Bacillus anthracis is an aerobic, spore-forming bacterium that causes anthrax disease. Anthrax occurs globally, especially in agricultural areas that do not have a livestock vaccination program. Naturally occurring anthrax is rare in the United States, which has successful vaccination programs among livestock and strict importation regulations. In 2001, anthrax bacteria were used in bioterrorism attacks involving the postal system and government buildings. Regardless of the cause, all suspected cases of anthrax must be reported to the local health department for investigation.
Anthrax bacteria infect people and animals when spores are inhaled, ingested, or enter the body through a break in the skin. Once inside the body, the spores replicate and produce three proteins: edema factor (EF), lethal factor (LF), and protective antigen (PA). It is the combination of these proteins that is believed to cause tissue damage, shock, and death. Sometimes there is a delayed onset of anthrax disease. This is because anthrax spores can remain in the lungs for weeks without replicating. Antibiotics do not kill the spores. When the spores finally do replicate, anthrax disease develops.
There are three forms of anthrax disease:
Antibiotics, such as ciprofloxacin, doxycycline, and amoxicillin, are the most important therapeutic interventions for any form of anthrax. A combination of antibiotics needs to be started as soon as the disease is suspected. In addition, aggressive supportive care will be needed.
In 1991, DoD Service members deploying for the Persian Gulf War received one or two doses of anthrax vaccine, labeled Vaccine A or Vacc A. Other abbreviations for anthrax vaccine include AVA and ANT. Before November 2008, the vaccine was given as a 6-dose series. Research on the vaccine showed, however, that five doses are as effective as six doses in preventing anthrax. So, in November 2008, the primary series of anthrax vaccine was changed to five doses. See "Dose/Schedule" for more information.
Product: Biothrax® (Anthrax Vaccine Adsorbed)
Manufacturer: Emergent BioDefense Operations Lansing Inc
Year licensed: 1970
Pregnant women who have received the anthrax vaccine during pregnancy should receive regular prenatal care and should discuss their anthrax vaccination with their healthcare provider and/or obstetrician. IHB has the latest information regarding pregnancy and vaccination, as well as adverse event research. IHB also offers pregnancy monitoring for women inadvertently vaccinated during pregnancy. For more information, please visit the Pregnancy page or contact IHB.
The Defense Health Board (DHB), formerly known as Armed Forces Epidemiological Board (AFEB), has a proud 60-year heritage of protecting the health of America's Armed Forces. The DHB consists of civilian physicians and scientists selected to advise the Surgeons General of the Armed Services.
From its first reviews of anthrax vaccine under DoD Directive 6205.3, the DHB has affirmed the value of this vaccine. In August 1994, the DHB concluded: "The licensed anthrax vaccine is suitable for use in personnel assigned, pre-designated or scheduled for deployment to areas with a validated higher threat under its approved indications." In November 1996, the Defense Health Board reported that it "endorses the proposed DoD anthrax vaccine implementation plan under the current vaccine protocol [i.e., dosing schedule]."
The DHB reaffirmed its recommendations to use anthrax vaccine for bio-defense of military personnel in 1999 and 2000. A March 25, 1999, report states "The DHB continues to strongly endorse the current DoD Anthrax Vaccine Immunization Program."
On March 29, 2000, the DHB reported: "...we are (DHB) concerned and somewhat surprised at the criticism surrounding the program given the high level of professionalism that had characterized this effort... Anthrax vaccine is a fully licensed FDA vaccine.
The vaccine does cause local side effects, but has an excellent safety profile. The Anthrax Vaccine Immunization Program has carefully tabulated person-specific immunization data and has assiduously investigated reported complications associated with receipt of anthrax vaccine. These data have been regularly reviewed by the board and attest to the safety of the vaccine." http://www.anthrax.mil/resource/library/afeb.asp
The DHB continues to receive regular updates regarding implementation of the Anthrax Vaccine Immunization Program and the variety of safety surveillance methods used by the Department of Defense to monitor the vaccine's use.