National Survey Finds Nurses Lack Critical Knowledge About Smallpox Vaccination

Majority of Nurses Support President's Smallpox Vaccination Plan, but Survey Findings Uncover Need for Immediate Education Plan


Jennifer Hudman, Burness Communications - (301) 652-1558
Sarah Danberg, NNii - (703) 299-0878

Enero 23, 2003

Alexandria, VA—Nurses and other health care personnel figure prominently in the current federal government plan to reintroduce smallpox vaccine in the United States, yet most nurses lack critical knowledge about when the vaccine can be administered, according to the results of a national survey conducted by the National Network for Immunization Information (NNii) and released today.

The survey of 2,661 practicing nurses, conducted late in 2002, found that only 21% of respondents believe that a vaccine given within a few days of exposure to smallpox would prevent the disease. Younger nurses, nurses trained in the past 25 years, and nurses with the least vaccine experience were most likely to believe that administering a vaccine a few days after exposure to smallpox would not prevent the disease.

“If nurses don’t understand how the smallpox vaccine works, we can be confident that the general public doesn’t either,” said Louis Z. Cooper, MD, interim director of NNii and professor of pediatrics at Columbia University. “And because nurses are trusted health educators, it is particularly critical that we quickly educate them about the vaccine so that they may help to inform the general public. For the president’s vaccination plan to work, everyone needs to know that the vaccine is considered effective if administered soon after exposure”

The survey also found that most nurses support the federal government’s plan to vaccinate health care workers on a voluntary basis as part of a broader strategy to prepare the nation for a bioterrorist attack.

“The good news for the administration is that the majority of nurses support the president’s smallpox vaccination plan, and they generally are willing to get vaccinated themselves,” said Thomas Stenvig, RN, PhD, MPH, associate professor at South Dakota State University’s College of Nursing and a co-author on the study. “But we also identified a challenge to the administration’s proposal: a significant minority of young and recently trained nurses is less likely to support the president’s plan and less certain of their willingness to get vaccinated themselves.”

The survey included six questions about the smallpox vaccine in addition to questions that address nurses’ attitudes toward immunization in general. Specific smallpox-related findings include:

  • Nearly seven in ten (69%) of respondents favor the White House proposal to vaccinate doctors and nurses, on a voluntary basis, as preparation for a larger mass vaccination effort. Conversely, nine percent oppose the proposal. Younger nurses, nurses trained in the past 10 years, and nurses with less vaccine experience were less likely to support the proposal.
  • More than two thirds (69%) of respondents think the smallpox vaccine is “very effective” in preventing the disease, while 22% think it is “somewhat effective,” and less than 1% think it is “not very effective” or “not at all effective.” Younger nurses and nurses who were trained in the past 25 years are less likely to believe the vaccine is “very effective.”
  • Almost two thirds of respondents thought it “very likely” (19%) or “somewhat likely” (43%) that they would contract smallpox if, while unvaccinated, they came within a few feet of someone with the disease. In contrast, about one in four felt the risk to be “not very likely” (23%) or “not at all likely” (4%).

“These survey results demonstrate the need to rapidly develop and implement a campaign to educate members of the nursing community, especially younger members, about the smallpox vaccine and the likely role of nurses if mass vaccinations ever become necessary,” said Louis Sullivan, MD, co-chair of NNii and former U.S. Secretary of Health and Human Services.

For more information, please see the study “Nurses’ Perceptions and Intentions Regarding Smallpox Vaccine: A National Survey”

The National Network for Immunization Information ( is a non-profit organization whose mission is to provide the public, health professionals, policy makers, and the media with up-to-date, scientifically valid information related to immunization to help them understand the issues and to make informed decisions. NNii’s partner organizations include the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the American Academy of Pediatrics, the American Nurses Association, the American Academy of Family Physicians, the National Association of Pediatric Nurse Practitioners, and the American College of Obstetricians and Gynecologists. NNii does not accept funding from the government or from vaccine manufacturers.

Some funding for NNii is provided by the Robert Wood Johnson Foundation. The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation’s largest philanthropic organization devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to basic health care at a reasonable cost; to improve care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social, and economic harm caused by substance abuse—tobacco, alcohol, and illicit drugs.