BACKGROUND:
Future smallpox biopreparedness activities may need to include primary care physicians to ensure sufficient capacity for vaccinating all interested individuals.

OBJECTIVE:
To determine the willingness of internists and family physicians to participate in smallpox pre-event vaccination efforts, including vaccinating first responders and/or the general public, and evaluating vaccinees with suspected adverse events.

METHOD:
Mail survey of randomly selected office-based general medicine internists (n= 727) and family physicians (n=720) between May and August 2003.

RESULT:
Overall response rate was 28% (24% internists, 32% family physicians). In the absence of a smallpox outbreak, 51% were not willing to offer vaccination to interested patients within their practice. However, 72% of physicians were willing to participate in vaccination to some extent, including vaccination in their practice of first responders (58%) or of interested members of the community (27%), or vaccination in a public health clinic (26%). Most physicians (66%) were somewhat or very willing to evaluate their patients who may have mild to moderate reactions to vaccinations. Willingness to vaccinate or evaluate those who with suspected adverse events did not vary by physician type or previous smallpox vaccination. Most physicians (56%) thought smallpox vaccination of the general public is a shared responsibility of the medical and public health communities.

CONCLUSION:
There is at least moderate support among these physicians for participating in smallpox pre-event vaccination efforts. Future studies will be needed to determine whether such support is adequate.

LEARNING OBJECTIVES:
To understand the willingness of primary care physicians to assist with smallpox biopreparedness activities.