High reaction rates in England, too.

[Guest guest]

1: J R Army Med Corps 2000 Oct;146(3):191-5

Adverse reactions to anthrax immunisation in a

military field hospital.

SC, World MJ.

33 Field Hospital Fort Blockhouse, Gosport,

Hants, PO12 2AB.

OBJECTIVE: To determine the outcome of anthrax

immunisation. METHODS: Adverse reactions (occurrence, nature, severity

and

incapacity) and immune responses to a voluntary

programme of anthrax immunisation at 0, 3, 6, and 24 weeks were

monitored by

questionnaire and voluntary blood sampling in 129

members, including 24 immunised 7 years previously (immunes), of a

military field

hospital alerted for possible deployment.

RESULTS: Follow-up was complete in 85%. Ninety-eight (76%) received the

first anthrax

immunisation. Uptake was greater (p = 0.015) in

immunes. Initial prevalence of adverse reaction was 63%. Subsequent

uptake and

adverse reaction dwindled significantly (p <

0.001). Only 28 (22%) were immunised at 24 weeks. Proportions reporting

adverse reactions

following the initial immunisation were greater

in immunes (p = 0.046) and officers (p = 0.02). There was no significant

(p = 0.36)

correlation between uptake of immunisation and

prevalence of adverse reaction. Antecedent adverse reaction did not

reduce the

proportion of participants accepting immunisation

subsequently. The nature of adverse reactions (47% local, 24% systemic

and 27% both)

and severity were the same throughout. Forty-five

percent of adverse reactions caused incapacity. Seventy-four percent of

these had pain

in the injected arm (+/- systemic symptoms) which

prevented lifting or driving for 48 hours in 63%. Immune responses were

greater in

immunes. CONCLUSIONS: It was concluded that

anthrax immunisation results in a higher than expected prevalence of

adverse reaction

with initial incapacity of military significance

affecting 18%. Greater immune responses may increase adverse reaction

but this does not

affect acceptance of anthrax immunisation. Poor

completion rates necessitate development of a new anthrax immunisation

strategy.

PMID: 11143687 [PubMed - indexed for MEDLINE]