information about the evolving program to the public and gauging public understanding and opinion about the issues.

Media reports provide a wide range of on-the-ground perspectives and informal program implementation updates. Some media reports about the vaccination program have reflected the concerns of organizations, agencies, and individuals, others have conveyed reassurance about the public health system’s readiness to respond to bioterror threats. Some adverse events following smallpox vaccination have been reported in the media before CDC has formally described these adverse events. There seems to be a range of perceptions, both reflected in and by the media, about the program and the vaccine. Some concerns about and attitudes toward the vaccination program may be in part related to the current lack of clarity about the program’s objectives mentioned above. For example, because the parameters for the program are unclear (e.g., timelines, definitions, and evaluation of preparedness), it is possible to conceive of each hospital that declines to participate as a blow to preparedness, or of vaccinee numbers that are far from target as a detriment to the first line of response. Such conclusions may not be warranted but are somewhat understandable in the existing information environment. Therefore, the committee recommends CDC revisit and communicate to the public the program’s objectives in view of state-level realities, and provide a preliminary perspective on the national and state success in reaching those objectives. The CDC should continue to support, as well as build on the experience of state and local health departments who are developing their communication strategies about state and local program implementation.

The committee is aware of CDC’s forthcoming public service announcements and looks forward to additional communication activities targeting the general public. A great range of groups are important to consider as audiences and as partners in communication, including schools, religious congregations, local community organizations, and professional associations, among others. Local resources, such as community leaders and other trusted individuals could be mobilized in addition to national spokesperson(s) for the vaccine, and a wide range of communication channels employed to reach the broadest constituencies.

States have begun to develop and disseminate public communications (e.g., newspaper inserts) on the subject of bioterrorism, including information about smallpox disease, vaccine, and the vaccination program. Although national and state efforts to keep communities informed are needed, the committee expressed some concern that the messages given to the public may not be timely, may be too broad, and may provide a great deal of unfocused, undifferentiated information.

The committee recommends that CDC and its state and local partners develop communications strategies that:



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