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Tuesday, March 22, 2005

Programmatic Factors Related to Uptake of Smallpox Vaccine among Healthcare Workers

Megan C. Lindley1, Pascale Wortley1, and Ben Schwartz2. (1) Health Services Research & Evaluation Branch, National Immunization Program, CDC, 1600 Clifton Road NE, MS E-52, Atlanta, GA, USA, (2) NIP, ESD, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA, USA

Despite significant government support and reportedly high willingness to be vaccinated, uptake of smallpox vaccine by healthcare workers during the national smallpox vaccination initiative was low. Characteristics of program implementation, in addition to individual attitudes and beliefs, may have impacted rates.

To examine characteristics of smallpox vaccination programs in a sample of hospitals and health departments and their effect on uptake of vaccine by healthcare workers at those sites.

Coordinators of smallpox vaccination programs in a convenience sample of 113 hospitals and health departments in five states were surveyed by e-mail from March-August 2004. Response rate was 94%. Respondents reported program characteristics related to planning, recruitment and implementation. Vaccination rates were calculated using reported numbers of vaccinees and invitees.

Vaccination rates ranged from 0%-83% (median: 15%). Factors strongly associated with rates at or above the median in preliminary significance tests, and which remained significant in multivariable analysis, include the site being a health department vs. a hospital (68% vs. 35% had a vaccination rate above or equal to the median), and inviting fewer persons (<75) to be vaccinated (61% vs. 40%). Policies pertaining to compensation for vaccine adverse events, liability insurance, and job reassignment following vaccination, as well as clinician involvement in planning and how actively staff was recruited were not associated with higher vaccination rates.

Participation rates were higher among health departments than hospitals. Scope of invitation was an important factor relating to uptake of smallpox vaccine, while policies surrounding the initiative did not affect uptake. This information may be useful for future mass vaccination programs and bioterrorism preparedness efforts.

Participants will be able to describe program characteristics associated with smallpox vaccine uptake in this sample.

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