Surgeon general tells Congress anthrax vaccine will save lives
Released: 31 Mar 1999
by Master Sgt. Linda Brandon
Air Force Print News
WASHINGTON -- A "life or death" message was delivered to Congress by the Air Force Surgeon General regarding recent controversy surrounding the Department of Defense's mandatory anthrax vaccine immunization program.
Calling the disease deadly, and the vaccine safe and effective, Lt. Gen. Charles H. Roadman II testified, "When it comes to pulmonary anthrax, there is one clear and simple truth. If you are not vaccinated, if you inhale the spores, you almost certainly will die."
He likened anthrax's 99-percent mortality rate (for the unprotected) to that of the ebola virus. He told representatives that although initial symptoms to anthrax exposure are flu-like, "the difference is that in three days you will be dead."
However, because vaccination turns the tables, skyrocketing survival odds to 99 percent, Roadman called the vaccine necessary and vital for a force required to be ready to deploy anywhere, anytime.
Labeled the "poor man's atomic bomb," anthrax tops the DOD list of potential biological weapons. Relatively easy and cheap to produce, this naturally occurring organism is difficult to detect and treat, is easily weaponized and highly lethal.
Roadman was part of a four-person panel led by Dr. Sue Bailey, assistant secretary of defense for health affairs, that testified March 24 during the House Committee on Government Reform's oversight of the DOD's force-wide anthrax immunization program. Lt. Gen. Ron Blanck, Army surgeon general, and Rear Adm. Todd Fisher, Navy deputy surgeon general, also testified.
As pro- and anti-anthrax groups prepared to testify, committee chairman Rep. Christopher Shays, R-Conn., said, "We will follow (the anthrax vaccination program) until we are sure medical force protection means assuring the long-term health of U.S. forces, not just short-term mission capability."
According to Bailey's testimony, 223,000 service members, including 65,000 airmen, have received a total of 600,000 actual immunizations under the program.
However, about 200 people have balked at the mandatory immunization. Many say it boils down to overall trust in what they call the Defense Department's poor track record concerning health issues. They point to controversies surrounding Gulf War illnesses, the specter of Agent Orange during the Vietnam Conflict and, going even further back, radiation testing at the advent of the atomic age.
Calling the secretary of defense's May 1998 decision to immunize the total force a deliberate and detailed process, Bailey testified that the program is built on many lessons learned over the last several years and the department's strong commitment to force health protection.
"The anthrax vaccination immunization program employs a very different and effective approach, incorporating a safe and efficacious vaccine, effective risk communication, extensive immunization tracking and strong command leadership with medical support," she said.
The Army surgeon general told the committee that risk communication -- education, talking to people -- is taken very seriously when it comes to the anthrax vaccine.
"We have a goal in all of the services," Blanck said, "that no one gets a needle in their arm without having been educated, having been briefed, often having seen the leadership getting their immunizations first, and having had the chance to ask questions and to get pertinent and appropriate answers."
Roadman told the committee that the Air Force has recently established an integrated process team on the immunization program. Run by the assistant vice chief of staff of the Air Force, it involves people from across the service and was formed to "ensure a comprehensive approach to the issue."
According to Roadman, the team has been erroneously framed as a task force looking at the efficiency and effectiveness of the drug.
"That's absolutely not what this is," he said.
He said it is similar to looking at any large system and asking, "Are our processes and messages coming across consistently and clearly?" He said the integrated process team "is an initiative that is about good management and strong leadership."
The committee posed many of the same probing questions wary service members reluctant to participate in the program are asking. Among other things, congressmen were interested in the vaccine's safety and effectiveness and raised concerns about quarantined vaccine, adverse side effects and long-term health affects.
The panel of military medical experts told the committee there are no known long-term health effects and that, depending on the study, somewhere from 4 percent to as high as 30 percent of those immunized will have minor local reactions to the vaccine.
They emphasized that in every study done by the DOD and others, the rate of adverse affects has been found to be lower than those of other mandatory vaccines, including tetanus, yellow fever, typhoid, hepatitis A and hepatitis B.
Adverse affects reported among service members receiving the vaccine are currently .007 percent. One severe illness, Guillain-Barre Syndrome, was reported shortly after receiving a third dose of the vaccine; however, that service member has since recovered and returned to duty.
Roadman said the Air Force has reported 12 adverse reactions for the 200,000 doses of vaccine they have administered.
Panel members testified that while Food and Drug Administration testing resulted in some lots of quarantined vaccine being destroyed, others were found to be OK.
However, to doubly insure the quality of the vaccine, the DOD put the approved lots through further supplemental testing in addition to Food and Drug Administration approval. They emphasized this was done to ensure standards for safety, sterility, purity and potency were met.
"At no time," Bailey testified, "have contaminated lots or vials of vaccine been administered to our service members or shipped by the DOD to any military facility."
Recounting another instance where 200,000 vials of vaccine shipped to Germany were destroyed, Blanck said, "On the basis of one vial having a little sludge in it -- ice crystals that is -- we feared that the vaccine had been frozen. We destroyed all of them. We really are trying to bend over backwards to make sure we have an absolutely 100 percent safe product."
After the military officials' testimony, the committee heard from a panel of six service members and other concerned people, including two Connecticut Air National Guardsmen and a member of the Air Force Reserve who painted a decidedly different picture of anthrax immunizations.
Calling most of the facts and studies on the safety and effectiveness of the vaccine contradictory and skewed, they told the congressmen that the mandatory program is misguided and they want to see it changed. Concerned that the vaccine will do more harm than good, they called, at the very least, for more study and, until then, an optional immunization program.