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Published at www.nejm.org December 19, 2002 (10.1056/NEJMsa023184)

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ABSTRACT

Background The potential for a bioterrorist attack involving smallpox has led to a debate about what national precautions should be taken. What is unclear is the public's knowledge of smallpox and views about precautions.

Methods We conducted a national survey of 1006 adults selected by means of random-digit dialing. Respondents were asked about their knowledge of and beliefs about the smallpox virus and the vaccine, their possible reactions to a bioterrorist attack involving smallpox, and a number of proposed state emergency powers.

Results The majority of the respondents have a number of beliefs about smallpox and smallpox vaccination that are false. The majority believe that there is an effective treatment for smallpox, that there have been cases of smallpox in the past five years, and that there is not enough smallpox vaccine to vaccinate everyone in the United States. Thirty percent believe that vaccination earlier in their lives would protect them from the disease. The majority of respondents said they wanted to be vaccinated; however, only 21 percent would want to be vaccinated if physicians declined vaccination. There was strong support among the respondents for several proposed state emergency powers.

Conclusions Our results suggest the need for public education about smallpox. These data also point to the importance of a discussion in the medical community about the advisability of vaccination of individual physicians at this time.

Notice: To help to inform the current national debate about smallpox vaccination, this article has been published early (on December 19, 2002). The article will appear in the January 30, 2003, issue of the Journal.

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