Anthrax Vaccine (Intramuscular, Subcutaneous)

The anthrax vaccine (more commonly known by its brand name, BioThrax) delivers a dormant, impotent strain of anthrax into the body, allowing the body to learn how to fight the virus and significantly reducing the patient's chances of ever suffering from anthrax.


Anthrax is a disease caused by bacteria known as Bacillus anthracis, which is most commonly found in soil. Herbivores, such as cows, sheep and goats, are usually the the first to get anthrax, and the disease can spread from livestock to humans. The bacteria can spread through contact with skin, stomach or lungs, with anthrax infection of the lung being the most serious.

BioThrax, the anthrax vaccine, helps patients develop an immunity to anthrax by exposing the body to a suspended, harmless version of the disease, allowing the body to learn how to deal with the bacteria without being faced with a full on infection.

The anthrax vaccine does not contain live Bacillus anthracis, or any Bacillus anthracis that ever was alive. There are no known cases of the anthrax vaccine causing anthrax in the patient.

Conditions treated

  • Risk of anthrax infection

Type of medicine

  • Bacterial vaccine

Side effects

The following side effects may require medical attention. Patients should contact their doctor immediately if they experience any of the symptoms discussed below.

The anthrax vaccine is delivered via a shot. Patients often experience pain, redness, or tenderness at the point of injection. Patients may also suffer temporary limited movement in the appendage (usually an arm) where the shot was given. Patients have also reported swollen or painful lymph nodes in the neck, face, armpits, and groin.

In isolated cases, patients have reported the following side effects:

  • Blistered skin
  • Loose or peeling skin
  • Chills
  • Cough
  • Diarrhea
  • Difficulty swallowing
  • Vomiting
  • Dizziness
  • Fainting
  • Irregular heartbeat/arrhythmia
  • Hives
  • Rash
  • Joint pain
  • Muscle pain
  • Swelling of the face, eyelids, tongue, or genitals
  • Puffiness on the face, particularly around the eyes, mouth, or tongue
  • Red skin lesions, sometimes with a purple center
  • Red or irritated eyes
  • Redness of the skin
  • Shakiness in the hands, feet, arms, or legs
  • Shortness of breath
  • Sores or ulcers
  • White spots around the patient's mouth or lips
  • Trembling
  • Unusual tiredness
  • Unusual weakness

Sometimes a patient's body simply needs time to adjust to a new medication. The following side effects do not necessarily require medical attention.

Patients most commonly report suffering from headaches, or experiencing muscle aches and pains. In less common instances, patients have reported suffering from:

  • Burning, crawling or itching skin
  • A feeling like pins and needles on/in the patient's skin
  • Dark or discolored urine
  • Difficulty moving
  • Irregular or rogue feelings of warmth
  • Hair thinning or hair loss
  • Muscle cramps, spasms, or stiffness
  • Nausea
  • Redness of the face, neck, arms, or chest
  • Swollen joints
  • Difficulty sleeping

This is not necessarily a complete list of side effects for the anthrax vaccine. Patients should report these or any other side effects to their doctor. New side effects can be reported to the FDA at 1-800-FDA-1088.


The anthrax vaccine is requires multiple injections to build up, along with yearly maintenance boosters. Patients who feel at high risk of contracting anthrax should be careful to maintain the vaccine.

Over the course of six weeks (three doses, once every two weeks), the patient will have 3.5ml doses of the anthrax vaccine injected under their skin. Following those six weeks, new .5 ml doses are recommended at six months, 12 months and 18 months. After the eighteen month mark, annual booster shots are recommended to ensure continuing immunity.

If a patient misses their booster or one of their scheduled doses, they should return to the vaccination schedule as soon as possible. Patients who miss a dose should consult with their doctor as to their best course of action. Typically, there is no need to start the vaccinating process over again.


The anthrax vaccine can interact with a considerable list of different drugs. Patients should weigh the risks and benefits of taking the vaccine carefully, and consult with their doctor before making a decision.

The principle interaction is decrease in the effectiveness of the vaccine. For medications that are taxing on the immune system, it may be advisable to give the patient's body time to recover either before or after the vaccine is given. Negative, sometime fatal, interactions can be possible.

Chemotherapy/cancer drugs, such as CARBOplatin, can mute the effects of the anthrax vaccine, with increased muting effects the longer the patient has been taking CARBOplatin. Patients who are or have taken chemotherapy/cancer drugs should consult with their doctor before beginning to receive the anthrax vaccine.

Patients who take or receive antibodies, such as guslekumab (brand name Tremfya), can also mute the effects of the anthrax vaccine, with an increased muting effect the longer the patient has been taking the antibodies. Patients who are taking or receiving antibody-based medication should consult with their doctor before beginning to receive the anthrax vaccine. Taking guselkumab for as short a time as two months may be enough to delay receiving the anthrax vaccine.

Corticosteroids, such as prednisone, can mute the effects of the anthrax vaccine. Patients who have taken or are taking corticosteroids should consult with their doctor before beginning to receive the anthrax vaccine. Additionally, patients who have recently begun receiving the anthrax vaccine may need to wait before starting to take corticosteroids, to give their body time to adapt.

Immunosuppressants, such as sirolimus, can mute the effects of the anthrax vaccine, with an increased muting effect the longer the patient has been taking the immunosuppressants. Patients who have or are currently taking immunosuppressants should consult with their doctor before beginning to receive the anthrax vaccine.

Antirheumatic medications, such as anakinra, can mute the effects of the anthrax vaccine on the patient when taken concurrently. Patients who are currently taking any antirheumatic medications should consult with their doctor before beginning to receive the anthrax vaccine.

The anthrax vaccine can also interact with flu shots, and the h1n1 (swine flu) vaccine. Patients should avoid taking both the anthrax vaccine and flu vaccines. Additionally, the anthrax vaccine can interact negatively with the drug interferon gamma-1b.

This is by no means a comprehensive list of drug interactions. Patients should disclose the full list of drugs, medications and supplements that they are taking to their doctor before deciding to receive the anthrax vaccine.


The anthrax vaccine will not treat any specific condition. Receiving the vaccine will do nothing to stop a preexisting anthrax condition. By receiving the anthrax vaccine, patients are simply lowering their risk of ever catching anthrax.

The following groups are considered at high risk for contracting anthrax: people who work with Bacillus anthracis, typically in a laboratory, people who handle animal products (meat, fur, dairy products, and more) that come from regions with a higher anthrax risk, doctors or veterinarians who frequently practice in regions that are at a higher risk for anthrax and military personnel.

Anthrax is airborne and can be used a weapon. In 2001, there was a rash of anthrax attacks where the bacteria was sent through the mail to targets. While such an attack is technically possible in the future, it is highly unlikely.

The anthrax vaccine can cause serious allergic reactions. Patients should inform their doctor of all their known allergies, especially allergies to latex, aluminium hydroxide, benzethonium chloride, or formaldehyde. Allergic reactions to the anthrax vaccine can include anaphylaxis, a potentially fatal condition. Patients should be vigilant for the typical signs of allergic reactions, including rash and hives.

The anthrax vaccine (BioThrax) is considered category D in terms of pregnancy risk. Pregnant patients have had their fetuses suffer adverse effects as a result of the anthrax vaccine, so patients who are pregnant or may become pregnant should exercise caution when deciding whether or not to receive the anthrax vaccine. Typically, only patients at high risk of contracting anthrax are given the anthrax vaccine while pregnant.

It is not known whether or not the anthrax vaccine can be transmitted through breast milk to a breastfeeding baby. Patients who are breastfeeding should consult their doctor before receiving the anthrax vaccine.

The anthrax vaccine has not been evaluated in geriatric patients (>65 years). Patients older than 65 should consult with their doctor before receiving the anthrax vaccine.

Patients who are taking blood thinners (such as warfarin, Coumadin, or Jantoven) should consult with their doctor before deciding to receive the anthrax vaccine. Complications may occur. Patients with weak immune systems, whether it be from steroids, HIV, chemotherapy, or any other condition, should consult with their doctors before receiving the anthrax vaccine.

Because of the nature of the drug, overdose on the anthrax vaccine is unlikely. Patients should stick to their dosing schedule and not receive extra doses of the vaccine unless instructed to by their doctor.


Vaccines are usually administered by the patient's doctor or other trained medical professional. It would be unusual for a patient to be in a situation where they have to store the anthrax vaccine themselves.

The anthrax vaccine should be stored between 36 and 46 degrees Fahrenheit. The vaccine should never be frozen.


The anthrax vaccine promises to drastically reduce a patient's risk of contracting anthrax. With that being said, large scale immunization of the general populace is not recommended. Cases of anthrax are rare, and patients should carefully evaluate their risk of contracting anthrax against the possible downsides and complication the anthrax vaccine may cause. Emergency responders, lab workers, agricultural workers and soldiers are typically considered to be the most at risk. In fact, the US Department of Defense is one of the largest purchasers and distributors of the anthrax vaccine.

Like any drug, the anthrax vaccine demands respect. Patients should ensure they are completely informed as to the risks and potential complications of the vaccine before choosing to receive it. Patients should also be sure to consult with their doctor before deciding to receive the anthrax vaccine.

Last Reviewed:
December 24, 2017
Last Updated:
April 04, 2018
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