US disaster planners' attitudes regarding preevent vaccine for first responders and point-of-dispensing workers

Disaster planners' attitudes toward pre-event anthrax and smallpox vaccine for first responders and point-of-dispensing (POD) workers have not been examined. An online questionnaire was sent to US Cities Readiness Initiative (CRI) and non-CRI public health disaster planners in 2013. Multivariate logistic regressions were used to assess determinants of belief that first responders and POD workers should be offered the anthrax and/or smallpox vaccine before an event. A total of 301 disaster planners participated. Only half (50.6%, n=126) were aware of the ACIP recommendation that first responders could be offered pre-event anthrax vaccine. Many (66.0%, n=164) believed that pre-event anthrax vaccine should be offered to first responders. The oldest respondents were least likely to believe anthrax vaccine should be given (OR: 0.27, 0.12, 0.63, p<.001). Fewer disaster planners believed that pre-event anthrax vaccine should be offered to POD workers compared to first responders (55.0% vs 66.0%, X(2)=151, p<.001). Almost 20% (18.3%, n=47) reported having already received pre-event smallpox vaccine. Among the unvaccinated (n=210), half (52.0%, n=105) were willing to receive pre-event smallpox vaccine if it was offered free of charge. Half (53.4%, n=133) believed that POD workers should be offered smallpox vaccine before an event. Many disaster planners support pre-event anthrax vaccination for first responders and POD workers, and about half support pre-event smallpox vaccine for POD workers. Jurisdictions should consider partnering with first responder agencies to implement a pre-event anthrax vaccination program.