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

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.