Health-related quality of life in the Anthrax Vaccination Program for workers in the Laboratory Response Network

BackgroundIn 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 Bacillus anthracis spores. There has been concern that AVA could be associated with long term impairment of physical and/or mental health.ObjectivesTo 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.MethodsWe enrolled 437 exposed (received AVA) and 139 control subjects. The exposed group received AVA under then-current Advisory Committee on Immunization Practices (ACIP) recommendations. SF-36v2 surveys were completed at 0, 12, and 30 months. SF-36v2 physical and mental scores both range from 0 to 100 with an estimated national average of 50 points.ResultsFor 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). In multivariable analysis, the difference in mental score change between exposed vs. controls at 30 months was less pronounced (p = 0.37) but other findings were similar to univariate analyses.ConclusionsThese results do not favor an association between receipt of AVA and an altered health related quality of life over a 30-month period.

► We evaluated quality of life after AVA in Laboratory Response Network workers. ► 437 exposed and 139 controls enrolled to complete the SF-36 at 0, 12 and 30 months. ► We found no change from baseline in either SF-36 physical or mental scores. ► Our study suggests no association between AVA and quality of life over 30 months.