Arguments Against Anthrax

With consideration of the First Responder Anthrax Preparedness Act in the U.S. Senate (S. 1915) following passage in the U.S. House of Representatives (H.R. 1300), as well as House consideration of the PREPARE Act (H.R. 3583), it is important to revisit the concerns of first responders as they relate to the threat of anthrax and anthrax vaccination. The health and safety of America's first responders are the reasons for consideration of these bills, which include language to provide emergency responders access to anthrax vaccine in the Strategic National Stockpile.
OVERALL TAKEAWAY
The best protection for first responders when faced with an intentional or accidental release of anthrax is to be previously vaccinated. Currently, the U.S. Congress
The threat of bioterrorism is real. Although the threat of bioterrorism, itself, and the specific use of anthrax cannot be accurately quantified, the threat does exist and includes antibiotic-resistant strains of the organism rendering traditional antibiotic treatment, including all currently stockpiled antibiotics, ineffective.1,2 In this worse-case attack scenario, post-exposure vaccination is likely to fail with infection rapidly progressing to sepsis and death before the vaccine is able to confer immunity to the exposed first responders.3 The best mitigation strategy for the threat to first responders during a bioterrorism-related release of antibiotic-resistant anthrax is a voluntary, pre-exposure immunization program.4 Pre-attack vaccination of any person who self-assesses a high risk of exposure is the best strategy for preparedness to anthrax bioterrorism since the resultant immunity protects against anthrax disease inflicted by both antibiotic-sensitive and antibiotic-resistant
Annually, 1.5 – 2-million vaccine doses of the FDA-licensed anthrax vaccine expire from the Strategic National Stockpile. Every year since 2009, according to the U.S. Government Accountability Office6, an estimated 1.5-2 million vaccine doses of the FDA-licensed anthrax vaccine stored in the Strategic National Stockpile (SNS) go to waste. Some estimates put the waste at 600,000 doses a month. These doses could be offered to Americans at high risk to anthrax bioterrorism, specifically first responders who would routinely respond to “white powder scares”.7 This group includes but is not limited to: police/security officers, fire fighters, paramedics/EMTs, public health officials, public works personnel, utilities employees, HAZMAT, SWAT, and health care professionals who serve as first receivers in emergency rooms. Additionally, based on the deadly two-wave, multi-site attack via the US Postal Service, the vaccine is also appropriate for all Americans from groups victimized by the 2001 anthrax attacks.8 This includes mail/shipping carriers, media personalities, government officials, and their