©2001 American Medical Association. All rights reserved.
(Reprinted) JAMA, June 6, 2001—Vol 285, No. 21 2769
a time when a killed vaccine was in use to 0.27 cases per 1000 person-years of risk after introduction of the live vac- cine.58 Although the incidence of ul- ceroglandular disease remained un- changed in the 2 periods, signs and symptoms were considered milder among those who received the live vac- cine. In volunteer studies, the live at- tenuated vaccine did not protect all re- cipients against aerosol challenges with virulent F tularensis.7,26
Correlates of protective immunity ap-
pear about 2 weeks following natural infection or vaccination. Given the short incubation period of tularemia and in- complete protection of current vac- cines against inhalational tularemia, vaccination is not recommended for postexposure prophylaxis. The work- ing group recommends use of the live vaccine strain only for laboratory per- sonnel routinely working with F tu- larensis.
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