A longitudinal study of UK military personnel offered anthrax vaccination: informed choice, symptom reporting, uptake and pre-vaccination health.

AIM To determine longer term health outcome in a cohort of UK service personnel who received the anthrax vaccination. METHOD We conducted a three year follow up of UK service personnel all of whom were in the Armed Forces at the start of the Iraq War. 3206 had been offered the anthrax vaccination as part of preparations for the 2003 invasion of Iraq. A further 1190 individuals who did not deploy to Iraq in 2003 were subsequently offered the vaccination as part of later deployments, and in whom we therefore had prospective pre-exposure data. RESULTS There was no overall adverse health effect following receipt of the anthrax vaccination, with follow up data ranging from three to six years following vaccination. The previous retrospective association between making an uninformed choice to receive the anthrax vaccination and increased symptom reporting was replicated within a longitudinal sample where pre-vaccination health was known. CONCLUSIONS Anthrax vaccination was not associated with long term adverse health problems. However, symptoms were associated with making an uninformed choice to undergo the vaccination. The results are important both for the safety of the vaccine and for future policies should anthrax vaccination be required in either military or non military populations.