Cross-sectional survey of anthrax vaccine coverage and KAP among deployed US military

Abstract

The recently refocused effort on anthrax (AVA) vaccination has been the source of much ethical and legal deliberation. However, the factors affecting one's decision to receive any or all of the vaccine doses are poorly understood. Using a self-administered questionnaire, we sought to evaluate AVA coverage among a cross-section of deployed active duty US military personnel and identify factors associated with receipt of the vaccine. A questionnaire was distributed to U.S. military personnel deployed to Iraq, Afghanistan and surrounding areas. Questions solicited demographic information, AVA vaccination status, and agreement to several questions attempting to assess the respondent's knowledge and attitudes regarding anthrax and the AVA vaccine. Of the 1,743 participants, 40.6% reported receiving all AVA vaccine doses. Older age and service in the Army were associated with an increased likelihood of AVA vaccination. Additionally, those who neither agreed nor disagreed with specific questions commonly rejected the AVA vaccine compared to those who agreed or disagreed to the same question. The only factor clearly associated with receipt or rejection of the AVA vaccine was whether the respondent thought that the anthrax vaccine is as safe as other vaccines. The individual decision to receive the AVA vaccine is most likely a multifactorial decision process even in a military population. Targeted educational interventions should be developed to increase AVA coverage and further understand drivers of vaccine receipt.

Pre-deployment vaccinations and perception of risk among US military personnel

“…Nevertheless, these data are consistent with previous findings that US military troops have concerns about the safety of pre-deployment vaccinations despite compulsory vaccination programs, [11][12][13][14] and additional research is needed on drivers of and barriers to vaccination status in a compulsory environment. Vaccinations remain a cost-effective, primary prevention strategy for protecting US troops from infectious diseases while deployed.…”

“…[11][12][13] Importantly, however, the overall self-reported vaccine coverage was higher than previous reports, with approximately only 10% reporting they had not received all pre-deployment vaccinations. This percentage is much lower than the 36% of service members who were classified as missing two or more of their required predeployment immunizations in 2003.…”

“…[11][12][13][14] This study builds upon the previous work by assessing positive and negative attitudes toward all pre-deployment vaccines in conjunction with compliance, without focusing on a specific disease or vaccination.…”

“…15 Additionally, concerns over vaccine safety and efficacy are prevalent even when compliance is high. [11][12][13][14] A study of anthrax vaccination among 1,743 personnel deployed to Iraq and Afghanistan found that only 40.6% reported receiving the full vaccine series, with vaccine safety concerns having a significant impact. 13 A similar study showed that over 60% of respondents disagreed that the anthrax vaccine was safe.…”

The public acceptance of smallpox vaccination to fight bioterrorism in Japan: results of a large-scale opinion survey in Japan

“…Any perceived low ratio of personal benefits compared to adverse effects results in non-vaccination decisions [11]. According to the past studies on adult vaccination behaviors (influenza, anthrax, pneumococcal vaccination), factors associated with the increased likelihood of vaccination are the belief that a vaccine is effective in preventing the disease (prevention of sickness absence and the prevention of disease spread) [12]; the belief that side effects of vaccination are uncommon and/or mild [13]; the perception of high vulnerability to the disease; [14], past vaccination experience [15,16]; older age [17]; provider (physician) recommendation [18,19]; awareness (and attention paid to media news) of vaccination [20]; and ethnicity [21,22]. On the other hand, the most common primary demotivators are concern about safety and efficacy [23,24].…”