MAPPING PERCEPTIONS RELATED TO ACCEPTANCE OF SMALLPOX VACCINATION BY HOSPITAL EMERGENCY ROOM PERSONNEL

Emergency department personnel would be first responders in the event of a bioterror smallpox outbreak, yet few were willing to be vaccinated during the 2002 federal campaign. To better understand vaccination concerns, perceptual map-ping methods were used to create multidimensional models of how emergency department personnel (N 73) in the Philadelphia area perceive the risks and benefits of smallpox vaccination under 4 levels of threat: (1) today; (2) if another terrorist attack happened anywhere in the U.S.; (3) if a smallpox attack happened somewhere in the U.S.; (4) if a smallpox attack happened locally. The perceptual maps show significant shifts in factors that are important for motivating respon-dents to accept vaccination under increasingly higher levels of threat. In the “today ” scenario, endorsement of vaccination from a credible source, such as a major hospital in the area, was a very important factor (mean 7.10 on a 0-10 scale). However, endorsement was not as important under the 2 higher levels of threat. Under these conditions, respondents’ sense of wanting to help in a disaster emerged as an important element the closer the hypothetical attack was to the re-spondent, ranging in importance from 3.87 under the least threat to 7.35 under the greatest threat scenario. The percep-tual maps yield information that would assist planners in designing more effective risk communication strategies tailored to particular audiences and levels of threat. Such communications are important to prepare for a smallpox event or other uncertain outbreak, where it is essential to rapidly vaccinate a critical mass of healthcare workers. 17