title: Will first-responders show up for work during a pandemic? Lessons from a smallpox vaccination survey of paramedics.
abstract: BACKGROUND
  The presence of H5N1 influenza in Southeast Asia has reawakened fears of a worldwide influenza pandemic of the sort that occurred in 1918. It is estimated that up to 1.9 million people in the United States could die if such an outbreak occurs. It is unlikely that a vaccine for a pandemic strain will be available quickly enough to protect first-responders. Similar concerns existed in 2002 when the United States attempted to vaccinate first-responders against smallpox, a potential biologic weapon.
  
  
  METHODS
  We conducted a survey of one group of first-responders, paramedics, to determine if fear of infection would compromise their ability to care for persons potentially infected with smallpox.
  
  
  RESULTS
  Three hundred paramedics were given the survey, and 95 (32%) responded. More than 80% of paramedics polled would not remain on duty if there were no vaccine and no protective gear. Even if protective gear was available but the vaccine was unavailable, only 39% of respondents would remain on duty. Finally, although 91% of paramedics would remain on duty if they were fully protected, this number falls to 38% if the respondent believed that his or her immediate family was not protected. The results of this survey are relevant to current concerns about an influenza pandemic. Every effort must be made to protect first-responders from pandemic influenza and educate them about it.
authors.affiliation: Ann Arbor Hematology Associates PC, Ann Arbor, MI 48105, USA.
authors.forename: Niklas
authors.initials: N
authors.lastname: Mackler
authors.forename: William
authors.initials: W
authors.lastname: Wilkerson
authors.forename: Sandro
authors.initials: S
authors.lastname: Cinti
mesh_terms: D000041:Absenteeism; D000328:Adult; D001291:Attitude of Health Personnel; D023482:Bioterrorism / Q000517:prevention & control / Q000706:statistics & numerical data; D004189:Disaster Planning / Q000458:organization & administration; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D004634:Emergency Medical Technicians / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D005190:Family; D005239:Fear; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D017053:Infection Control; D053124:Influenza A Virus, H5N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D032541:Mass Vaccination / Q000523:psychology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D016272:Occupational Health; D011481:Protective Clothing; D012899:Smallpox / Q000453:epidemiology / Q000517:prevention & control*; D012900:Smallpox Vaccine; D011795:Surveys and Questionnaires
chemical_list: D012900:Smallpox Vaccine