ACIP opens door to anthrax shots for first responders

first_imgOct 23, 2008 (CIDRAP News) – The federal Advisory Committee on Immunization Practices (ACIP) has opened the door to voluntary anthrax vaccination for first responders, revising an 8-year-old recommendation against that step.The committee, meeting yesterday, said the risk of anthrax exposure for emergency responders is low but “may not be zero,” and therefore first-responder agencies may want to offer the vaccine on a voluntary basis, according to information supplied by the Centers for Disease Control and Prevention (CDC) today.The CDC routinely adopts the ACIP’s recommendations.Anthrax vaccination—which currently involves six doses over 18 months, followed by annual boosters—is required for US military personnel serving in the Middle East and other high-risk areas. Nearly 2 million service members have been vaccinated under the program, according to ACIP reports.However, a number of military members have complained of negative side effects from the shot, and a lawsuit by several of them interrupted mandatory vaccinations for about 2 years starting in October 2004. Another lawsuit against the program is still in the courts.Allowing the optionThe new recommendation adopted by the ACIP does not actively encourage anthrax shots for first responders. It states:”Emergency and other responders, including police departments, fire departments, hazardous material units, government responders, the National Guard and others, are not recommended for routine pre-event anthrax vaccination. However, the committee recognized that while the risk of exposure for first responders to anthrax is low it may not be zero. Therefore, first responder units may choose to offer their workers pre-event vaccination on a voluntary basis. The vaccination program should be carried out under the direction of a comprehensive occupational health and safety program.”In 2000 the ACIP recommended against “pre-event” anthrax shots for first responders, and that stance was reaffirmed when the committee revisited the issue after the anthrax attacks of late 2001, according to an online summary of the June 2008 ACIP meeting. The reasons for reconsidering that recommendation included a growing supply of the vaccine and new data suggesting a change in the vaccine’s safety profile, plus interest from some first-responder groups, according to comments made at that meeting.Interest from emergency respondersA change in the recommendation for first responders was proposed at the June meeting by an ACIP subcommittee called the Anthrax Vaccine Workgroup. The panel’s work was described by Jennifer G. Wright, DVM, MPH.”Post-event vaccination in combination with antibiotics is an effective intervention following exposure to B[acillus] anthracis spores, but the workgroup felt that pre-event vaccination could offer additional protection beyond that afforded by antibiotics and post[exposure] vaccination by providing early priming of the immune system,” the meeting summary states. “Some respondent organizations have stated that their members would be more willing to respond to a bioterrorism event if they were vaccinated prior to the occurrence of the event.”Dr. Richard Besser, director of the CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response, commented at the June meeting that a number of emergency response agencies had indicated interest in preemptive anthrax immunization for their workers, but the existing negative recommendation was seen as an impediment.Also at that meeting, the CDC’s Nancy Messonier said that the workgroup’s intent in proposing a change was “to open the door, knowing that the vaccine is commercially available and that first responder groups are at liberty to call the manufacture to obtain the vaccine themselves,” the meeting summary states.The FDA-licensed vaccine, called anthrax vaccine adsorbed (AVA) (Biothrax), is made by Emergent BioSolutions Inc. Current annual production capacity is 8 million to 9 million doses, up from about 2 million in 2002, the June meeting report says. A new manufacturing facility that is being tested will eventually boost production to as many as 30 million to 35 million doses, it says.”The workgroup felt that at the current time, vaccine supply was sufficient to support vaccination for a large group of individuals,” the report states. It says the nation may have as many as 3 million first responders, depending on how the term is defined.The work group concluded that the risk of anthrax exposure for first responders through a bioterrorism event is “undefinable,” the summary states. However, the group concluded that the available data suggest that the vaccine is safe and effective.Fewer adverse eventsThrough June 2008, 4,705 reports of adverse events associated with anthrax vaccination of military personnel were filed with the government’s Vaccine Adverse Event Reporting System, the report says. That represents a rate of 61.1 reports per 100,000 doses, as compared with 117 reports per 100,000 doses of smallpox vaccine. About 10% of the reports described “serious” adverse events.The report also said that in February the ACIP looked at data showing a decrease in local adverse events when the vaccine was given intramuscularly rather than by the standard subcutaneous route. That was an apparent reference to interim findings in a CDC study, which were reported in the Oct 1 Journal of the American Medical Association (JAMA; see link to news story below).The JAMA report said people who were vaccinated intramuscularly had fewer injection-site reactions after four doses than those who received subcutaneous shots. It also said those who received three intramuscular shots in the first 6 months had about the same immune response as those who received the standard four subcutaneous shots, suggesting that dose reduction may be possible.Discussion at the June ACIP meeting pointed out the challenges that would be posed by any effort to vaccinate large numbers of first responders, given the number and timing of doses involved. These include determining who would administer the vaccine, tracking recipients to keep them on schedule, providing liability coverage, monitoring adverse events, and caring for those who experience adverse events.Postexposure protectionAt yesterday’s meeting, the CDC reported, the ACIP also made a recommendation on postexposure protection against anthrax: 60 days of antimicrobial treatment in combination with three doses of vaccine. Vaccine should be offered within 10 days of exposure.”Anthrax vaccine is not licensed for children and has not been studied in children,” the CDC update said. “However, postexposure anthrax vaccination in children potentially exposed to anthrax may be considered on an event-by-event basis in conjunction with 60 days of antibiotics.”The recommendation on postexposure prophylaxis includes pregnant women. “Pregnancy is neither a precaution nor a contraindication. Pregnant women should receive vaccine and antibiotics if they are exposed to inhalation anthrax,” the CDC said.See also: Minutes of June 2008 ACIP meeting, including discussion of anthrax vaccinehttp://www.cdc.gov/vaccines/recs/acip/downloads/min-archive/min-jun08.pdfOct 6 CIDRAP News story “Trial offers hope for shortening anthrax-shot series”Oct 2 CIDRAP News story “To blunt anthrax attack, mail carriers to get antibiotics”last_img read more

103-year-old Iran woman survives coronavirus: report

first_imgThe woman was the second elderly patient in Iran to have survived the disease.The other was a 91-year-old man from Kerman, in the southeast of Iran, the news agency said.After being sick for three days, he recovered on Monday despite having pre-existing medical conditions including high blood pressure and asthma, it added.The report did not say how the pair were treated. A 103-year-old woman in Iran has recovered after being infected with the new coronavirus, state media reported, despite overwhelming evidence the elderly are most at risk from the disease.The unnamed woman had been hospitalized in the central city of Semnan for about a week, IRNA news agency said.But she was “discharged after making a complete recovery”, Semnan University of Medical Sciences head Navid Danayi was quoted as saying by IRNA late Tuesday. Since Iran announced its first deaths on Feb. 19, the novel coronavirus has spread to all of the country’s 31 provinces and killed nearly 1,000 people.The elderly are the most vulnerable to the disease, which first emerged in China late last year.The World Health Organization this month estimated the novel coronavirus kills 3.4 percent of all those infected.But for people aged over 80 the fatality rate was 21.9 percent, according to a report the WHO carried out with the Chinese authorities.center_img Topics :last_img read more

Neymar Agrees Five-year £450m PSG World-record Deal

first_imgIt is understood the total value of the deal is worth nearly £450m (€500m), which includes wages, bonuses and a buyout clause of £198m (€222m). Neymar has been offered a basic salary of £26.8m-a-year (€30m) after tax, around £515,000-a-week.Barcelona confirmed the buyout clause will have to be “deposited in its entirety” for the deal to pull through.Sky Sports News has been told that a key meeting took place in Brazil earlier last month involving Neymar, his father and super-agent Pini Zahavi, who has brokered the deal.Zahavi has known Neymar since the age of 17 and has become one of his closest advisors.A source in Spain close to Neymar has told Sky Sports News: “Since he decided to leave, Neymar has had to deal with huge pressure to stay at Barcelona. His teammates wanted him to stay but his decision was made.”The source added that Neymar had been “close” to joining Manchester United in last summer’s transfer market but chose PSG after a further season at Barcelona.Neymar is expected to join five Brazilian international teammates at PSG, including Dani Alves and Thiago Silva.The source said: “People will say this has been driven by money, but he wants to become the leader at the club. He wants to be independent, and wants to win the Ballon d’Or. He believes he can do that in Paris.”La Liga President Javier Tebas has threatened to block the transfer but it’s understood PSG officials remain “very confident” there will be no issues with the buyout clause.PSG has yet to confirm whether an agreement has been reached.Share this:FacebookRedditTwitterPrintPinterestEmailWhatsAppSkypeLinkedInTumblrPocketTelegram Brazil and Barcelona star, Neymar, has agreed a five-year deal with Paris Saint-Germain and is due in Paris within the next 24 hours to finalise the most expensive transfer in world football history, according to Sky sources.Sky Sports News learnt that Neymar decided to leave Barcelona following talks on holiday near Rio de Janeiro in early July, before he joined the club’s pre-season tour of the United States.He is expected to arrive in the French capital by Friday at the latest to complete his move.last_img read more