Emergency physicians' perspectives on smallpox vaccination.
OBJECTIVE
To evaluate emergency physician (EP) attitudes toward smallpox vaccination, the treatment of patients with suspected smallpox, and the threat of a bioterrorist attack.


METHODS
This was a prospective study utilizing a standardized survey instrument that was distributed on November 16, 2002, and collected by February 1, 2003. EPs from a sample of 50 accredited emergency medicine programs were surveyed regarding their perspectives on smallpox vaccination.


RESULTS
A total of 989 surveys were collected from 42 emergency medicine programs. Of the respondents, 43.4% would currently volunteer for smallpox vaccination. EPs previously vaccinated against smallpox were 1.46 times more likely to volunteer for vaccination (95% CI = 1.14 to 1.93). EPs who believed they were at risk for complications were less than half as likely to volunteer for vaccination. EPs who perceived a significant risk of a bioterrorist attack were 2.7 times more likely to volunteer for the vaccine compared with those who thought the risk was minimal (95% CI = 2.06 to 3.47). Of the respondents, 34.4% believed the risks of the vaccination outweighed the benefits, 33% did not, and 32.6% were unsure.


CONCLUSIONS
Currently, fewer than half of EPs surveyed would volunteer for smallpox vaccination. Factors associated with a willingness to be vaccinated include previous smallpox vaccination and the perceived threat of a bioterrorist attack. The variation in EP attitudes toward smallpox vaccination may be due to uncertain risk-to-benefit ratio. The opinions and actions of EPs may be influential on current and future government policy and public opinion.
Kwon
Nancy
N
Bellevue Hospital/NYU Medical Center, New York, NY, USA.
Raven
Maria C
MC
Chiang
William K
WK
Moran
Gregory J
GJ
Jui
Jon
J
Carter
Richard A
RA
Goldfrank
Lewis
L
D000328:Adult; D001291:Attitude of Health Personnel; D023482:Bioterrorism / Q000517:prevention & control; D002983:Clinical Competence / Q000706:statistics & numerical data; D004635:Emergency Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016079:Refusal to Treat / Q000706:statistics & numerical data; D012899:Smallpox / Q000517:prevention & control*; D012900:Smallpox Vaccine / Q000627:therapeutic use*; D014481:United States
D012900:Smallpox Vaccine