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anthrax vaccine adsorbed (AVA)

An Al(OH)3 precipitated preparation of Bacillus anthracis protective antigen from an attenuated, non encapsulated strain of B anthracis (Sterne). (See 'Virulence factors' under Bacillus anthracis.) Indications: - exposure to Bacillus anthracis spores - risk of exposure to Bacillus anthracis spores - postexposure prophylaxis, especially exposure to aerosolized Bacillus anthracis spores Dosage: (administration) 1) 0.5 mL SQ 2) repeat doses at 2 & weeks, then at 6, 12 & 18 months 3) 5 doses (total) for pre-exposure primary series [2] 4) IM injection for pre-exposure primary series [2,4] 5) boosters annually; booster can be given every 3 years [4] 6) may be administered concurrently with antibiotics for suspected exposure 7) 60 days of antimicrobial prophylaxis in conjunction with 3 doses of AVA for previously unvaccinated persons after exposure to aerosolized Bacillus anthracis spores [2] Notes: 1) 2 inoculations afforded protection to rhesus monkeys against inhalation anthrax 2) AVA provides protection against cutaneous anthrax in humans 3) there is a need for vaccines with better protection & a simpler schedule [1] 4) no new vaccines in last decade [2]

Related

anthrax (woolsorter's disease) B. anthracis protective antigen Bacillus anthracis

General

vaccine

References

  1. Dixon TC et al Anthrax. N Engl J Med 1999, 341:815 PMID: 10477781
  2. Wright JG et al Use of Anthrax Vaccine in the United States Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009 Morbidity and Mortality Weekly Report (MMWR); July 23, 2010 / 59(rr06);1-30 PMID: 20651644 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5906a1.htm corresponding NGC guideline withdrawn Jan 2016
  3. Lowes R Anthrax Vaccine Approved for Postexposure Protection. Medscape Oncology. Nov 24, 2015 http://www.medscape.com/viewarticle/854945?nlid=91968_3663&src=wnl_edit_newsal&uac=40275SJ&impID=899989&faf=1 - FDA News Release. November 23, 2015 FDA approves vaccine for use after known or suspected anthrax exposure. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm474027.htm
  4. Bower WA, Schiffer J, Atmar RL, et al. Use of Anthrax Vaccine in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2019. MMWR Recomm Rep 0019;68(No. RR-4):1-14 https://www.cdc.gov/mmwr/volumes/68/rr/rr6804a1.htm