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Health-Related Quality of Life in the Anthrax Vaccination Program for Workers in the Laboratory Response Network
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2 27 2012
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Source: Vaccine. 30(10):1841-1846
[PDF-209.97 KB]
Details:
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Alternative Title:Vaccine
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Personal Author:
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Description:Background:
In 2002 CDC initiated the Anthrax Vaccination Program (AVP) to provide voluntary pre-exposure vaccination with Anthrax Vaccine Adsorbed (AVA) for persons at high risk of exposure to B. anthracis spores. There has been concern that AVA could be associated with long term impairment of mental and/or physical health.
Objectives:
To ascertain whether physical and mental functional status, as measured by the SF-36v2 health survey (Medical Outcomes Trust, Boston, MA), of AVA recipients and controls changed differently over time.
Methods:
We enrolled 437 exposed (received AVA) and 139 control subjects. The exposed group received AVA under then-current Advisory Committee on Immunization Practices (ACIP) recommendations of 0.5 mL doses given SQ at 0, 2, and 4 weeks, and 6, 12, and 18 months, followed by annual boosters. SF-36v2 surveys were completed just before injection at 0, 12, and 30 months. The subjects’ answers to the survey questions were summarized into a physical and a mental score at each of the three time points. SF-36v2 physical and mental scores both range from 0-100 with an estimated national average of 50 points. We assessed change in physical and mental score from baseline at 12 and 30 months, and examined whether there was a difference between the exposed and control subjects; positive changes in the scores indicated improving, and negative changes worsening, physical or mental function.
Results:
At baseline, average physical scores were 55.4 among exposed and 54.5 among controls (p=0.07); mental scores were 55.0 among exposed and 51.4 among controls (p<0.0001). For physical scores, the average change from baseline was −0.53 for exposed vs. −0.67 for controls at 12 months (p=0.80) and −1.09 for exposed vs. −1.97 for controls at 30 months (p=0.23). For mental scores, the average change from baseline was −1.50 for exposed vs. −1.64 for controls at 12 months (p=0.86) and −2.11 for exposed vs. −0.24 for controls at 30 months (p=0.06). When adjusting for demographic and employment factors in multivariate linear models, the difference in mental score change between exposed vs. controls at 30 months was less pronounced (p=0.37 than it had been in univariate analyses, but other findings were similar to univariate analyses.
Conclusions:
We found no evidence that change in physical scores differed between the exposed and control groups at 12 or 30 months. Although the unadjusted change in mental score in exposed vs. control approached statistical significance at 30 months, the magnitude of this difference was small and a significant difference was not found in the the multivariable analysis. These results do not favor an association between receipt of AVA and an altered health related quality of life over a 30-month period.
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Source:
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Pubmed ID:22230591
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Pubmed Central ID:PMC11325479
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