Anthrax Vaccination: What Everyone Should Know

• Who Should Get Anthrax Vaccine?
• Who Should Not Get This Vaccine?
• What Types of This Vaccine Are There?
• How Well Does This Vaccine Work?
• What Are the Possible Side Effects?
• Where Can I Find This Vaccine?
• How Do I Pay for This Vaccine?

Vaccines Recommended for Travel and Some Specific Groups

Key Facts

There is a vaccine to prevent anthrax, but it is not typically available for the general public. Anyone who is at increased risk of being exposed to anthrax, including certain U.S. military personnel, laboratory workers, and some people who handle animals or animal products (such as veterinarians who handle infected animals), may get the vaccine.

Who Should Get Anthrax Vaccine?

There is a vaccine licensed to prevent anthrax, but it is not typically available for the general public. Below is more information about who should and should not get an anthrax vaccine.

Talk to your healthcare professional about what is best for your specific situation.

Learn about the anthrax vaccine at CDC’s What Are the Types of Anthrax Vaccines?.

Before Exposure to Anthrax

CDC recommends anthrax vaccination for three groups of adults 18 through 65 years old who may be at risk of coming in contact with anthrax because of their job:

• Certain laboratory workers who work with anthrax
• Some people who handle animals or animal products, such as veterinarians who handle infected animals
• Certain U.S. military personnel

After Exposure to Anthrax

CDC also recommends vaccination for people who have been exposed to anthrax in certain situations, such as after a bioterrorism attack involving anthrax.

Anthrax vaccination may be recommended for pregnant women who have been exposed to anthrax. However, when risk to anthrax exposure is low, pregnant women are not recommended to get the vaccine.

Who Should Not Get This Vaccine?

Because of age or health conditions, some people should not get certain vaccines or should wait before getting them. Read the guidelines below and ask your healthcare professional for more information.

Tell the person who is giving you an anthrax vaccine if:

You have had a life-threatening allergic reaction or have a severe allergy.

• Anyone who has had a serious allergic reaction to a previous dose of the anthrax vaccine should not get another dose.
• Anyone who has a severe allergy to any vaccine component should not get a dose. Tell your provider if you have any severe allergies, including latex. Your healthcare professional can tell you about the vaccine’s ingredients.

You have been previously diagnosed with specific illnesses or conditions.

• If your immune system is weakened due to medication or illness.
• If you have had anthrax disease in past.

You are not feeling well.

• If you have a mild illness, such as a cold, you can probably get the vaccine. If you are moderately or severely ill, you should probably wait until you recover. Your healthcare professional can advise you.

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What Types of This Vaccine Are There?

There is one anthrax vaccine licensed for use in the United States by the Food and Drug Administration:

• BioThrax®: It is given to people 18 through 65 years old at increased risk of exposure in five doses, with a booster dose each year thereafter for those that continue to be at increased risk of exposure. It is given, in combination with antibiotics, as a three-dose primary series after exposure.

How Well Does the Anthrax Vaccine Work?

Summary

Vaccines that help protect against anthrax work well, but cannot prevent all cases.

• A study showed that the anthrax vaccine protects about 9 people out of every 10 vaccinated prior to exposure to the bacteria.

In Depth

The anthrax vaccine is effective at protecting most people from anthrax, including the most deadly form that can happen when someone breathes the bacterial spores into their lungs. To build up protection against anthrax, people need 5 doses over a period of 18 months. However, it is unknown how long that protection lasts so people who are recommended to get this vaccine are advised to get a booster dose each year to stay protected.

What Are the Possible Side Effects?

Most people who get an anthrax vaccine do not have any serious problems with it. With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own within a few days, but serious reactions are also possible.

Mild Problems

Mild problems following an anthrax vaccine can include:

• Reactions where the shot was given
  • Redness
  • Swelling
  • Soreness or tenderness
  • A lump or bruise
  • Itching
• Muscle aches or temporary limitation of movement in the arm where the shot was given
• Headache
• Feeling tired

Problems that Could Happen after Any Injected Vaccine

• People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your healthcare professional if you feel dizzy, have vision changes, or have ringing in the ears.
• Some people get severe arm pain and have difficulty moving the arm where a shot was given. This happens very rarely.
• Any medicine can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.
• As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

For more information on possible side effects from vaccination, visit CDC’s Possible Side effects from Vaccines webpage.

Where Can I Find the Anthrax Vaccine?

Anthrax vaccine is only recommended under specific circumstances and for specific individuals. While your healthcare professional’s office is usually the best place to receive recommended vaccines, it is unlikely they will carry anthrax vaccine.

If anthrax vaccine is recommended or required by your employer because of your job responsibilities, you should ask your employer if they offer the vaccine or to refer you to a clinic in your community where the vaccine is available. You can also contact your state health department to learn more about where to get the vaccine in your community if it is recommended for you.

How Do I Pay for This Vaccine?

If your employer recommends or requires anthrax vaccine, you should ask if they provide the vaccine to their employees. The vaccine may also be paid for by:

Private Health Insurance

Private health insurance plans may cover these vaccines if recommended for your job or in emergency situations. Check with your insurance provider for details on whether there is any cost to you and for a list of in-network vaccine providers.

• CDC’s Anthrax Website
• Educational Materials on Anthrax
• Anthrax Vaccine Information Statement (English / Other Languages)
• Vaccine Safety
  • CDC’s Vaccine Safety Website
  • Frequently Asked Questions about Vaccine Safety

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Anthrax Vaccine Information Statement | CDC

Current Edition Date: 1/8/2020

• Print VIS [2 pages]
• RTF file [3 pages]
  (For use in electronic systems)

• VIS in other languages
• More information about anthrax vaccination

• Why get vaccinated?
• Adenovirus vaccine
• Talk with your health care provider
• Risks of a vaccine reaction
• What if there is a serious problem?
• Countermeasures Injury Compensation Program
• How can I learn more?

Anthrax vaccine can prevent anthrax.

People can get anthrax disease from contact with infected animals or contaminated animal products such as wool, meat, or hides. The anthrax bacteria could also be used as a biological weapon.

Anthrax is not spread from person to person. It is spread in one of four ways, and signs and symptoms can vary depending on how anthrax enters the body:

• Through breaks in the skin. Cutaneous anthrax causes blisters or bumps on the skin, swelling around the sore, and a painless skin sore (ulcer) with a black center. The sore is usually on the face, neck, arms, or hands.
• From eating infected meat. Ingestion anthrax can cause fever and chills. It can affect the upper part of the gastrointestinal (GI) tract, the lower part of the GI tract, or both. When it affects the upper part, there is swelling of the neck or neck glands, sore throat, and painful swallowing or difficulty breathing. When it affects the lower GI tract, nausea and vomiting, stomach pain and swelling, and diarrhea may be present. The patient may also look flushed (red), have red eyes, or faint.
• From inhaling spores of the bacteria that causes anthrax. Inhalation anthrax can cause shortness of breath, cough, chest discomfort, confusion, nausea or vomiting, stomachache, sweats, and dizziness.
• From injecting heroin. Injection anthrax can result in swelling at the injection site, nausea and vomiting, and sweats.

All types of anthrax can cause fever, chills, fatigue, and headache.  Anthrax can spread throughout the body and cause severe illness, including brain infections and even death, if left untreated.

Anthrax vaccine is approved by the Food and Drug Administration (FDA) and recommended for adults 18 through 65 years of age who are at risk of exposure to anthrax bacteria, including:

• Certain laboratory workers who work with Bacillus anthracis
• People who handle potentially infected animals or their carcasses
• Some military personnel (determined by the Department of Defense)
• Some emergency and other responders whose response activities might lead to exposure

These people should get 3 doses of anthrax vaccine, followed by booster doses for ongoing protection.

Anthrax vaccine is also recommended for unvaccinated people of all ages who have been exposed to anthrax. These people should get 3 doses of anthrax vaccine together with recommended antibiotic drugs.

Anthrax vaccine has not been studied or used in children less than 18 years of age. Because its use in exposed children is not approved by FDA, it must be used under an expanded access Investigational New Drug (IND) program and requires informed consent from a parent or legal guardian.

Tell your vaccine provider if the person getting the vaccine:

• Has had an allergic reaction after a previous dose of anthrax vaccine, or has any severe, life-threatening allergies.
• Is pregnant or thinks she might be pregnant.
• Has a weakened immune system.
• Has a history of anthrax disease.

In some cases, your health care provider may decide to postpone anthrax vaccination to a future visit.

People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting anthrax vaccine.

If you are receiving the vaccine because you have been exposed to anthrax, tell your health care provider if you are not feeling well.  You might need immediate medical care.

Your health care provider can give you more information.

After getting a shot of anthrax vaccine, you may have:

• Tenderness, redness, itching, or a lump or bruise where the shot is given
• Muscle aches or short-term trouble moving your arm
• Headaches or fatigue

People sometimes faint after medical procedures, including vaccination. Tell your provider if you feel dizzy or have vision changes or ringing in the ears.

As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death.

An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness), call 9-1-1 and get the person to the nearest hospital.

For other signs that concern you, call your health care provider.

Adverse reactions should be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website or call 1-800-822-7967.  VAERS is only for reporting reactions, and VAERS staff do not give medical advice.

The Countermeasures Injury Compensation Program is a federal program that may help pay for costs of medical care and other specific expenses of certain people who have been seriously injured by certain medicines or vaccines. If you have been injured by the anthrax vaccine, you can learn more about this Program by visiting the program’s website, or calling 1-855-266-2427.

• Ask your health care provider.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
  • Call 1-800-232-4636 (1-800-CDC-INFO) or
  • Visit CDC’s anthrax website

Many Vaccine Information Statements are available in español and other languages. See https://www.immunize.org/vis.

Vaccine Information Statement
Anthrax Vaccine (1/8/20)

Department of Health and Human Services
Centers for Disease Control and Prevention

Office Use Only

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“Veterinaria.rf”: Oleg Sklyarov: “The cause of complications may not be a vaccine, but a violation of the rules for its use” in the soil for a long time. To prevent the disease in Russia, mass vaccination of farm animals is carried out. In the main part of them, intense immunity is created, however, post-vaccination complications are recorded in goats and some other animals.

Employees of the All-Russian State Center for the Quality and Standardization of Medicines for Animals and Feed (VGNKI) are starting a study that will improve the safety and effectiveness of immunization. Oleg Sklyarov, Doctor of Veterinary Sciences, Head of the Laboratory for the Quality and Standardization of Bacterial Medicines of the Federal State Budgetary Institution VGNKI, told us about the tasks and details of the upcoming work.

– Oleg Dmitrievich, what kind of anthrax vaccine is used today?

– Live, liquid or dry vaccine against anthrax of farm animals (large and small cattle, horses, donkeys, camels, deer, pigs, fur-bearing animals) of various domestic manufacturers, as well as associated vaccine against anthrax and emphysematous carbuncle – for cattle.

– How often are cases of post-vaccination complications recorded?

– VGNKI periodically receives data on cases of post-vaccination complications in farm animals as a result of prophylactic immunization against anthrax. This information concerns mainly goats, sometimes horses and cattle. In particular, the Committee of Veterinary Medicine of the city of Moscow and the Main Department of Veterinary Medicine of the Moscow Region reported five such cases in 2013, four in 2014 and nine in 2015. Complications were recorded after vaccination in goats in the village of Vasilievka, Voronezh region, in five cattle in Buryatia (four of them died), in four goats in the Pavlovo-Posad district of the Moscow region, where one animal died.

– Who registers cases of complications after vaccination?

– As a rule, such cases are registered by employees of the territorial departments of the Rosselkhoznadzor or the veterinary departments of the subjects. They or the owners of the affected animals bring this information to the manufacturer of the vaccine.

In addition, after the adoption of the law “On the Protection of Consumer Rights”, the proceedings in such cases are conducted between the owner and the manufacturer of the drug. VGNKI can participate and participates in arbitration testing of drug samples from the places of application. We control vaccine samples of the same series, selected from the manufacturer’s archive in accordance with the requirements of regulatory documents regulating the quality of drugs.

– Is it always possible to pinpoint the exact cause of complications?

– It is not always easy to do this, because the cause may not be a vaccine at all, but a violation of the procedure for its use prescribed in the instructions for the drug. For example, if clinically ill animals or animals with a latent form of the disease are immunized. It happens that age restrictions are not taken into account when immunizing, or they are vaccinated in the cold season.

– How good are vaccine safety practices?

– According to the requirements of regulatory documents and GOST R 52616-2006 “Vaccination against anthrax of animals from strain 55-VNIIVViM live” control of anthrax vaccines in terms of quality “harmlessness” is carried out on rabbits. According to the results of tests of reclamation and archival samples of vaccines, as well as samples tested by our organization over the past five years as part of drug monitoring and selective quality control of medicines, vaccines in terms of “harmlessness” almost always met the requirements of regulatory documents. This implies the use of another animal model, for example, sheep and (or) goats, when testing vaccines for harmlessness, which, by the way, is regulated by the Guidelines for Diagnostic Tests and Vaccines of the International Epizootic Bureau. Of course, this will affect the cost of control and the price of the vaccine.

– What was the prerequisite for new research work in this direction?

– The problem with the immune status of goats, resulting from the vaccination of animals against anthrax and sometimes leading to their death, causes dissatisfaction with the owners. Complaints and reports of cases of post-vaccination complications are periodically received. Therefore, the question arose of the need to improve the methods of quality control of anthrax vaccines. The Scientific and Technical Commission of the Rosselkhoznadzor approved the program and stages of research work, the purpose of which is to increase the effectiveness and safety of the anthrax vaccine used in Russia.

– What tasks are planned to be solved within the framework of this work?

– First of all, it is necessary to determine the sensitivity of goats of various breeds to anthrax vaccines of domestic manufacturers, taking into account local and general reactions of the body in the post-vaccination period. It is also necessary to establish the optimal immunizing dose and develop a scheme for immunizing goats against anthrax. This will take into account the results of studying the sensitivity of animals to cultures of different vaccine strains. Another task is to improve the method of quality control of anthrax vaccines in terms of “harmlessness”.

– How much time is devoted to these tasks?

– The work is planned for the period from 2019 to 2021. Its responsible executor is the deputy head of the laboratory for the quality and standardization of bacterial medicines of the Federal State Budgetary Institution “VGNKI”, candidate of veterinary sciences, associate professor Lusine Hamletovna Tsaturyan, who specializes in the study of this zoonosis. Researchers and junior staff of this laboratory will participate in the work.

Scientists will have to monitor the content of antibody titer in the blood of vaccinated animals. Representatives of all breeds of goats that are found on the territory of our country will take part in the tests.

– How will the results be used?

– Upon completion of the research work, an optimal scheme for immunizing goats and other animals against anthrax will be proposed and appropriate methodological recommendations will be given. The results obtained will serve as the basis for making changes to GOST R 52616-2006, as well as to the regulatory documents of vaccine manufacturers, subject to their consent. Research aimed at improving the efficacy and safety of anthrax vaccines should help overcome the reluctance of owners to vaccinate animals against anthrax, as well as their mistrust of veterinarians.

It is worth noting that this urgent problem should be solved as quickly as possible. Moreover, its decision depends not only on VGNKI specialists, but also on vaccine manufacturers, the country’s veterinary services, regardless of their departmental subordination, as well as on animal owners. Joint efforts of all interested parties are needed. Inaction will contribute to the persistence of the risk of new anthrax outbreaks with all the negative consequences inherent in this.

Anthrax – pathogen, how it is transmitted, symptoms, signs, diagnosis, treatment, prevention

Etiology

How it is transmitted

Forms

Symptoms

Diagnosis

Treatment

900 02 Prevention

Anthrax (anthrax) is a particularly dangerous infection, characterized by the formation of specific carbuncles on the skin and mucous membranes or the development of inflammatory-hemorrhagic changes in the intestines and lungs, proceeds with severe intoxication.

In Russia, outbreaks of anthrax among animals are annually recorded, leading to infection of humans.

Anthrax etiology

The causative agent of anthrax is a large anthrax bacillus (Bacillus anthracis), 6–10 μm long and 1–2 μm wide, with ends cut off at a right angle, immobile, gram-positive, forms spores and a capsule, facultative aerobe.

Vegetative forms are found in the body of sick or dead people and animals. The bacterium has capsular and somatic antigens. The capsule distinguishes anthrax from other representatives of the genus Bacillus, it provides the microorganism with protection from phagocytes. Vegetative forms quickly die without access to air, are sensitive to boiling (at a temperature of 75–80 ° C they die after 1 minute), chlorine-containing and mercury-containing disinfectants.

Spores are resistant to poor environmental conditions and can survive for years on dried or treated skins and soil. When autoclaved (110 °C), they die only after 40 minutes.

How anthrax is transmitted

The source of anthrax infection is livestock and wild animals. Poultry is not susceptible to infection. Causes of anthrax infection: direct or indirect contact with a sick animal.

Ways of disease transmission:

• contact (most common) – care of infected animals and their slaughter; when a person with pre-existing skin damage comes into direct contact with anthrax spores;
• alimentary – the use of raw or undercooked meat of an infected animal;
• airborne – inhalation of air contaminated with anthrax spores.

The spread of anthrax from person to person is extremely unlikely. A relatively large dose is required to infect a human – between 8,000 and 50,000 spores would have to be inhaled. Thus, it takes only 10 to 100 microorganisms to cause smallpox. It is extremely rare that infection is possible when discharged from carbuncles gets on the injured skin or comes into contact with objects contaminated with the patient’s biomaterial.

After suffering from anthrax, a strong immunity remains.

Anthrax forms

1. Skin form.
2. Lung form.
3. Gastrointestinal form.
4. Anthrax sepsis.
5. Anthrax meningitis.

Symptoms and signs of anthrax

The time from the moment of infection to the first clinical manifestations is usually 1–3 days, may be delayed up to 7–14 days or reduced to several hours. The clinical picture of the disease depends on how the infection occurred.

Skin form. At the site of penetration of Bacillus anthracis, hyperemia, swelling and papule appear (similar to an insect bite), itching occurs. Further, a vesicle (vesicle) is formed, filled with light serous contents, which then becomes dark, bloody (pustula maligna). With mechanical damage, the bubble collapses, and a painless ulcer with a necrotic bottom is determined in the center. The edges of the ulcer are swollen and dense. Along the edges of a necrotic ulcer, single or multiple vesicles are formed. A new row of bubbles opens and, as it were, pushes the wound apart, the bottom of which sinks, becomes darker. Approximately a week later, an anthrax carbuncle is formed – in the center of the wound there is a black scab, the edges are raised, surrounded by a crimson inflammatory shaft.

Pulmonary form. It is characterized by lightning current. There are pains behind the sternum, cough, shortness of breath, palpitations, hyperthermia. A large amount of foamy bloody sputum is released, consciousness is disturbed. Death occurs on the 2-3rd day of the disease.

The intestinal form is also characterized by rapid development, a progressive course. The main manifestations: sharp increasing pain and bloating, hematemesis and diarrhea, dehydration, fever and chills.

Anthrax diagnostics

The diagnosis is established in the presence of characteristic symptoms, aggravated epidemiological history (contact with infected animals or animal skins, stay in endemic areas), isolation of Bacillus anthracis during bacteriological examination of the patient’s biological material:

• sputum;
• vomit and feces;
• discharge from the ulcer;
• pleural effusion;
• liquor;
• blood.

Using serological methods, the level of antibodies in the blood is determined (immunofluorescence reaction and indirect hemagglutination). As an auxiliary method, a skin-allergic test with anthraxin is performed (the reaction is taken into account after 24 and 48 hours – hyperemia and an infiltrate of more than 8 mm indicate infection).

Possible sources of infection are also investigated: wool, animal carcasses.

Anthrax treatment

According to the clinical guidelines for the management of patients with anthrax, all patients are subject to hospitalization, regardless of the form of the disease.

Etiotropic therapy. The best results are given by the early use of antibiotics in combination with anthrax immunoglobulin. Antibacterial drugs for the treatment of anthrax: “Benzylpenicillin”, “Ampicillin”, “Doxycycline”, “Ciprofloxacin”, “Ceftriaxone”.

Pathogenetic therapy. For removal from infectious-toxic shock, infusions of colloidal, crystalloid solutions are required to replenish the volume of circulating blood, to conduct detoxification. Steroid preparations (“Prednisolone”, “Dexamethasone”), anticoagulants (“Heparin”, “Warfarin”), cardiac glycosides (“Digoxin”, “Strophanthin K”) are used.

In the skin form of the disease, ulcers are treated with antiseptic solutions. Bandages are not applied, surgical treatment of wounds is not carried out – generalization of infection is possible.

Do not use antibiotics or any other medicine for treatment or self-protection without first consulting a doctor.

Prevention of anthrax

1. Prevention of diseases in farm animals by vaccination. If a disease is detected in animals, a veterinary quarantine is established. In the barns, disinfection is carried out, sick animals are isolated and treated, the corpses of animals that have died from anthrax are burned (burial is prohibited). The carcass must not be opened, as exposure to oxygen will allow bacteria to form spores.
2. Persons who have been in contact with sick cattle are subject to medical supervision for 8 days. Emergency prophylaxis is carried out with penicillin preparations and anthrax immunoglobulin.
3. Sick and suspected of infection are hospitalized in a separate infectious unit with the issuance of individual items of care, linen, dishes. Biological secretions of patients (vomit, feces, urine, feces) are disinfected. Discharge from the hospital after a complete clinical recovery with epithelization of ulcers, and with intestinal and pulmonary forms – after a double negative bacteriological examination of feces, urine and sputum for Bacillus anthracis.
4. Anthrax vaccines are available for livestock and humans. Veterinary vaccines are used to control anthrax in livestock. Anthrax prophylaxis is used primarily to protect individuals who may be exposed to occupational exposure to anthrax.

The author of the article:

Vasilevskaya Darya Mikhailovna

infectious disease specialist

work experience 3 years

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