title: An accelerated schedule for tick-borne encephalitis vaccine: the American Military experience in Bosnia.
abstract: Tick-borne encephalitis (TBE) is a viral illness endemic to the Balkan region. United States military forces were deployed to Bosnia in early 1996 as part of Operation Joint Endeavor, a U.S.-led multinational peace-keeping operation. To counteract the TBE threat, an inactivated, parenteral vaccine (FSME-Immun Inject; Immuno AG, Vienna, Austria) was offered to soldiers at high risk on a volunteer basis in an accelerated, 3-dose schedule (0, 7, and 28 days). Passive adverse reaction surveillance was conducted on 3,981 vaccinated personnel. Paired sera from a randomly selected group of 1,913 deployed personnel (954 who received vaccine and 959 who were unvaccinated) were tested for antibodies to TBE by an ELISA. Three-dose recipients demonstrated an 80% seroconversion rate (4-fold or greater increase in anti-TBE titers). By comparison, the TBE infection rate in the unvaccinated cohort was found to be only 0.42% (4 of 959). Only 0.18% of vaccinees reported self-limited symptoms. An accelerated immunization schedule appears to be an acceptable option for military personnel or travelers on short-term notice to TBE-endemic areas.
authors.affiliation: Directorate of Epidemiology and Disease Surveillance, U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground (EA), Maryland 21010, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Craig
authors.forename: P R
authors.initials: PR
authors.lastname: Pittman
authors.forename: T E
authors.initials: TE
authors.lastname: Lewis
authors.forename: C A
authors.initials: CA
authors.lastname: Rossi
authors.forename: E A
authors.initials: EA
authors.lastname: Henchal
authors.forename: R A
authors.initials: RA
authors.lastname: Kuschner
authors.forename: C
authors.initials: C
authors.lastname: Martinez
authors.forename: K F
authors.initials: KF
authors.lastname: Kohlhase
authors.forename: J C
authors.initials: JC
authors.lastname: Cuthie
authors.forename: G E
authors.initials: GE
authors.lastname: Welch
authors.forename: J L
authors.initials: JL
authors.lastname: Sanchez
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D017522:Bosnia and Herzegovina; D015331:Cohort Studies; D004669:Encephalitis Viruses, Tick-Borne / Q000276:immunology*; D004675:Encephalitis, Tick-Borne / Q000276:immunology / Q000517:prevention & control*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008887:Military Medicine / Q000379:methods; D008889:Military Personnel; D009784:Occupational Diseases / Q000517:prevention & control*; D014481:United States; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000009:adverse effects; D014765:Viral Vaccines / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000914:Antibodies, Viral; D015164:Vaccines, Inactivated; D014765:Viral Vaccines