Nearly 60% of public would want smallpox vaccination if available

Jun 11, 2002 (CIDRAP News) – Fifty-nine percent of respondents to a recent nationwide poll said they would get vaccinated against smallpox if they could, despite the risk of adverse reactions and the decades-old absence of the disease, according to the Harvard School of Public Health.

Though they were told that the vaccine can cause serious complications, 59% of the 2,000 people polled said they would get vaccinated as a precaution against a bioterrorist attack if the vaccine were made available, Harvard officials reported. The poll was conducted in May by Harvard and the Robert Wood Johnson Foundation.

More than three fourths (81%) of the respondents said they would get vaccinated if smallpox cases occurred in their own community. But 9% said they would not get vaccinated even in that situation, officials said.

Robert J. Blendon, professor of health policy and political analysis at the Harvard school, said the results raise the question whether front-line medical and emergency personnel should be vaccinated. "If there were a bioterrorist attack using smallpox, millions of Americans would want to find health professionals to vaccinate them," he said. "If the professionals themselves have not been vaccinated, it could lead to serious delays and public panic."

The results were announced last week, on the eve of a series of public forums on smallpox vaccination policy. Committees of immunization experts who advise the Centers for Disease Control and Prevention (CDC) are expected to make recommendations on smallpox vaccination to the CDC Jun 20.

Forty-three percent of those polled said they worry about a possible future attack involving smallpox, down from 53% in a poll conducted last November, according to the Harvard report. More women than men—49% versus 36%—voiced that concern. Only 8% of respondents thought they or someone in their family would contract smallpox in the next year, whereas 20% believed they or a family member would likely be injured in some other type of terrorist attack in the next year.

The poll included questions about people's confidence in the public health system. A strong majority—84%—reported confidence that their own doctor could recognize smallpox, and 70% felt that their local hospital emergency department is prepared to diagnose and treat people who have the disease. Similarly, 66% were confident that their local health department is prepared to contain a smallpox outbreak, though only 19% classified the department as "very prepared."

The survey indicated there is no one person whom a majority of the public trusts on smallpox issues. When people were asked which of six officials they would trust most to provide correct information about smallpox in case of an outbreak, 43% said a senior scientist from the Centers for Disease Control and Prevention (CDC). No other official was chosen by more than 16%. The other choices were the heads of the Department of Health and Human Services, the Office of Homeland Security, and the FBI, plus the US surgeon general and the city or state health commissioner.

Public knowledge about smallpox is uneven, the poll indicates. Eighty-five percent of those questioned knew that smallpox is contagious, and 90% knew that smallpox patients should be isolated. However, only 43% knew that if a person is exposed to smallpox but does not have symptoms, vaccination may prevent the disease. Only 32% knew that there is no cure for smallpox once symptoms appear.

"This is the central issue for public health education," said Blendon. "Americans need to know that according to experts, if people are exposed to smallpox but do not yet have symptoms, an immediate vaccination will help protect them against the disease."

Some Americans believe there would be cases of discrimination if smallpox reappeared. Twenty-eight percent expressed the view that if they had smallpox, their local hospital would probably refuse them treatment in order to protect others at the hospital. Also, 12% of respondents, including 28% of African-Americans, think African-Americans would face discrimination from health professionals in that situation.

The poll also included some questions unrelated to smallpox. One finding was an increase in the share of respondents reporting that they or someone in their family has obtained a precription for antibiotics because of concern about bioterrorism—from 5% in October 2001 to 15% currently.

The survey was the third in a series by the Harvard School of Public Health/Robert Wood Johnson Foundation Survey Project on Americans' Response to Bioterrorism. The poll involved a nationally representative sample of people aged 18 and older; the margin of sampling error was 2.7 percentage points, officials said.

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