Increasing concerns regarding smallpox as a biologic weapon have led to massive production of vaccinia vaccine and targeted vaccination campaigns. A regional mail survey was conducted among pediatricians to assess their knowledge and perceptions on smallpox and smallpox vaccine. Fifty-nine percent of the responders were unable to differentiate chickenpox from smallpox, and the majority would not accept vaccination in the absence of an outbreak and would not recommend smallpox vaccine to their patients. Even in previously vaccinated pediatricians, willingness to receive smallpox vaccine is poor and vaccination campaigns in the absence of a smallpox outbreak may not be successful.
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