of them indicated they would still be willing to receive the vaccine. More than half of all HCWs surveyed reported concerns about vaccine-related adverse effects.
HCWs who perceived themselves at high risk for vaccine-related adverse events were 27 percent less willing to receive the pre-event smallpox vaccine. Self-protection was the most common reason cited for wanting to receive the vaccine, followed by protecting one's family. Thus, many pediatric HCWs were willing to receive pre-event smallpox vaccine, but they reported ambivalent or contradictory attitudes toward the vaccine. These inconsistent attitudes might have contributed to the unexpected poor participation in this program. Fewer than 10 percent of the targeted health care workers had been immunized (38,759 out of 440,000) as of October 31, 2003. The researchers call for further research to identify conflicting beliefs and gaps in knowledge so that educational interventions can be designed for targeted populations.
See "Pre-event vaccination against smallpox: A survey of pediatric emergency health care providers," by Worth W. Everett, M.D., Theoklis L. Zaoutis, M.D., Scott D. Halpern, M.D., Ph.D., and others, in the April 2004 Pediatric Infectious Disease Journal 23(4), pp. 332-337.
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