US Disaster Planners’ Attitudes Regarding Preevent Vaccine for First Responders and Point-of-Dispensing Workers Terri Rebmann, Travis M. Loux, Thomas K. Zink, Zachary Swick, and Mary Wakefield Disaster planners’ attitudes toward preevent 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 preevent anthrax vaccine. Many (66.0%, n = 164) believed that preevent 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 preevent 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 preevent smallpox vaccine. Among the unvaccinated (n = 210), half (52.0%, n = 105) were willing to receive preevent 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 preevent anthrax vaccination for first responders and POD workers, and about half support preevent smallpox vaccine for POD workers. Jurisdictions should consider partnering with first responder agencies to implement a preevent anthrax vaccination program. L arge-scale biological events, such as an aerosol- ized release of anthrax or a smallpox bioterrorism at- tack, would have a devastating impact on peoples’ health. For example, the projected mortality rate for a smallpox outbreak in the United States could reach 30% or higher. 1 In addition, mathematical modeling studies have esti- mated that the costs associated with an anthrax attack would reach $26.2 billion per 100,000 exposed individuals. 2 The Centers for Disease Control and Prevention (CDC) has identified 15 public health preparedness capabilities as the basis for state and local public health readiness for large-scale biological events; these capabilities fall into the following domains: biosurveillance, com- munity resilience, countermeasures and mitigation, inci- dent management, information management, and surge management. 3 Terri Rebmann, PhD, RN, CIC, is Associate Professor and Director, Institute for Biosecurity; Thomas K. Zink, MD, is Associate Professor; and Mary Wakefield is a graduate student; all in the Department of Environmental and Occupational Health, Saint Louis University, College for Public Health and Social Justice, Saint Louis, Missouri. Travis M. Loux, PhD, is Assistant Professor, Department of Biostatistics, Saint Louis University, College for Public Health and Social Justice. Zachary Swick, MS, is Domestic Preparedness Planner, Oregon Military Department, Oregon Office of Emergency Management, Portland, OR. Health Security Volume 13, Number 1, 2015 ª Mary Ann Liebert, Inc. DOI: 10.1089/hs.2014.0066 29