Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, USA.
MMWR Recomm Rep. 2010 Jul 23;59(RR-6):1-30.
These recommendations from the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations for anthrax vaccine adsorbed (AVA) (CDC. Use of anthrax vaccine in the United States: Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2000;49:1-20; CDC. Use of anthrax vaccine in response to terrorism: supplemental recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51:1024-6) and reflect the status of anthrax vaccine supplies in the United States. This statement 1) provides updated information on anthrax epidemiology; 2) summarizes the evidence regarding the effectiveness and efficacy, immunogenicity, and safety of AVA; 3) provides recommendations for pre-event and preexposure use of AVA; and 4) provides recommendations for postexposure use of AVA. In certain instances, recommendations that did not change were clarified. No new licensed anthrax vaccines are presented. Substantial changes to these recommendations include the following: 1) reducing the number of doses required to complete the pre-event and preexposure primary series from 6 doses to 5 doses, 2) recommending intramuscular rather than subcutaneous AVA administration for preexposure use, 3) recommending AVA as a component of postexposure prophylaxis in pregnant women exposed to aerosolized Bacillus anthracis spores, 4) providing guidance regarding preexposure vaccination of emergency and other responder organizations under the direction of an occupational health program, and 5) recommending 60 days of antimicrobial prophylaxis in conjunction with 3 doses of AVA for optimal protection of previously unvaccinated persons after exposure to aerosolized B. anthracis spores.
这些建议来自免疫实践咨询委员会（ACIP），更新了之前对吸附型炭疽疫苗（AVA）的建议（CDC. 在美国使用炭疽疫苗：免疫实践咨询委员会（ACIP）的建议[ACIP]。MMWR 2000;49:1-20;CDC. 应对恐怖主义使用炭疽疫苗：免疫实践咨询委员会（ACIP）的补充建议[ACIP]。MMWR 2002;51:1024-6），并反映了美国炭疽疫苗供应的状况。本声明 1）提供了炭疽流行病学的最新信息；2）总结了关于 AVA 的有效性和功效、免疫原性和安全性的证据；3）提供了 AVA 用于事前和暴露前使用的建议；4）提供了 AVA 用于暴露后使用的建议。在某些情况下，对没有改变的建议进行了澄清。没有提出新的获得许可的炭疽疫苗。对这些建议的重大修改包括：1）将完成事前和暴露前初级系列所需的剂量从 6 剂减少到 5 剂；2）建议在暴露前使用肌内而非皮下 AVA 给药；3）建议在孕妇接触气溶胶化炭疽芽孢杆菌孢子时，将 AVA 作为暴露后预防的一部分；4）提供了在职业健康计划指导下，对紧急和其他应急响应组织进行暴露前接种的指导；5）建议在接触气溶胶化 B. anthracis 孢子后，对以前未接种过疫苗的人进行 60 天的抗菌预防，并联合使用 3 剂 AVA，以获得最佳保护。
