Anthrax vaccine
- Drugs List
- Therapeutic Indications
- Dosage
- Administration
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Vaccine containing anthrax antigens.
Drugs List
Therapeutic Indications
Uses
Anthrax - prophylaxis
Prophylaxis against anthrax infection where exposure to Bacillus anthracis is anticipated.
For comprehensive information or advice on this product or the immunisation programme in the UK, the following website should be accessed.
https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book
Dosage
The following dose schedules are in line with national guidelines.
Adults
Primary immunisation
Inject 0.5ml preferably in to the deltoid muscle for 3 doses, each dose should be separated by an interval of three weeks.
After 6 months from the third dose, a fourth dose of 0.5ml should be administered.
Booster immunisations
For those considered to be at continued risk, a booster dose of 0.5ml (preferably into the deltoid muscle) should be given every 10 years for up to 3 doses following completion of the primary immunisation schedule.
Where one or more of the recommended doses has been missed, advice should be sought from Public Health England.
Elderly
Caution should be exercised as there is no evidence to recommend doses in the elderly.
(See Dosage; Adult).
Children
Caution should be exercised as there is no evidence to recommend doses in children.
(See Dosage; Adult).
Administration
Intramuscular injection, preferably in to the deltoid muscle.
Individuals with a bleeding disorder should be given the vaccine by deep subcutaneous injection.
Contraindications
None known
Precautions and Warnings
Children under 18 years
Elderly
Immunosuppression
Severe febrile conditions
Breastfeeding
Coagulopathy
Immunodeficiency syndromes
Pregnancy
Postpone immunisation if there is active or suspected infection
Impaired response possible in immunocompromised patients
Seek expert advice on post-exposure prophylaxis
Vaccine may not be effective in 100% of patients
Presentation (e.g. syringe, needle cap) may contain a derivative of latex
Some brands may contain formaldehyde
Some brands may contain thiomersal
Some formulations contain benzethonium chloride
Do not mix with other vaccines in the same syringe
Inject other vaccines at different sites
Record name and batch number of administered product
Resuscitation facilities must be immediately available
Follow national immunisation guidelines
Seek expert advice if one or more doses are missed
Vaccination during chemotherapy, high dose corticosteroid therapy of greater than 2 week duration, or radiation therapy may result in a suboptimal response. Deferral of vaccination for 3 months after completion of such therapy may be considered.
Pregnancy and Lactation
Pregnancy
Use anthrax vaccine with caution during pregnancy.
The manufacturer does not recommend the use of anthrax vaccine during pregnancy unless the potential benefits of vaccination clearly outweigh the potential risks to the foetus. Anthrax vaccine may be given to pregnant women when clinically indicated.
There is limited published information regarding the use of anthrax vaccine during pregnancy (Briggs, 2015). No effects on pregnancy, maternal behaviour, female fertility or postnatal development were observed in animal studies.
Lactation
Use anthrax vaccine with caution during breastfeeding.
The manufacturer states that it is unknown if anthrax vaccine is excreted in human milk.
There is limited published information regarding the use of anthrax vaccine during breastfeeding, vaccination should be avoided unless it is considered essential (Briggs, 2015).
Side Effects
Alopecia
Anaphylactic reaction
Angioedema
Arthralgia
Asthenia
Breathing difficulties
Bronchospasm
Chills
Circulatory collapse
Cold sweat
Cough
Decrease in heart rate
Diarrhoea
Dizziness
Dry skin
Dysmenorrhoea
Dyspepsia
Dysphagia
Dysphonia
Eczema
Erythema at injection site
Fatigue
Febrile reactions
Fever
Guillain-Barre syndrome
Headache
Herpes zoster
Hives
Hypersensitivity reactions
Hypotension
Increased heart rate
Increased sweating
Influenza-like symptoms
Injection site reactions
Insomnia
Local pain (injection site)
Lymphadenopathy
Malaise
Malignant breast disease
Myalgia
Nausea
Ocular allergy
Pain
Pallor
Palpitations
Paraesthesia
Pruritus
Pseudotumour cerebri
Radiculitis
Rash
Renal disorders
Respiratory congestion
Respiratory tract infection
Rhabdomyolysis
Rhinitis
Rotator cuff injury
Seizures
Sinusitis
Sneezing
Somnolence
Stiffness
Swelling (injection site)
Swelling of lips and face
Syncope
Throat swelling
Upper abdominal pain
Urticaria
Vomiting
Weakness
Wheezing
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: March 2019
Reference Sources
Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.
Summary of Product Characteristics: Anthrax vaccine. Secretary of State for Health. Revised May 2015.
Summary of Product Characteristics: BioThrax suspension for injection in multidose vial. Secretary of State for Health. Revised May 2018.
Immunisation against infectious disease: the Green Book.
Available at: https://www.gov.uk/government/publications/anthrax-the-green-book-chapter-13
Anthrax vaccine Last revised: 21 February 2017.
Last accessed: 20 March 2019.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 20 March 2019.
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