Press Releases

2002 Releases

After 'ER' Smallpox Episode, Fewer 'ER' Viewers Report They Would Go to Emergency Room If They Had Symptoms of the Disease

For immediate release:  June 13, 2002 

BOSTON, MA – Regular "ER" viewers who saw or knew about that television show's May 16, 2002, smallpox episode were less likely to say that they would go to a hospital emergency room if they had symptoms of what they thought was smallpox than were regular "ER" viewers questioned before the show.

In a survey by the Harvard School of Public Health and Robert Wood Johnson Foundation, 71% of the 261 regular "ER" viewers interviewed during the week before the episode said they would go to a hospital emergency room. A separate HSPH/RWJF survey conducted after the episode found that a significantly smaller proportion (59%) of the 146 regular "ER" viewers who had seen the episode, or had heard, read, or talked about it, would go to an emergency in this circumstance. This difference may reflect the pandemonium that broke out in the fictional emergency room when the suspected smallpox cases were first seen.

Regular "ER" viewers who saw or knew about the smallpox episode were also less likely (19% to 30%) than regular "ER" viewers interviewed before the show to believe that their local hospital emergency room was very prepared to diagnose and treat smallpox.

Survey results and tables are available at:

Knowledge about smallpox

The biggest difference before and after the show involved the level of knowledge about smallpox vaccination. A majority (57%) of regular "ER" viewers who saw or knew about the smallpox episode knew that if a person has been exposed to smallpox but does not have symptoms, getting a smallpox vaccination will prevent the person from coming down with the disease. Only 39% of regular "ER" viewers interviewed before the show knew this key fact.

"This change is important, because it is the central issue for public health education about smallpox," said Robert J. Blendon, professor of Health Policy and Political Analysis at the Harvard School of Public Health. "The message is that, if you have been exposed to the disease, you should get vaccinated right away. Don’t wait until you get sick, because once the symptoms start, there is no treatment to stop the course of the disease."

The post-episode group was also more likely to know that a person who has contracted smallpox and has symptoms should be kept isolated from uninfected people, although the level of knowledge was high (98% and 91%, respectively) among both groups.

Talking about smallpox

The "ER" episode did not lead most regular "ER" viewers who watched or knew about the show to talk about smallpox with other people. Interviewed during the five days after the show, more than three-fourths (80%) of that group reported that they had not talked with anyone else about smallpox during the past week.

In the episode, two children whose parents worked for the foreign service came to the ER with pox-like lesions. Smallpox was suspected and tissue samples were sent to the Centers for Disease Control and Prevention. By episode's end, smallpox had not been confirmed, and bioterrorism was not considered as a likely cause. According to the Neilsen ratings, 27.5 million Americans watched the episode.

Comparisons between the pre- and post-episode groups

The analysis was confined to regular "ER" viewers in order to reduce the chance that differences between the pre- and post-episode groups might be caused by pre-existing differences between regular "ER" viewers and non-viewers. It is still possible that a greater proportion of certain types of regular "ER" viewers–for instance, those more interested in or worried about smallpox–watched this particular episode.

However, it is unlikely that differences in the make-up of the pre- and post-episode groups of "ER" viewers account for the differences in their responses. The two groups were similar demographically, with no statistically significant differences in their gender, racial, age, or educational composition. In addition, on one measure of interest–being worried about the possibility that terrorists may use smallpox in future attacks–the groups' responses did not differ significantly.

In spite of efforts to create comparable before and after groups, however, changes in attitudes and levels of knowledge cannot necessarily be attributed to watching or knowing about the show.

No significant difference on other questions

On 18 other survey questions about smallpox and related issues, no statistically significant differences were found. For instance, the two groups did not differ in their level of confidence in their own doctor to recognize smallpox symptoms or in their local health department's preparedness to prevent smallpox from spreading.

For further information, please contact:

Robin Herman
Office of Communications
Harvard School of Public Health
677 Huntington Avenue
Boston, MA 02115
Phone: 617-432-4388