Considerations for anthrax vaccine adsorbed (AVA) post- exposure prioritization : final
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Considerations for anthrax vaccine adsorbed (AVA) post- exposure prioritization : final

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    This document reflects the current understanding of the unique situation that will exist after a wide-area aerosol anthrax attack and outlines a prioritization scheme for post-event use of AVA. Supplies of AVA may be insufficient to protect the entire exposed population in a large scale release. Producing new lots of AVA can take months, so production may not be rapidly increased in a surge fashion when an event occurs.

    These guidelines are a risk-based approach to handling prioritization of AVA following an intentional release of Bacillus anthracis spores. The initial focus is on individuals present in the primary area of release (affected area) because they are at the highest risk of exposure to primary aerosols of B. anthracis spores. Risk based on exposure to secondary aerosols of B. anthracis spores will determine subsequent groups. The document describes the risk-based approach to prioritization of AVA on page 9. Please note, early in the wake of a release of B. anthracis spore aerosols, the ability to precisely identify boundaries of the affected area will be difficult. As more illness surveillance data and analyses from environmental sampling emerge, our understanding of the event and risk of illness will evolve and improve over time.

    As stated in the disclaimer, this document considers prioritization of AVA in a post-event wide-area B. anthracis spore aerosol attack and not policy considerations for pre-event vaccination or for reserving vaccine post-event. All persons with potential exposure to B. anthracis spores will be offered a 60-day course of antibiotics post-event. Thus, there are no prioritizations for antibiotics,1 since adequate supplies of antibiotics are available. In addition, this guidance is focused on considerations for vaccine only and will not consider specific worker safety requirements, such as personal protective equipment (PPE).2 This document offers guidelines for operational planning. Ultimately, decisions about vaccine administration, program monitoring, and implementation of these guidelines will be made by federal, state, and local health and emergency management officials who are responsible for administration of vaccine.


  • Content Notes:
    Background on anthrax and AVA -- AVA prioritization guidance background and methods -- Definitions and major concepts -- Summary of post-exposure prophylaxis (PEP) prioritization rationale -- Vaccine prioritization tiers -- Appendix A: National Infrastructure Protection Plan Sectors and Sector Components -- Appendix B: Summary of Focus Group Results -- Appendix C: August 20th Stakeholder Meeting Invitees/Attendees -- Appendix D: Federal Steering Committee Members.
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