title: Differential willingness to undergo smallpox vaccination among African-American and white individuals.
abstract: OBJECTIVE
  To examine potential disparities in willingness to be vaccinated against smallpox among different U.S. racial/ethnic groups.
  
  
  METHODS
  Cross-sectional survey using an experimental design to assess willingness to be vaccinated among African Americans compared to whites according to 2 strategies: a post-exposure "ring vaccination" method and a pre-exposure national vaccination program.
  
  
  METHODS
  Philadelphia County district courthouse.
  
  
  METHODS
  Individuals awaiting jury duty.
  
  
  METHODS
  We included 2 scenarios representing these strategies in 2 otherwise identical questionnaires and randomly assigned them to participants. We compared responses by African Americans and whites.
  
  
  RESULTS
  In the pre-exposure scenario, 66% of 190 participants were willing to get vaccinated against smallpox. In contrast, 84% of 200 participants were willing to get vaccinated in the post-exposure scenario (P =.0001). African Americans were less willing than whites to get vaccinated in the pre-exposure scenario (54% vs 77%; P =.004), but not in the post-exposure scenario (84% vs 88%; P =.56). In multivariate analyses, overall willingness to undergo vaccination was associated with vaccination strategy (odds ratio, 3.29; 95% confidence interval, 1.8 to 6.1).
  
  
  CONCLUSIONS
  Racial disparity in willingness to get vaccinated varies by the characteristics of the vaccination program. Overall willingness was highest in the context of a post-exposure scenario. These results highlight the importance of considering social issues when constructing bioterror attack response plans that adequately address the needs of all of society's members.
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. ellyn@mail.med.upenn.edu
authors.forename: Ellyn
authors.initials: E
authors.lastname: Micco
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Gurmankin
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001294:Attitude to Health / Q000208:ethnology*; D023482:Bioterrorism; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D012899:Smallpox / Q000517:prevention & control*; D012900:Smallpox Vaccine / Q000008:administration & dosage* / Q000627:therapeutic use; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000523:psychology*
chemical_list: D012900:Smallpox Vaccine