Anthrax vaccine option has few takers so far

Jan 2, 2001 (CIDRAP News) – Aside from Capitol Hill staff members, only 52 of more than 3,500 people who have been offered the anthrax vaccine because of the recent mail attacks have decided to take it, according to the Centers for Disease Control and Prevention (CDC).

Kathy Harben of the CDC press office in Atlanta said 3,544 people in New York City, New Jersey, Florida, and Washington, DC, have been briefed about the vaccine and an additional 40-day course of antibiotic treatment. Of that number, 52 decided to take the vaccine and antibiotics, and 864 decided to take only the additional antibiotics, she said.

Harben said these numbers do not include congressional staff members in Washington, some of whom have taken antibiotics because of possible exposure from contaminated letters sent to Sen. Tom Daschle, D-S.D., and Sen. Patrick Leahy, D-Vt. Updated figures for the congressional staff members were not immediately available, but previous reports said that 48 Capitol Hill staff members started taking the anthrax shots Dec 20.

Because of a small theoretical risk that anthrax spores can persist in the body longer than 60 days, federal officials announced Dec 18 that the extended antibiotic treatment and the vaccine would be offered to people who might have been exposed to anthrax recently. About 10,000 people were advised to take a 60-day antibiotic regimen to protect them from inhalational anthrax as a result of the mail attacks last fall, according to Harben. Most of those at risk are postal workers; some are news media employees.

The current vaccination program is considered experimental because the anthrax vaccine has not been used previously for postexposure prophylaxis. The vaccine is used by the US military to protect soldiers who face a potential risk of future exposure. Because the risk of late-erupting anthrax from the mail attacks is believed to be very low and the vaccine can cause side effects, federal health officials are offering the vaccine as an option rather than firmly recommending it.

The vaccine is being made available to all the people who were advised to take 60 days of antibiotics after the anthrax episodes in October, Harben told CIDRAP news. She said that through Dec 31, 3,544 people had been "educated" about the vaccine and additional antibiotics. That number included 2,165 people in New York City, 880 in Washington, 477 in New Jersey, and 62 in Florida.

The 52 people who decided to take the vaccine and antibiotics included 7 in New York City, 26 in Washington, 15 in New Jersey, and 4 in Florida, Harben said. The 864 who are taking only the antibiotics include 158 in New York City, 513 in Washington, 155 in New Jersey, and 38 in Florida. The vaccine is being offered only in conjunction with the continued antibiotics. The vaccine is being given in three doses over 4 weeks, which is believed to provide protection for several months.

Harben said the vaccine also will be offered to people in Connecticut who may have been exposed in connection with the case of Ottilie Lundgren, an elderly Oxford, Conn., woman who died of inhalational anthrax Nov 21. But the program in Connecticut has not yet been started because the group there began their 60-day antibiotic regimen later than the other groups. How Lundgren was exposed to anthrax remains unknown, but anthrax spores were found on three mail-sorting machines in a Wallingford, Conn., postal facility that serves Oxford and other nearby towns.

Educational programs for the at-risk groups have included small-group and one-on-one counseling and printed materials that individuals could take to their own physicians, Harben said. Those choosing the antibiotics or vaccine plus antibiotics were required to sign an informed consent form (see link below) advising them of possible side effects and explaining that this use of the vaccine is experimental. The form says that the Food and Drug Administration considers the vaccination program a clinical investigation, and participants therefore will be asked to keep a health diary for the first 6 weeks.

In military personnel, common temporary side effects of the anthrax vaccine are reported to include irritation or a nodule at the vaccination site and systemic symptoms such as rash, headache, and joint aches. Severe allergic reactions are said to occur in about 1 in 100,000 people. Some military personnel have complained that the vaccine has caused chronic health problems.

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