Anthrax Vaccine Recommendations

For the recommendations of the Advisory Committee on Immunization Practices (ACIP), see Anthrax ACIP Vaccine Recommendations.

Pre-exposure Vaccination

CDC recommends anthrax vaccination for three groups of adults 18 through 65 years of age who may be at risk for occupational exposure to the bacteria:

• 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

Post-exposure Vaccination

CDC recommends a post-exposure regimen of 60 days of appropriate antimicrobial prophylaxis combined with 3 subcutaneous doses of the anthrax vaccine for previously unvaccinated people 18 years or older who have been exposed to aerosolized Bacillus anthracis spores.

Contraindications and Precautions

Anthrax vaccine should not be administered to:

• A person who has ever had a severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine component
• Pregnant women when the risk to anthrax exposure is low

Anthrax vaccine may be administered, if the provider deems the benefits of vaccination to outweigh the risks, to:

• A person with a latex allergy. Because the vaccine vial stopper contains dry, natural rubber, caution should be used when administering the vaccine to persons with a latex allergy. Epinephrine solution (1:1000) should be available for immediate use in the event that an anaphylactic reaction occurs.
• A person with a history of anthrax disease. A history of anthrax disease might increase the potential for severe local reaction after anthrax vaccine administration.
• A person with an impaired immune response. Patients with an impaired immune response might not be adequately immunized after administration of an anthrax vaccine.
• A person with a moderate or severe acute illness. In a standard pre-exposure vaccination program, vaccination of persons with moderate or severe acute illness should be postponed until after recovery. In a post-event setting, the risks of administering an anthrax vaccine to a person who has been exposed to anthrax but has moderate or severe acute illness should be weighed against the benefits of vaccination. The anthrax vaccine may be administered to persons who have a mild illness with or without a low-grade fever.