A growing number of troops, especially in the Guard and Reserve, are refusing to take their anthrax Up in the AnthraxAir About
By Peter Grier
ir Force Capt. Jonathan proving that the vaccine is the cause, A E. Richter is a third- but he’s not taking any chances. He generation military of- told a Congressional panel on July ficer. A C-5 pilot in the Air Force 21 that “taking another shot is not Reserve at Dover AFB, Del., he part of the Jon Richter health care flew missions in both Operations program” and that he will resign his Desert Storm and Northern Watch commission before taking another and is not, in his own estimate, the anthrax injection. sort of person who normally goes “Those in command seem to have around looking for ways to disobey shrugged their shoulders at the his superiors. numbers of people leaving military However, on Feb. 3, 1999, Richter service, with the attitude that an was injected with anthrax vaccine order was given and it should be from lot #FAV 030. The same lot carried out,” he said in an appear- was used for his second shot on Feb. ance before a House subcommittee. 19. Five days later, his problems “We are growing tired of the deni- began. His right shoulder began to als—that everything is OK—when ache, as if he’d thrown a baseball in fact it isn’t.” hard without warming up. Then Two years after Secretary of his left shoulder began to feel the Defense William S. Cohen first same way. Soon, his spine hurt so announced that all US military per- badly that he could hardly get out sonnel would be vaccinated against of bed in the morning. the deadly biological agent anthrax, Since then, his arthritis-like symp- the Pentagon is facing a growing toms have stabilized mostly in his revolt against the program. Around feet and left hand. He has no way of 200 active, Guard, and Reserve
68 AIR FORCE Magazine / October 1999 members of the armed services have Ryan. of a suspicious envelope caused refused to take part in the six-shot Pentagon health officials acknowl- a virtual shutdown of downtown vaccination program, according to edge that they have been somewhat Washington, D.C., for hours and DoD’s own records. However, the taken aback by the sudden squall of sent office workers into the streets Pentagon admits it doesn’t have resistance to anthrax vaccinations. to be cleaned by paramedics. These a formal tracking system. The They felt that the rise of unconven- reactions show how seriously the numbers refusing to take the shots tional means of warfare and regional US government takes the threat. in the Guard and Reserve may be conflicts would make only too obvi- “[Anthrax] has been weaponized greater than DoD reports, based ous the need for such a program of and we know it is deployed in about on Congressional testimony from protection. 10 countries around the world,” reservists and news articles around The program’s foundation was Peters told the Senate panel. “Our the country. laid in 1993. In that year, Defense view is that it is unconscionable Some of the active duty holdouts Department officials issued a direc- to allow our pilots and aircrews have been court-martialed. Reservists tive on immunizations for biological to fly into those countries, which face not courts-martial but a sudden warfare defense, which established are high-threat countries, without end to their military careers. government policy, responsibilities, being inoculated against anthrax, and procedures for the stockpiling of just as we would inoculate people Morale at “All-Time Low” biological agent vaccines. Military against smallpox.” For instance, Richter claims that planners are studying the virtues of In May 1998, Cohen ordered many pilots—by his count, about 60 a dozen or more different kinds of that everyone who wears a US percent of those in the unit—plan to shots to safeguard US troops from military uniform—active, Guard, or resign rather than face the anthrax attacks by the Saddam Husseins of Reserve—eventually receive anti- vaccine needle. He said, “I can only the future. anthrax shots. Under Cohen’s order, assume that the people in the other From the outset, say planners, the Total Force will be covered specialties required to execute the it was clear that anthrax would be by a three-phase program. Phase mission of an airlift airplane such the biggest near-term biowar dan- 1 involves inoculating all forces as the C-5 are leaving as well. Word ger. It is cheap, easy to produce, that are now assigned to or will be travels fast. Morale is at an all-time and easy to load into a long-range rotating through high-threat areas low.” weapon. The Iraqi military knows in Southwest Asia and Korea. Phase US military health officials find all about it. 2 will involve forces designated for this development frustrating. They Anthrax is a disease that occurs early deployment into those areas. claim that the vaccine is safe and naturally in herd animals, such as Phase 3 is everyone else. effective and that many reluctant cows. Humans can catch it by eating DoD envisions finishing this huge members of the military are being contaminated meat, handling con- inoculation project by 2006. frightened by outdated and inac- taminated animals or animal products, Inoculation involves more than curate information. or directly inhaling anthrax germs. rolling up a sleeve for a single shot. Furthermore, anthrax is a deadly In their natural state, anthrax germs The present Anthrax Vaccination threat that terrorists could well em- live in spores, which can survive for Immunization Program entails a se- ploy against US forces in the years decades if buried. To turn the disease ries of six shots administered over a ahead. It is, in the words of the Pen- into a weapon, these spores are milled period of 18 months. The first three tagon, “a clear and present danger into a fine-ground dust that can be inoculations are delivered at zero, to US service personnel.” Declining sprayed over a wide area through two, and four weeks. Boosters are anthrax vaccinations is akin to refus- the use of any number of delivery then administered at six, 12, and 18 ing to wear a helmet in combat, top methods. months. officials argue. The Pentagon insists that the vac- “If you get anthrax, ... you are How It Kills cine is safe. Army Maj. Gen. Robert effectively dead,” Secretary of the Once inhaled, anthrax reproduces G. Claypool, deputy assistant sec- Air Force F. Whitten Peters told the and releases toxins that attack the retary of defense, health operations Senate Armed Services Committee lungs. The victim’s first indication policy, said that several studies have during his July 21 confirmation that he or she has been poisoned is shown that the incidence of adverse hearing. the onset of vague flu-like symptoms, reactions to anthrax vaccination is Moreover, virtually every senior notably high fever and chest pain. comparable to that for other com- uniformed and civilian military Death comes abruptly, through oxy- monly used vaccines. leader has either begun or completed gen depletion, shock, and respiratory Studies done at the time of FDA the full series of six anthrax shots and cardiac failure. licensure of the vaccine showed that required for complete protection. Absent vaccination, anthrax is in 16,000 doses the anthrax vaccine Inoculees include Cohen, Peters, virtually always fatal. causes a mild reaction in 3 to 20 Deputy Secretary of Defense John J. At least 10 potential US adver- percent of those who take it. Fewer Hamre, Army Gen. Henry H. Shelton saries have worked on anthrax than 1 percent exhibited a severe reac- (Chairman of the Joint Chiefs of weapons, according to US intel- tion, Claypool reported to Congress Staff), USAF Gen. Joseph W. Ralston ligence data. The reaction of law on July 21. (JCS vice chairman), and all four enforcement authorities to anthrax By way of comparison, the pneu- chiefs of the uniformed services, hoaxes has been extraordinary. In monia vaccine has a 71 percent rate including USAF’s Gen. Michael E. one recent incident, the presence of localized soreness. The typhoid
AIR FORCE Magazine / October 1999 69 tracking system is underreporting ad- Is It Mythology? verse events for a number of reasons, these critics claim. These examples were drawn from a statement published on the Defense Department’s In some units, fear of possible official anthrax vaccination Web site (www.anthrax.osd.mil). side effects has proved as contagious as any flu virus. An ANG member Myth: There is no defense against anthrax. testifying before Congress stated Fact: Vaccination is the best defense against biological warfare involving anthrax. that the Connecticut Air National Nuclear, biological, and chemical gear and protective masks should also be used. Guard lost eight pilots who refused Myth: Antibiotics are just as effective against anthrax as the vaccine. the shots. At Travis AFB, Calif., the Fact: Antibiotics can be effective in cases of cutaneous anthrax [caused by contact guardsman said that 17 KC-10 crew with infected animals or contaminated animal products], ... [but] antibiotics have not members resigned rather than face been proven effective against the more deadly forms of anthrax: inhaled and ingested. the anthrax needle. Myth: The anthrax vaccine can cause me to catch anthrax. It works by actually inject- Many of those who are wor- ing live cells into my body to build immunity. ried about the vaccine’s effects cite the military’s long history of Fact: The anthrax vaccine does not use live bacteria. It is a sterile product made from a strain of anthrax that does not cause disease. underplaying the threat posed to its members by certain substances Myth: Service members will have ample warning of an anthrax attack due to effec- and practices, from Agent Orange tive detection devices. to radiation testing. Fact: Until reliable detectors are available in sufficient numbers, usually the first “The missing element of the man- indication of a biological attack in unprotected soldiers will be ill soldiers. datory anthrax vaccine program is Myth: Anthrax must be hand-delivered; it cannot survive any other means of deployment. trust,” said Rep. Christopher Shays (R–Conn.) during a series of Congres- Fact: Anthrax bacteria can be deployed by missiles and artillery shells. sional hearings on the issue. Myth: The anthrax vaccine is experimental and under investigation. Dover is one of the Air Force bases Fact: The anthrax vaccine is not experimental or investigational. It has been used where suspicion about the vaccine safely to protect at-risk industrial and laboratory workers for almost 30 years. has been strong and widespread, due Myth: The reliability of the anthrax vaccine is based on only one human efficacy to a large number of personnel with group—wool mill workers. unexplained health problems that began to crop up around the time of Fact: Clinical studies with approximately 1,200 wool mill workers have demonstrated protection against cutaneous anthrax. Since conducting lethal challenge studies in vaccination. humans is considered unethical, determining the actual efficacy of the vaccine is not At least 30 Dover personnel have possible. However, there have been numerous tests of the anthrax vaccine involv- filed reports with the Anthrax Vac- ing animal models (i.e., rhesus monkey model) upon which the FDA determined its cine Adverse Event Reporting Sys- safety and efficacy. tem in recent months, according to Myth: The anthrax vaccine may cause sterility. Lt. Richard J. Rovet, a health care Fact: The vaccination has been routinely used for the past 28 years and has not integrator for the flight medicine been associated with sterility. clinic at the base. These included six reports of dizziness, six reports Myth: Anthrax kills only farm animals. of ringing in the ears, 10 reports of Fact: Anthrax kills both animals and humans. joint pain, two reports of chronic fatigue, and one report of a pain- fully swollen testicle. Capt. Michelle Piel is a 13-year Air Force veteran and a C-5 Galaxy pilot stationed at Dover. She says that her arm went numb for about 20 vaccine causes localized tenderness nel around the time they received minutes after she received her first in 98 percent of recipients, pain by an anthrax shot. But they say they anthrax shot on Oct. 21, 1998, from 56 percent, a feeling of malaise in are not aware of any pattern of lot #030. Weeks later, while flying a 24 percent, and headaches in 11 long-term side effects from the return leg from humanitarian relief percent. anthrax vaccine. operations in Honduras, the right As of midsummer, the Pentagon side of her head filled up with fluid. reported only 103 adverse reactions “Some Degree of Risk” “It was as if a faucet were turned to the anthrax vaccine, out of more “Any vaccine carries with it some on inside my head,” she told Congress than 977,000 doses administered. Of degree of risk with its use,” said in written testimony. these 103 events, only 14 reactions Claypool. “In the case of the anthrax A flight surgeon grounded her for resulted in more than 24 hours of vaccine, the scales of balance are a head cold and middle ear infection. lost duty. clearly tipped in favor of its use to Thus began a long struggle with Pentagon health officials say they protect our military forces.” fatigue, nausea, and other flu-like are aware of isolated, inexplicable These explanations do not satisfy symptoms. Six months later, 12 doc- systemic health problems that have those who believe that their anthrax tors had yet to reach a firm diagnosis developed in some military person- shot made them sick. The Pentagon’s of her condition. Her wing com-
70 AIR FORCE Magazine / October 1999 mander sent her to the immunology Still, Rep. Dan Burton (R–Ind.) to keep our deployed military person- clinic at Walter Reed Army Medical decried a situation “when five Ma- nel safe and prevent combat casual- Center, where researchers did tests rines are court-martialed because ties,” said Dr. Sue Bailey, assistant that revealed some indications of an they are concerned they may not be secretary of defense for health affairs. immune system disorder. fit for duty if they take a vaccine, The anthrax vaccine was first li- “The last few months I have felt and when 30 percent of the pilots in censed by the FDA in 1970. “There some improvement in my condi- a Reserve unit resign rather than take have been no long-term side effects tion,” she said. “The dizziness has this vaccine.” These kinds of events, reported,” according to Bailey. become less frequent. ... There is said Burton, constitute “clear signals Furthermore, the vaccine is indeed no way that I know of to prove that that something is wrong.” effective against inhaled anthrax, the anthrax vaccine caused any of For the critics, one major and DoD says. Or at least, the preven- this. All I can tell you is that I be- specific concern is that the anthrax tion of inhalation anthrax “is not came uncharacteristically ill after vaccine is in fact untested. Studies inconsistent with the current product I started taking the anthrax shots. of its effects, they say, all carry the label,” said Bailey, reading from an It has taken 12 doctors and eight label “short-term.” FDA memo. months for me to finally find any According to the Pentagon’s top reason for my symptoms.” Small Sample? doctor, it is not possible to directly Though the Food and Drug Ad- determine the efficacy of the vaccine Dover Calls a Halt ministration has approved use among in humans against aerosol exposure In May, Col. Felix M. Grieder, veterinarians, laboratory workers, to anthrax spores. Conducting such commander of the 436th Airlift and livestock handlers for 30 years, a study would be highly unethical. Wing at Dover, suspended anthrax very few such workers have actually Numerous studies using animals vaccinations for a week for those taken it, charged Mark S. Zaid, a have indeed been carried out, the under his command until he could lawyer who has represented military Pentagon said. Military researchers obtain more information about the personnel who refuse the vaccine. He have relied in particular on rhesus vaccine’s safety. He is not the only said that only about 20,000 to 30,000 monkeys for these studies. field commander who ordered such people received anthrax shots in the “These animal studies showed that a pause. In July, the commander of last half-century, prior to the Penta- the FDA–approved anthrax vaccine the Air National Guard’s 122nd gon’s first widespread use. provided greater than 95 percent Fighter Wing, Fort Wayne IAP, Ind., “The Defense Department’s inocu- protection against high-dose aerosol suspended shots for his 950-member lation of 150,000 servicemen during challenge with anthrax in the monkey unit, in part to allow more time for the Gulf War ... was the first major model,” said Bailey. vaccine education efforts. Vaccina- use of the vaccine in any significant A February 1998 FDA investiga- tions will resume this fall or winter, quantity,” he said. tion of state-run Michigan Biologics said Guard officials. Others question whether the vac- Product Institute found “significant The rebellion has reached the cine would be effective against deviations” from FDA regulations, point where some House Republi- inhaled anthrax germs—the most according to FDA officials. As a cans want the vaccinations stopped likely method of ingestion. They result of this probe, BioPort Corp., altogether. A number of GOP mem- point out that the only US producer which bought MBPI in September bers are backing legislation that of the vaccine has had FDA–docu- 1998 and is now the DoD contractor would either make the vaccinations mented quality control problems in for anthrax vaccine, is holding 11 voluntary or suspend the program the past. And Zaid, among others, lots of the vaccine in quarantine until the National Institutes of claims that the Pentagon’s own storage. Health conducts a safety study. studies show a systemic reaction Kathryn C. Zoon, director of the The idea of going to a voluntary an- rate to the vaccine that is two to FDA Center for Biologics Evaluation thrax immunization program does not seven times higher than the manu- and Research, told Congress, “These sit well with senior Pentagon leaders. facturer’s predictions. lots are still in quarantine and will In a joint statement this summer on this Even a systemic reaction rate of 1 remain in quarantine until the com- subject, Cohen and Shelton had this percent or so will incapacitate from pany submits required information to say: “Our commanders must know 17,000 to 32,000 service members, to [the FDA].” that all, not simply some fraction, of said Zaid, considering the large num- DoD officials say they will con- their forces are protected from this bers of service personnel receiving tinue to be vigilant as they look for biological threat. Soldiers, sailors, the vaccine. unexpected reactions to the vaccine. airmen, and Marines fight in teams, The Pentagon strongly defends They insist that they are committed and they need to know that all team its decision to opt for servicewide to fully investigating all questions members are protected from anthrax. anthrax protection. The effort is about the shots’ value. ... Allowing a voluntary vaccination not primarily a medical program, Said the Pentagon’s Claypool: “We program is inadequate in the face of officials say. know anthrax kills and immuniza- this deadly threat.” “It is a line commanders’ program tion protects. ... Immunizing men and women we place in harm’s way Peter Grier, the Washington editor of the Christian Science Monitor, is a longtime to prevent death or a serious injury defense correspondent and regular contributor to Air Force Magazine. His most is our moral and ethical duty. ... It recent article, “The China Problem,” appeared in the August 1999 issue. would be unconscionable for us not to do so.” ■
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