Recommendations for use of anthrax vaccine absorbed, by type of population

PEP: post-exposure prophylaxis.
* Five 0.5 mL doses administered intramuscularly at 0 weeks, 4 weeks, 6 months, 12 months, and 18 months; annual boosters are required to maintain immunity.
¶ Three 0.5 mL doses administered subcutaneously at 0, 2, and 4 weeks after exposure to aerosolized Bacillus anthracis spores for persons who have not completed the pre-event vaccination schedule.
Δ Recommended only if handling potentially infected animals in research settings or in areas with a high incidence of enzootic anthrax or when standards and restrictions are insufficient to prevent exposure to B. anthracis spores.
◊ Laboratorians who work (1) with pure cultures of B. anthracis or preparations of B. anthracis spores, (2) with environmental samples associated with anthrax investigations, or (3) in spore-contaminated areas or other settings with exposure to aerosolized B. anthracis spores. Laboratorians who do not work in these settings are not recommended for pre-event vaccine.
§ Persons involved in emergency response activities might include persons who work in police departments, fire departments, hazardous material units, and the National Guard, as well as other government responders. These persons might perform site investigations, respond to suspicious substance reports (also known as white powder incidents), and perform other related activities, such as evacuation procedures or other activities critical to the maintenance of infrastructure.