Agent	Route of administration	Schedule	Comments
Anthrax pre-exposure22	Intramuscular (0.5 mL)	0, 1, and 6 months (primary series) Booster at 12 months and 18 months Then 12-month intervals If the above regimen is completed: booster may be given every 3 years (instead of annually) to people not at high risk of exposure who want to maintain protection	High-risk groups:  Military members on deployment to specific regions as outlined by the U.S. Department of Defense  Laboratory personnel involved with Bacillus anthracis  Farmers, veterinarians, or other workers who may handle infected animals  Pregnant patients should not be vaccinated for anthrax unless benefits outweigh risks
Anthrax postexposure22	Subcutaneous (0.5 mL)	0, 2, and 4 weeks postexposure Augment with appropriate antibiotic therapy	Must have suspected or known exposure to B. anthracis 18 to 65 years of age Emergency authorization for children, pregnant patients, and older patients If vaccine cycle is interrupted, do not restart; administer the next dose and finish the series
Smallpox vaccine (Vaccinia)23	Percutaneous	Revaccination schedule:  At least every 10 years if exposed to vaccinia viruses  Every 3 years if potential for exposure to variola virus or monkeypox	Severe adverse effects: progressive vaccinia, postvaccine encephalitis, eczema vaccinatum, myopericarditis Contraindications: significant cardiovascular disease, pregnant or breastfeeding, HIV infection, immunosuppression, history of eczema or other significant skin disorder, or close contact with any of the above. If exposed to smallpox then there are no absolute contraindications
Live, non-replicating smallpox vaccine (Jynneos)24	Subcutaneous (0.5 mL)	0 and 4 weeks	Approved by U.S. Food and Drug Administration in 2019 for people at risk of smallpox and monkeypox 18 years and older Attenuated nonreplicating vaccinia virus No severe adverse effects
Live, Ebola Zaire vaccine25	Intramuscular (1 mL)	Single-dose pre-exposure prophylaxis Single-dose postexposure prophylaxis ideally administered immediately after exposure	Prevention of Ebola Zaire only 18 years and older Duration of immunity is unknown Effectiveness is not known when combined with antivirals or immunoglobulins Pregnancy consideration: neonatal outcomes are poor when mothers are infected with Ebola virus; the decision to vaccinate should be based on risks vs. benefits and potential exposure to Ebola Zaire People who are vaccinated should continue to follow infection control precautions