Open AccessDifferential Willingness to Undergo Smallpox Vaccination Among African‐American and White Individuals
Author(s) -
Micco Ellyn,
Gurmankin Andrea D.,
Armstrong Katrina
Publication year - 2004
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2004.30067.x
Subject(s) - medicine , vaccination , context (archaeology) , demography , odds ratio , confidence interval , willingness to pay , ethnic group , gerontology , environmental health , immunology , sociology , paleontology , anthropology , economics , biology , microeconomics
OBJECTIVE: To examine potential disparities in willingness to be vaccinated against smallpox among different U.S. racial/ethnic groups. DESIGN: Cross‐sectional survey using an experimental design to assess willingness to be vaccinated among African Americans compared to whites according to 2 strategies: a post‐exposure “ring vaccination” method and a pre‐exposure national vaccination program. SETTING: Philadelphia County district courthouse. PARTICIPANTS: Individuals awaiting jury duty. MEASUREMENTS: We included 2 scenarios representing these strategies in 2 otherwise identical questionnaires and randomly assigned them to participants. We compared responses by African Americans and whites. MAIN RESULTS: In the pre‐exposure scenario, 66% of 190 participants were willing to get vaccinated against smallpox. In contrast, 84% of 200 participants were willing to get vaccinated in the post‐exposure scenario ( P = .0001). African Americans were less willing than whites to get vaccinated in the pre‐exposure scenario (54% vs 77%; P = .004), but not in the post‐exposure scenario (84% vs 88%; P = .56). In multivariate analyses, overall willingness to undergo vaccination was associated with vaccination strategy (odds ratio, 3.29; 95% confidence interval, 1.8 to 6.1). CONCLUSIONS: Racial disparity in willingness to get vaccinated varies by the characteristics of the vaccination program. Overall willingness was highest in the context of a post‐exposure scenario. These results highlight the importance of considering social issues when constructing bioterror attack response plans that adequately address the needs of all of society's members.