Correlates of public health workforce acceptance of smallpox immunization in Virginia.
OBJECTIVE
By October 24, 2003, 38,577 of 500,000 targeted civilians received smallpox vaccine in the Pre-Event Smallpox Vaccination Campaign, Phase I. We investigated reasons for the low vaccination uptake.


METHODS
Cross-sectional survey, conducted in May 2004.


METHODS
We surveyed 225 health care personnel, potential members of smallpox response teams in Virginia, who were offered vaccination. We assessed respondents' acceptance of vaccination and its association with factors potentially influencing vaccination: perceptions of vaccine safety, contraindications, concerns about bioterrorism, and workplace influences.


RESULTS
Among nonvaccinees (n=44), 70% had a contraindication to the vaccine compared with 8% among vaccinees (n=132). The desire to prepare America for potential bioterrorist attack was associated with acceptance of smallpox vaccination (odds ratio [OR]: 17.7, 95% confidence interval [CI]: 3.6-85.9). Among respondents with contraindications, vaccinees reported more often than nonvaccinees having been asked by their supervisors to be vaccinated (OR: 5; 95% CI: 1.1-22.1) and to have been concerned that their vaccination choice would affect positively their job evaluation (OR: 11; 95% CI: 1.6-81.1).


CONCLUSIONS
Concerns about bioterrorism and willingness to help in the preparedness effort were motivations for vaccination. Continued vigilance to avoid vaccination of those with contraindications is needed.
Bryant-Genevier
Marthe
M
CBER/OBE/DE/Vaccine Safety Branch, Food and Drug Administration, Rockville, Maryland 20852-1448, USA. marthe.bryant-genevier@fda.hhs.gov
Sommer
Sandra
S
McMahon
Ann
A
Ball
Robert
R
Braun
M Miles
MM
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D023482:Bioterrorism; D003430:Cross-Sectional Studies; D004189:Disaster Planning; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D012899:Smallpox / Q000517:prevention & control*; D014768:Virginia