title: Smallpox vaccination: a national survey of emergency health care providers.
abstract: Concerns about bioterrorism have prompted a national voluntary smallpox (SP) vaccination program in the United States. Although emergency health care providers are among the first targeted for vaccination, little is known about how these providers view the risks and benefits of SP vaccination.
  
  
  OBJECTIVE
  To assess the willingness of emergency health care personnel to receive pre-event SP vaccination prior to the start of the national program.
  
  
  METHODS
  The authors conducted a national cross-sectional, anonymous survey of 1,701 emergency physicians, nurses, and mid-level practitioners working full time in 13 adult and pediatric academic emergency departments in large U.S. cities in November and December 2002. The main outcome measure was willingness to be vaccinated against SP. Secondary outcomes included the prevalence of self-reported contraindications, and reasons for and against vaccination.
  
  
  RESULTS
  732 emergency health care providers returned questionnaires (response rate 43%). Overall, 73% (95% CI = 66% to 80%) were willing to receive pre-event SP vaccination. 18% (95% CI = 14% to 23%) reported contraindications to vaccination, and 50% (95% CI = 39% to 61%) of these providers were willing to receive pre-event SP vaccination. Self-protection (72%) was the most common reason cited for desiring vaccination against SP; concern about vaccine-related adverse events (54%) was the most common reason cited for not wanting immunization.
  
  
  CONCLUSIONS
  Most emergency health care providers express a willingness to receive pre-event SP immunization; self-protection is a principal motivating reason. A subset of health care providers, however, may place themselves at increased risk by desiring vaccination despite contraindications.
authors.affiliation: Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104, USA. worth.everett@uphs.upenn.edu
authors.forename: Worth W
authors.initials: WW
authors.lastname: Everett
authors.forename: Susan E
authors.initials: SE
authors.lastname: Coffin
authors.forename: Theoklis
authors.initials: T
authors.lastname: Zaoutis
authors.forename: Scott D
authors.initials: SD
authors.lastname: Halpern
authors.forename: Brian L
authors.initials: BL
authors.lastname: Strom
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001291:Attitude of Health Personnel; D023482:Bioterrorism / Q000517:prevention & control; D000075202:Contraindications; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012899:Smallpox / Q000517:prevention & control*; D012900:Smallpox Vaccine / Q000627:therapeutic use*; D014481:United States
chemical_list: D012900:Smallpox Vaccine