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Q&A: The Pentagon’s mandatory anthrax vaccine policy

Stars and Stripes

Q: Have any servicemembers contracted anthrax or died from the disease?

A: We do not know of any servicemembers that have contracted anthrax or died from the disease.

Q: Then why vaccinate troops and DOD civilians against anthrax?

A: DOD immunizes servicemembers to protect against a biologic threat agents. Intelligence experts have determined that anthrax poses a clear and present danger to operational forces. The anthrax attacks through the U.S. Postal Service provide evidence that the threat is real, and in those exposed, is potentially deadly. Immunization represents the most effective round-the-clock protection for our troops.

Q: What are the side effects of the anthrax vaccine?

A: Like all vaccines, anthrax vaccine can cause soreness, redness, itching, swelling, and lumps at the injection site. Beyond the injection site, some will notice rashes (an average of 16 percent), headaches (14 percent to 25 percent), joint aches (12 percent to 15 percent), malaise (6 percent to 17 percent), muscle aches (3 percent to 34 percent), nausea (3 percent to 9 percent), chills (2 percent to 6 percent), fever (1 percent to 5 percent). These symptoms usually go away after a few days. The rates of these reactions are similar to those experienced by recipients of other common vaccines.

Q: Is the anthrax vaccine regimen discontinued for troops who develop symptoms of the disease or who have an adverse reaction?

A: The anthrax vaccine does not contain bacillus anthracis bacteria, and does not cause anthrax. Immunity from natural anthrax infection is lifelong. Vaccine-associated adverse reactions are managed through the military health system and medical exemptions are granted by the servicemember’s primary healthcare provider (or specialist consultant) consistent with good medical practice.

Q: How can DOD require emergency-essential civilians and contractors to be vaccinated?

A: DOD has authority to establish appropriate requirements necessary for the successful performance of duties. In the case of emergency-essential employees and comparable contractors, they agree to comply with agency requirements that are generally comparable to those applicable to military personnel.

Q: What legal ramifications do troops and DOD civilians who refuse to take the vaccine face?

A: Any failure to obey a lawful order may result in administrative or disciplinary action. There is no specification provided by law for the particular punishment that might be imposed in any case of failure to obey a lawful order. Authority is vested in the command structure and under the Uniform Code of Military Justice to determine the appropriate action, with protections for the due process rights of the member.

Q: Are the services preparing to prosecute troops and DOD civilians who refuse to be vaccinated?

A: There are no special preparations planned or needed. DOD experience with mandatory anthrax and smallpox vaccination programs, as well as all other mandatory vaccinations, is that there is overwhelming compliance and a very tiny degree of noncompliance.

Q: Why is it important to complete the vaccine regimen for troops who have already rotated out of theater if they might not go back to an area that requires anthrax vaccinations?

A: It is important because properly completing the vaccine regimen is good medical practice — following the full FDA-approved dose schedule. By continuing the vaccinations, even when they leave the high threat area, allows them to become fully protected and provides the U.S. Armed Forces with a more medically ready force.

Q: Are troops only fully protected after the sixth dose at 18 months?

A: Each dose is like walking up a set of stairs toward full protection. Most people begin to make antibodies with the first dose of anthrax vaccine. The goal is to climb the whole staircase, which is six doses for anthrax vaccine. The licensed anthrax vaccine recommends a six-dose regimen to be administered over an 18-month schedule. Yearly boosters are administered thereafter to maintain immunity.

Q: Do you have a chart showing how much protection each dose gives troops — for example, does the third dose provide 50 percent protection?

A: We don’t have a chart. The question of levels of protection provided by each dose of the schedule is under active clinical investigation. However, DOD must administer vaccines for force health protection consistent with the product license (FDA-approved schedule). Any changes to the licensed schedule would require FDA-approval of the manufacturer’s supplement to the original biologic license application (a regulatory requirement).

— Source: Defense health officials