title: Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009.
abstract: These recommendations from the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations for anthrax vaccine adsorbed (AVA) (CDC. Use of anthrax vaccine in the United States: Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2000;49:1-20; CDC. Use of anthrax vaccine in response to terrorism: supplemental recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51:1024-6) and reflect the status of anthrax vaccine supplies in the United States. This statement 1) provides updated information on anthrax epidemiology; 2) summarizes the evidence regarding the effectiveness and efficacy, immunogenicity, and safety of AVA; 3) provides recommendations for pre-event and preexposure use of AVA; and 4) provides recommendations for postexposure use of AVA. In certain instances, recommendations that did not change were clarified. No new licensed anthrax vaccines are presented. Substantial changes to these recommendations include the following: 1) reducing the number of doses required to complete the pre-event and preexposure primary series from 6 doses to 5 doses, 2) recommending intramuscular rather than subcutaneous AVA administration for preexposure use, 3) recommending AVA as a component of postexposure prophylaxis in pregnant women exposed to aerosolized Bacillus anthracis spores, 4) providing guidance regarding preexposure vaccination of emergency and other responder organizations under the direction of an occupational health program, and 5) recommending 60 days of antimicrobial prophylaxis in conjunction with 3 doses of AVA for optimal protection of previously unvaccinated persons after exposure to aerosolized B. anthracis spores.
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, USA. jgwright@cdc.gov
authors.forename: Jennifer Gordon
authors.initials: JG
authors.lastname: Wright
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Quinn
authors.forename: Sean
authors.initials: S
authors.lastname: Shadomy
authors.forename: Nancy
authors.initials: N
authors.lastname: Messonnier
mesh_terms: D000881:Anthrax / Q000453:epidemiology* / Q000517:prevention & control*; D022122:Anthrax Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia; D023482:Bioterrorism; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007115:Immunization Schedule; D007273:Injections, Intramuscular; D016920:Meningitis, Bacterial; D016273:Occupational Exposure; D056990:Post-Exposure Prophylaxis; D011247:Pregnancy; D012306:Risk; D014481:United States / Q000453:epidemiology
chemical_list: D022122:Anthrax Vaccines; D000900:Anti-Bacterial Agents