1. ¹Department of Veterans Affairs Medical Center, Denver, Colorado, USA
2. ²Department of Dermatology, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, USA
3. ³Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, USA
4. ⁴Department of Medicine, University of Colorado at Denver and Health Sciences Center, Aurora, Colorado, USA

Correspondence: Dr Robert P. Dellavalle, Department of Veterans Affairs Medical Center, Denver, Colorado 80220, USA. E-mail: Robert.dellavalle@uchsc.edu

Received 21 November 2005; Revised 22 December 2005; Accepted 8 January 2006; Published online 9 March 2006.

Abstract

The risk of a bioterrorist attack with smallpox has increased owing to breakthroughs in the de novo synthesis of long-chain DNA molecules. Although the leading roles of dermatologists in diagnosing recent outbreaks of cutaneous anthrax and monkeypox demonstrate the importance of dermatologist preparedness for bioterrorism, dermatologist knowledge regarding smallpox vaccination has not been extensively examined. We conducted a cross-sectional worldwide electronic survey of all members of the American Academy of Dermatology with available e-mail addresses. The response rate was 23% (1,303/5,723): 34% of respondents were women, 52% were age 50 or older, 85% practiced in the US, and 90% reported English as their primary language. Less than 37% indicated the Centers for Disease Control and Prevention estimated rate of death owing to smallpox vaccination (1 in 1,000,000), and many failed to identify vaccination contraindications: previous myocardial infarction (83%), angina (83%), congestive heart failure (78%), steroid eye drop use (65%), and the non-emergency vaccination of those younger than age 18 (95%). Widespread dermatologist smallpox vaccination knowledge deficits pinpoint opportunities for educational efforts.