Institutional members access full text with Ovid®

Preevent vaccination against smallpox: a survey of pediatric emergency health care providers

EVERETT, WORTH W. MD; ZAOUTIS, THEOKLIS L. MD; HALPERN, SCOTT D. MD, PHD; STROM, BRIAN L. MD, MPH; COFFIN, SUSAN E. MD, MPH

Pediatric Infectious Disease Journal: April 2004 - Volume 23 - Issue 4 - pp 332-337
Original Studies

Background. In January 2003, smallpox vaccinations were offered to health care workers to create hospital-based teams prepared to care for patients with smallpox as part of national bioterrorism preparedness activities.

Methods. An anonymous survey of pediatric emergency health care workers was conducted in November and December 2002. Two mailings were sent to physicians, nurses and ancillary staff at five academic pediatric emergency departments in major US cities. We assessed the willingness to receive preevent smallpox vaccine. In addition we measured the prevalence of vaccine contraindications, perceived likelihoods of a local smallpox outbreak or a vaccine-related adverse event and reasons for or against wanting to receive the vaccine.

Results. Overall 72% of respondents were willing to receive the smallpox vaccine. Individuals who were willing to receive the smallpox vaccine, compared with those not willing, believed a local outbreak was more likely to occur (odds ratio, 1.29; 95% confidence interval, 1.16 to 1.44). One-fifth of respondents reported a contraindication to smallpox vaccine; however, more than half indicated they would still be willing to receive vaccine. Individuals who perceived themselves at high risk for vaccine-related adverse events were less willing to receive the preevent smallpox vaccine. Self-protection was the most common reason cited for wanting to receive the vaccine.

Conclusions. A majority of pediatric healthcare workers were willing to receive preevent smallpox vaccine before the onset of Phase I of the CDC Smallpox Vaccination Program. A greater understanding of the knowledge, attitudes and beliefs of pediatric health care workers toward preevent smallpox vaccination will assist in the development of future bioterrorism preparedness programs.

From the Departments of Emergency Medicine (WWE) and Medicine (SDH, BLS), Hospital of the University of Pennsylvania, Centers for Clinical Epidemiology and Biostatistics (WWE, TLZ, SDH, BLS, SEC) and Education and Research on Therapeutics (WWE, TLZ, SDH, BLS), University of Pennsylvania, and the Division of Infectious Diseases, Department of Pediatrics (TLZ, SEC) and Stokes Research Institute, Children’s Hospital of Philadelphia (SEC), Philadelphia, PA.

Portions of these data were presented to the Institute of Medicine Committee on Smallpox Vaccination Program Implementation in Washington, DC on December 19, 2002, and as a poster abstract at the 2003 Pediatric Academic Society meeting. 21

Address for reprints: Susan E. Coffin, M.D., M.P.H., ARC 1202, Children’s Hospital of Philadelphia, 3651 Civic Center Blvd., Philadelphia, PA 19104. Fax 215-590-2025; E-mail coffin@email.chop.edu.

Accepted for publication Dec. 11, 2003.

© 2004 Lippincott Williams & Wilkins, Inc.