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http://bmj.com/cgi/content/full/324/7338/630/b
The anthrax vaccine licensed in the United States is safe and effective, but it has major drawbacks that "underscore the need for a new and improved alternative," said Dr Brian Strom, announcing the publication of a report on anthrax vaccine by the US Institute of Medicine.
Dr Strom, professor of biostatistics and epidemiology at the University of Pennsylvania, chaired the committee that prepared the report.
Among the vaccine's disadvantages are that it requires six doses over 18 months to achieve full protection and a booster dose is needed every 12 months. The vaccine is given subcutaneously rather than intramuscularly, which, the report says, may result in a higher incidence of local reactions than with a reduced schedule or with intramuscular administration.
The vaccine, which dates back to 1970, is manufactured using old technologies that could be improved, Dr Strom added. He said the prospects for developing a new vaccine were good. A study is currently being done by the Centers for Disease Control and Prevention in Atlanta to determine whether other routes of administration can provide protection.
The need for an anthrax vaccine became a national concern in the United States late last year when deliberate distribution of anthrax spores through the postal system caused five deaths and 13 non-fatal infections. This, said Dr Strom, spurred the committee into completing its report earlier than planned. The committee had started work reviewing the safety and efficacy of the vaccine late in 2000, at the request of the US Department of Defence.
In 1998 the uniformed services started routine immunisation of troops to protect against exposure to anthrax bioweapons. The move raised questions among some people, who feared untoward reactions to the vaccine. Although some two million personnel were vaccinated, more than 400 refused.
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Footnotes
The Anthrax Vaccine: Is it Safe? Does it Work? is available on the National Academy Press website: www.nap.edu
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