title: Emergency physicians' perspectives on smallpox vaccination.
abstract: 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.
authors.affiliation: Bellevue Hospital/NYU Medical Center, New York, NY, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kwon
authors.forename: Maria C
authors.initials: MC
authors.lastname: Raven
authors.forename: William K
authors.initials: WK
authors.lastname: Chiang
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Moran
authors.forename: Jon
authors.initials: J
authors.lastname: Jui
authors.forename: Richard A
authors.initials: RA
authors.lastname: Carter
authors.forename: Lewis
authors.initials: L
authors.lastname: Goldfrank
mesh_terms: 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
chemical_list: D012900:Smallpox Vaccine