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Growing Doubts On Vaccine In Military

By Marilyn W. Thompson
Washington Post Staff Writer

With each report on the absence of weapons of mass destruction in Iraq, Airman Jessica Horjus asked a question: If inspectors could find no signs of anthrax, why should the Pentagon risk her health by requiring her to get the anthrax vaccine?

"I have a kid to take care of," said Horjus, 23, the mother of a 2-year-old, who lives with her daughter in military housing at Seymour Johnson Air Force Base in Goldsboro, N.C. "The Air Force can always fill my slot with someone else, but who's going to fill the mommy slot?"

When a January order came for Horjus to get the vaccine before deploying to a Kuwait air base about 30 miles from Iraq, the soldier with commendations and Good Conduct Medals declined. Her commander demoted her and cut her pay in half, to less than $800 a month. In February, she declined a second and third order.

Horjus is one of a number of soldiers who cite the lack of anthrax in Iraq as a reason behind their stance against the mandatory anthrax vaccine. As the Pentagon moves thousands of troops into Iraq as part of a huge rotation of forces, soldiers, citizen groups and members of Congress are increasingly calling upon defense officials to stop the vaccinations.

Sen. Jeff Bingaman (D-N.M.) sent a letter last week to Defense Secretary Donald H. Rumsfeld asking him to reevaluate the mandatory policy in light of events in Iraq. "The apparent absence of an Iraqi biological warfare capability raises serious questions about the threat of an anthrax attack against our troops," Bingaman wrote. "The use of a vaccination which appears to have the potential for serious health consequences for our troops in an effort to counter a threat that may not exist seems to unnecessarily expose our troops to risk."

The Pentagon now requires inoculation for any soldier about to deploy for more than 15 days to what it defines as a "high-risk" area for anthrax attack. Concerned about reports of illnesses and a death last year that officials linked to the vaccine, soldiers headed to Iraq, Afghanistan and elsewhere are asking more questions about the program's rationale.

"There is no evidence that stockpiles of anthrax exist in Iraq or with Al Qaeda in Afghanistan or elsewhere," Horjus wrote in a memo to the base's appellate authority. "As a single mother, I cannot afford to unnecessarily risk my long-term health on a highly-reactive vaccine that supposedly protects against a threat that cannot be found."

After four years of service, the young mother last week accepted the Air Force's offer of an other-than-honorable discharge and prepared to return home to Yorktown, Va.

Vaccine opponents say they are tracking dozens of cases of soldiers who are refusing the vaccine. The demand for troops is so high that unvaccinated soldiers may find themselves deployed nonetheless. Some are on duty in and near Iraq and are closely monitoring the frustrated hunt for banned weapons, knowing they will face punishment for disobeying orders when they return.

Pentagon officials insist that refusals are extremely rare and that the unsuccessful search for the weapons has not changed their thinking about the merits of the mandatory vaccine. The anthrax threat, they say, is not a distant risk but was underscored by the 2001 domestic letter mailings that killed five people and left thousands vulnerable to grave illness or death.

"The lethal anthrax attacks of the fall of 2001 did not need a sophisticated delivery system," Defense Department spokesman Jim Turner said in an e-mail response to questions. "We vaccinate our people to keep them healthy."

Vaccine opponents have become increasingly organized and vocal about the health risks of the AVA vaccine, a product that has accumulated thousands of reports of adverse reactions ranging from headaches and vomiting to severe autoimmune and neurological problems. Opponents are using the courts to press the health issues and lobbying Congress to give relief to soldiers whose careers ended abruptly over their refusals to line up for shots.

"When troops find out that any one portion of what they've been told is a lie, they question the rest of it," said Kathryn Hubbell, who helped set up a nonprofit group, the Military Vaccine Education Center, to work with soldiers. It is also organizing a political action committee to raise money for its lobbying efforts.

Among the hotly contested issues is the Pentagon's accounting of the number of soldiers who have been "separated" from the services for refusing to take the required six-shot regimen. Congress was so concerned about the issue in the program's early years, when hundreds of soldiers resigned the military rather than be vaccinated, that it began requiring the Defense Department to report annually the number of soldier separations.

The department's reports for 2001 and 2002 show only three separations, and numbers for 2003 are due this spring. Vaccine opposition leader John Richardson, a retired Air Force Reserve lieutenant colonel, calls the Pentagon numbers a "willful misrepresentation" used to encourage good order and discipline. He says the Pentagon uses the strictest interpretation of the data, failing to count cases such as Horjus's that did not result in court-martial and forced removal from the military. Since the vaccine program began, about 100 active-duty soldiers have been court-martialed for refusing the vaccine, according to congressional testimony and documents.

Victims' advocates say they have become aware of 45 cases involving vaccine refusers since 2002. These soldiers find themselves subjected to a wide range of punishments.

"We've seen everything from quiet discharge to court-martial to imprisonment with 60 to 90 days in the brig," said Randi Airola, a victims' advocate who left the Michigan Air National Guard in 1999 because of her own vaccine refusal. "We've seen soldiers threatened with two to three to 10 years in prison when, in the military, even rape or drug charges may not get you 10 years in prison. The punishment is based solely on the discretion of the individual commander -- and some want to use a sledgehammer to get people to comply."

Airola recently gave a congressional committee 32 pages of e-mails sent to her by soldiers who believe they have been made sick by the shots or are refusing to be vaccinated.

"In light of these problems," she wrote, and the absence of weaponized anthrax spores in Iraq or Afghanistan, "it is unacceptable for Congress to continue to follow the line that the vaccine is safe, effective and good enough for our troops and to jail those who refuse."

A key question in the vaccine debate is the safety of AVA, a product that has been used since the 1950s to inoculate textile workers and laboratory personnel at high risk of anthrax exposure. The vaccine was licensed by federal regulators without being tested in large-scale human clinical trials. But the Pentagon points to a 2002 report from the Institute of Medicine declaring the vaccine safe and effective.

The vaccine, made by BioPort Inc. of Lansing, Mich., is now under attack in three separate federal lawsuits brought by affected soldiers.

In U.S. District Court in Washington, Judge Emmet G. Sullivan issued a preliminary injunction late last year that caused the Pentagon to briefly halt vaccinations. The program resumed after the Food and Drug Administration offered assurances in February that the vaccine was safe. The case, brought on behalf of six anonymous servicemen who believe they were made ill by the vaccine and for all of those "similarly situated," is set for oral arguments in May.

Two federal judges have suggested that the military will be held accountable if it is using soldiers to test an investigational drug without their informed consent. Pentagon officials seemed poised to stop the program before the Sept. 11, 2001, attacks gave it a reprieve. In December, the Pentagon agreed to buy an additional 245 million doses of BioPort's vaccine.

The Defense Department and other federal agencies have worked to find a new anthrax vaccine that will produce fewer side effects.

Horjus said her decision to refuse the BioPort vaccine was based largely on research and observation. Her estranged husband took the shots before deploying to Saudi Arabia and became ill with a fever and lung congestion. She said she read everything she could about the vaccine, doing what the military expects a good soldier to do -- "use your head."

Horjus said she became convinced that the BioPort vaccine was unsafe and experimental, its effects on women of childbearing age unknown. She and others were upset by a case that drew wide attention in November, when a coroner ruled that "post-vaccine" problems may have contributed to the death of Army Spec. Rachel Lacy.

Army Lt. Gen. James B. Peake of the U.S. Army Medical Command sent a memo to commanders in February mentioning Lacy's death and telling them to be alert for adverse reactions. "The overwhelming majority of immunizations are followed by mild symptoms. . . . Unfortunately, the U.S. Army lost a valuable soldier in April, 2003, a month after receiving five vaccinations during mobilization," Peake wrote. "Although the evidence was inconclusive, medical experts determined that vaccination may have contributed to her death."

Adding to Horjus's concern were reports of two airmen at Seymour Johnson who became seriously ill after receiving the shots.

One soldier said in an interview she has suffered lightheadedness, night sweats and "grayouts" since receiving three of the six required shots. She asked that her name not be used because of fears that it could hurt her effort to get specialized treatment at a Walter Reed Army Medical Center vaccine clinic.

"Before these shots, I was a normal, healthy 20-year-old," she said. "So far, I've dodged the fourth shot, but if they try to make me take it, I'll be traveling down Jessica Horjus's path."

Horjus and the two sick soldiers have become part of Airola's outreach network. She directs soldiers and their families to medical information and counsels soldiers preparing to refuse the vaccine. Many, she said, write letters to their commanders explaining that they are willing to deploy, even to indemnify the military against any possible anthrax exposure they might suffer on the battlefield, but "they just don't want to take these shots."

At Fort Campbell, Ky., Army Sgt. Richard Norris, 27, is awaiting punishment for refusing the shots. When his unit of the 101st Airborne Division left for Iraq in February 2003, Norris was sent anyway, with no vaccine -- and no questions asked.

He returned in December to find himself still flagged as "punishment pending," a status that has "put my whole career basically on pause.

"I've served my country for seven years," said Norris, a Seventh-Day Adventist who tried unsuccessfully to get a religious exemption from the vaccine program. "Refusing this vaccine is the first bad thing I've ever done. It wasn't even necessary to have this vaccine, and still I'm going to be punished."