WEBCAST TRANSCRIPT

Transcript of "Smallpox Vaccine Program: Communications with the Public
and Stakeholders"\
Presented by Dr. Glen Nowak, 5 December 2002, on the satellite broadcast
of "CDC Bioterrorism Update: Smallpox Preparedness"

(Associated graphics can be found at
[www.bt.cdc.gov/agent/smallpox/training/webcast/dec2002/files/communications.ppt](http://www.bt.cdc.gov/agent/smallpox/training/webcast/dec2002/files/communications.ppt)
and
[www.bt.cdc.gov/agent/smallpox/training/webcast/dec2002/files/communications.pdf](http://www.bt.cdc.gov/agent/smallpox/training/webcast/dec2002/files/communications.pdf).)

Glen Nowak, PhD, Associate Director, Health Communications, National
Immunization Program, CDC

(Slides 1 and 2 are title and objectives, respectively)

# NOWAK:

Good communications planning begins with a brief situation analysis.

## Slide 3

In the case of smallpox, smallpox vaccination preparedness programs need
to keep in mind they will affect a wide range of people, from response
team members to emergency responders to the general public. And we
should also assume that most people, including healthcare professionals
have relatively little knowledge about smallpox and small smallpox
vaccination. After all, smallpox and smallpox vaccination have not been
things we've had to worry about for over 30 years.

## Slide 4

At CDC when we developed our smallpox preparedness communication plans,
we began by articulating what our goals were. We have four primary
goals. The first goal with our smallpox preparedness communication plan
is to increase awareness and understanding of smallpox preparedness
activities, including the recommendations on who should be vaccinated.
Our plans are also designed to help instill and educate the public \--
or help instill and extend public confidence in national, state and
local ability to respond to and effectively manage a smallpox release or
outbreak.

## Slide 5

Our third communication goal is to provide accurate, consistent, timely
and comprehensive information and resources. We have learned that there
are many audiences and these audiences need to have a wide range of
materials. Our fourth goal is to assist state, local and health care
professional communication efforts.

## Slide 6

In terms of developing effective state smallpox preparedness
communication plans, there are a number of steps and a number of things
that need to be kept in mind. I want to walk through a few of them right
now.

## Slide 7

The first thing is, what should you assume when you\'re developing your
smallpox communication plans?

## Slide 8

At CDC we\'re making a number of assumptions that help us in our
strategies and planning. The first assumption we're making is that most
people, including health care providers, need more information about
smallpox disease, smallpox vaccine and smallpox vaccination. Again, you
need to keep in mind that for many people, these have not been topics
that have been recently discussed.

## Slide 9

A second assumption that we\'re making here at CDC, and we recommend
that others make, is that smallpox vaccinations will generate interests
and requests for information from many people. This includes the public,
the media and the family of those affected. There will be a lot of
people interested in what smallpox is, a lot of people interested in the
specifics of smallpox vaccination and we need to be prepared to answer
and respond to requests from a lot of different sources.

## Slide 10

A third assumption we should make in developing communication plans is
that we\'re going to need many systems to distribute our messages, to
provide updates and to provide information to a wide range of people.
One of the things that will probably be invaluable in this effort is
developing partnerships and networks that can help get messages, updates
and materials to the intended target audiences.

## Slide 11

A fourth assumption that communication planners should make is that the
first serious adverse reactions whether they are claimed or real, will
generate much local and national media attention and public interest.
People are going to want to know the specifics about what happened, why
the person may have had the adverse reaction and what is being done as a
result of this report.

## Slide 12

The second thing that communication planners need to keep in mind is
that they need to recognize and prepare for what we\'re calling smallpox
communication realities.

## Slide 13

There are a number of things that we need to keep in mind about smallpox
communications, but the ones I want to list here are probably the most
important. First, it is very helpful if you anticipate the questions and
concerns that different audiences will have regarding your smallpox
preparedness efforts. One of the things we recommend doing is taking and
listing your specific target audiences and then trying to write down for
each of the audiences the kinds of questions, the kinds of interests and
kinds of concerns that those audiences may have and then trying to
formulate answers to those questions right now. The second thing that
people need to be prepared to do is that it\'s helpful to have more
messages, more materials, more resources prepared in advance and ready
before a smallpox vaccination begins or before there is a confirmed case
of outbreak. The more messages, materials and resources that you have
prepared in advance, the better you will be able to manage the
communications needs.

## Slide 14

It\'s also important to recognize that different groups and audiences
will have different information questions, different information needs
and different interests. And that one brochure, one pamphlet, one fact
sheet is not likely to serve all those different audiences. Rather, you
need to keep in mind that different groups will have different ways of
being reached, they will have different sources that they rely on for
information, they will use different media to learn about these
recommendations and finally, they will have different educational,
cultural and occupational backgrounds. These backgrounds will affect the
kinds of things they\'re interested in and will also affect the kinds of
things we need to provide in order to reach their needs.

## Slide 15

State and local smallpox preparedness communication plans need to
address five key elements. I\'m going to walk through them now.

## Slide 16

The first element that your plan needs to address is the target
populations or audiences. You need to start by identifying the primary
populations or audiences that you need to reach with your messages and
your efforts. There are at least four audiences that we think are
important. The first audience is, the people for whom smallpox
vaccination is now recommended. This group of people is going to have a
number of questions and a number of needs relative to communications and
education. A second group is people for whom smallpox vaccination is now
recommended but who are contraindicated or are not interested in
receiving smallpox vaccine. These people are going to want reassurances
that they, too, are protected without being vaccinated. A fourth group
\-- or a third group is people for whom vaccination \-- the vaccination
recommendation may be extended to. There are obviously some people who
will be among the first to receive smallpox vaccination and others for
whom smallpox vaccination is recommended, but they will not be part of
the immediate vaccination efforts. These people will have questions as
to when will they be able to receive smallpox vaccine and why will they
have to wait for a few weeks before they can get it? A fourth group that
you need to be prepared for is the general public. And this includes the
media. You need to be thinking about the kinds of messages that you want
to disseminate and provide to members of the general public about your
program and about these recommendations.

## Slide 17

The second important thing to do in terms of developing a communications
plan is to articulate or develop your primary communications messages.
And you need to do this on two levels. First, what are your overall
communications messages? What do you want to say to everybody? After
you\'ve articulated or identified those messages, the next thing you
need to do is identify the primary messages for each of your identified
populations or audiences. At CDC we have a number of primary messages
regarding smallpox vaccination. I want to touch upon five of them.

## Slide 18

One of our first messages is in regards to the likelihood of a smallpox
release or outbreak. And at CDC what our primary message is there, is
that the probability of an intentional release of smallpox virus is low
but since the consequences would be great, we must be prepared.

## Slide 19

Our second primary message speaks to the need for these recommendations
and the purpose of these recommendations. These recommendations
strengthen national and state preparedness by making licensed vaccine
available to those people who would be called upon to respond to a
smallpox release or outbreak.

## Slide 20

Our third primary message speaks to why it\'s important that these
people receive smallpox vaccination. And the message there is that
smallpox vaccination before a confirmed smallpox case or outbreak
provides response team members and other first responders personal
protection from smallpox disease.

## Slide 21

Thanks to this personal protection from smallpox disease it enables them
to rapidly take the actions necessary to protect the public, which
includes identifying people who need to be vaccinated to control the
outbreak as well as establishing public vaccination clinics. In other
words, by vaccinating the people who would first be called upon to
respond to a smallpox outbreak, we are strengthening our ability to
quickly and effectively respond and in doing so, we are protecting the
public.

## Slide 22

In terms of summarizing the CDC\'s primary messages, what you see here
are \-- the bottom line \-- by protecting those people who would
initially be called upon to respond, we, one, further strengthen our
ability to protect the public and, two, we increase the capacity and
capabilities of the public health system and the nation\'s hospitals to
respond to and control a smallpox outbreak.

## Slide 23

The third part of effective communications plans is to get prepared now
to communicate about vaccine reactions, vaccine risks and adverse
events. We have learned there\'s much interest among people when it
comes to immunization about the kinds of reactions that are typical, the
risks associated with immunization and vaccine adverse events, including
how to recognize them, how to respond to them, and who to call if a
person thinks that they may be experiencing an adverse event. You need
to have all that information ready to go right now in order to
effectively communicate to people when they want that information.
Related, you need to establish your systems and methods for getting
messages, information, and materials to your intended populations today.

## Slide 24

Finally, can you also expect there\'s going to be a lot of interest and
demand from the media, the public and policymakers for information and
it\'s important that you establish the protocols for meeting those
demands. You should assume there will be frequent, perhaps daily
information requests from the media and the public. They will want
updates, status reports. They\'ll be interested in the number of people
who are eligible to be vaccinated, the number of people you have
vaccinated, the number of people who have suffered reactions to the
vaccine. You need to have systems in place to get that kind of
information on a regular and frequent basis and also have systems in
place so that the media and members of the public know where to get that
information.

## Slide 25

One of the things we strongly encourage states and others to do in terms
of the communications efforts is to use the CDC\'s smallpox-related
resources and materials and to tailor them as appropriate and necessary.

## Slide 26

At CDC we have been working to develop a wide range of materials and our
portfolio materials can be found on our main CDC website. We have a
specific address for smallpox resources,
[www.cdc.gov/smallpox](http://www.cdc.gov/smallpox). On the CDC website,
you will also find a large number of materials available in Spanish. We
have also developed a smallpox resource kit for health professionals.
This resource kit contains a wide range of materials, including
educational materials for perspective patients about smallpox and
smallpox immunization.

## Slide 27

In terms of materials that are available for the public, the CDC is
working to develop a portfolio of fact sheets. We currently have fact
sheets on smallpox disease, on smallpox vaccine, on who should not
receive the smallpox vaccine, on reactions after smallpox vaccination.
We have information on live virus vaccines and vaccinia. We have a list
of frequently asked questions and answers. These materials are available
in not only English, but also are available in Spanish.

## Slide 28

The CDC website also houses a wide range of materials for clinicians and
healthcare providers. It ranges from in depth resources to, again, one
page or two-page fact sheets. In terms of in-depth resources, people can
find the *Smallpox Response Plan Guidelines*, which includes the
*Smallpox Vaccination Clinic Guide* on the CDC website. We also have
information on medical management of smallpox and vaccinia vaccine
adverse events and we have a CD-ROM that is available, included on the
website on *What Every Clinician Should Know* about smallpox and
smallpox immunization. You can also find an image library. There are
images on the CDC website that show what smallpox looks like as a
disease, as well as reactions to smallpox vaccination, including vaccine
adverse reactions.

## Slide 29

We have fact sheets on adverse reactions following smallpox, we have
fact sheets on smallpox vaccine. We also have the vaccine information
statement for smallpox available on the CDC website. We also have
training tools and materials. This includes webcasts, slide
presentations, smallpox vaccination and adverse events training modules
and finally, we have telephone information services for both the public
and health care professionals.

## Slide 30

In terms of concluding advice, there are three points I would like to
leave you with \-- first, remember that communication needs will be
ongoing. There will be things that people will be interested in before
smallpox vaccinations begin, during the program and after smallpox
vaccinations begin. Communication needs are something that are going to
have to be responded to regularly. Second, be prepared to respond to
daily information requests. These requests are likely come from the
media, the public and from people for whom smallpox vaccination is now
recommended. And finally, get prepared for immediately and effectively
responding to vaccine safety questions and issues.

The more prepared you are today, the better you will be should the need
arise. Thank you.

For more information, visit
[www.cdc.gov/smallpox](http://www.cdc.gov/smallpox), or call the CDC
public response hotline\
at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646
(TTY)