title: Recent developments in the understanding and use of anthrax vaccine adsorbed: achieving more with less.
abstract: Anthrax Vaccine Adsorbed (AVA, BioThrax™) is the only Food and Drug Administration (FDA) approved vaccine for the prevention of anthrax in humans. Recent improvements in pre-exposure prophylaxis (PrEP) use of AVA include intramuscular (IM) administration and simplification of the priming series to three doses over 6 months. Administration IM markedly reduced the frequency, severity and duration of injection site reactions. Refinement of animal models for inhalation anthrax, identification of immune correlates of protection and cross-species modeling have created opportunities for reductions in the PrEP booster schedule and were pivotal in FDA approval of a post-exposure prophylaxis (PEP) indication. Clinical and nonclinical studies of accelerated PEP schedules and divided doses may provide prospects for shortening the PEP antimicrobial treatment period. These data may assist in determining feasibility of expanded coverage in a large-scale emergency when vaccine demand may exceed availability. Enhancements to the AVA formulation may broaden the vaccine's PEP application.
authors.affiliation: a MPIR Laboratory, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention (CDC) , Atlanta , GA , USA.
authors.forename: Jarad M
authors.initials: JM
authors.lastname: Schiffer
authors.affiliation: b Immunization Safety Office, Division of Healthcare Quality Promotion , National Center for Emerging and Zoonotic Infectious Diseases , Atlanta , GA , USA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: McNeil
authors.affiliation: c Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases , National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC) , Atlanta , GA , USA.
authors.forename: Conrad P
authors.initials: CP
authors.lastname: Quinn
mesh_terms: D000818:Animals; D000881:Anthrax / Q000517:prevention & control*; D022122:Anthrax Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D007273:Injections, Intramuscular; D023421:Models, Animal; D056990:Post-Exposure Prophylaxis; D065129:Pre-Exposure Prophylaxis
chemical_list: D022122:Anthrax Vaccines
keywords: Anthrax; Bacillus anthracis; BioThrax; antibody formation; correlates of protection; humans; nonhuman primate; post-exposure prophylaxis; pre-exposure prophylaxis; vaccines