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Anthrax I: Vaccine Could Be Good Post-Exposure Remedy, Experts Say By Mike Nartker Brian Strom, chair of the institute committee that produced the report, said he supports using U.S.-licensed vaccine in tandem with antibiotics such as Cipro to prevent germination of anthrax spores in the body after exposure. In 2000, the Defense Department commissioned the institute to examine the safety and effectiveness of the sole U.S. licensed anthrax vaccine (see GSN, March 1). The institute found that the vaccine is both safe and effective for developing immunity to anthrax and preventing progression of the disease after exposure. When asked whether he would have recommended that postal workers take the vaccine, Strom said that as a physician, “knowing what I know now,” he would have recommended that they be inoculated. Strom stressed the need to administer antibiotics with the vaccine in post-exposure regimens to allow time for the vaccine to trigger immunity. More long-term studies on the vaccine as a post-exposure option are needed, because current data are based on limited animal studies, and the U.S. Food and Drug Administration would have to approve the treatment, he said (see GSN, Feb. 1). The anthrax vaccine could be effective against all strains of the anthrax bacterium, Bacillus anthracis, including genetically modified forms, Strom said. The vaccine works directly on toxins released by anthrax bacteria, and for the disease to be fatal the toxins must remain unchanged. Although the vaccine is safe, Strom said he would not recommend a broad immunization program. The vaccine does have risks and should not be used indeterminately, he said. There is no need to inoculate the general population because anthrax does not spread through person-to-person contact. Instead, the vaccine has been categorized for “high risk” recipients, Strom said. Further Development Needed Although the anthrax vaccine is safe and effective, side effects and the high number of inoculations needed over a long time-period indicate need for continued development of new alternatives, the report said. Currently, the vaccine is administered in a series of six injections over an 18-month period. Additional annual booster injections sustain immunity. The side effects associated with the vaccine, such as redness and swelling at the injection site, are comparable with those for other vaccines, Strom said, adding that some of the side effects might come from the fact the vaccine is injected under the skin, instead of into the muscle as with other vaccines. Other reported side effects, such as malaise and muscle pains, occur less frequently, Strom said. He added that the data used in the study showed no permanent, disabling reactions associated with the vaccine. Even though most side effects from the current anthrax vaccine are mild, Strom said, he still recommends developing an alternative — one requiring fewer injections. That would allow people to build up immunity to anthrax faster and reduce the total risk from any side effects, Strom said. The main reason for a new vaccine, however, is that “getting injections hurts,” Strom said.
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