Will ED nurses receive the anthrax vaccine?

Bioterrorism experts are calling for the anthrax vaccine to be offered to civilian emergency responders and critical infrastructure public safety workers, which could include emergency nurses.

"I believe emergency nurses who might come into contact with patients exposed to anthrax spores who have not been decontaminated should be offered the anthrax vaccine on a voluntary basis; however, I do not believe that this will happen in the near future and possibly not [at all] unless we face a large scale anthrax attack," says R. Gregory Evans, PhD, MPH, one of the authors of a consensus statement on the anthrax vaccine and director of the Institute for Biosecurity at the Saint Louis (MO) University School of Public Health.

As with any vaccine, the risks of unintended effects must be weighed against the risk of contracting the disease, according to K.C. Rondello, MD, MPH, assistant professor of emergency management and health services administration at Adelphi University in Garden City, NY. "As the risk is so low in the general population, routine vaccination of health care workers would seem unwarranted at this time."

Anthrax vaccination is "no simple matter," says Rondello. It is given as a series of six injections over an 18-month period. "While the efficacy is high after receiving the full regimen, the duration of that efficacy is unknown," he adds.

Cutaneous anthrax is easily treated with antibiotics, and although the pulmonary form can be deadly, it has a low mortality rate, notes Lisa Kosits, RN, MSN, BC, CCRN, CEN, clinical inservice instructor for the ED at Montefiore Medical Center in Bronx, NY. "You have to be exposed to a high number of spores in order to contract the illness. It is not transmittable from patient to patient," she says. "Since the risk to ED nurses is low, I would not recommend the vaccine for them."

Kosits says she has not been asked about it by any staff. "I do not believe there is an interest amongst ED nurses," she says.

However, there may be an unfounded fear of the anthrax vaccine among ED nurses, says Mercedes L. Wilson, RN, BSN, CEN, an ED nurse at Oregon Health & Sciences University in Portland. "From what I have read, the vaccine is as safe as any other vaccine. The severe problems associated with it are rare — less than one in 100,000," she says. "From a personal standpoint, I would be willing to get the vaccine if it was offered."

Sources

For more information on the anthrax vaccine, contact:

  • R. Gregory Evans, PhD, MPH, Professor and Director, Institute for Biosecurity at the Saint Louis (MO) University School of Public Health. Phone: (314) 977-8133. E-mail: evansrg@slu.edu.
  • Lisa Kosits, RN, MSN, BC, CCRN, CEN, Clinical Inservice Instructor, Emergency Department, Montefiore Medical Center, Bronx, NY. Phone: (718) 920-5241. Fax: (718) 324-4246. E-mail: lkosits@montefiore.org.
  • K.C. Rondello, MD, MPH, Assistant Professor, Emergency Management & Health Services Administration, Adelphi University, Garden City, NY. Phone: (516) 877-4544. E-mail: Rondello@adelphi.edu.
  • Mercedes L. Wilson, RN, BSN, CEN, Emergency Department, Oregon Health & Sciences University, Portland. Phone: (503) 494-6051. E-mail: wilsonm@ohsu.edu.