Short Supply Forces Anthrax Vaccination Slowdown
By Rudi Williams
American Forces Press Service
WASHINGT0N, July 12, 2000 DoD's dwindling supply of anthrax vaccine has forced a temporary slowdown in inoculations, except to those personnel serving or about to serve in high-threat areas of Southwest Asia and South Korea, defense officials said during a July 11 Pentagon press conference.
Marine Corps Maj. Gen. Randy L. West, senior adviser to the deputy secretary of defense for chemical and biological protection, told reporters DoD has only about 160,000 doses of the vaccine on hand. He said DoD is trying to avoid suspending or shutting down the anthrax inoculation program.
What's left of the vaccine is being largely reserved for the 10,000 DoD people "with boots on the ground" in Southwest Asia and 37,000 in South Korea, said Dr. J. Jarrett Clinton, first assistant to the assistant secretary of defense for health affairs.
For the time being, most personnel in those areas who have begun the six-shot series will stop the inoculations if they rotate out. West said DoD guidance allows for local commanders' discretion, so, for instance, rotating soldiers might still get shots because the 10-dose vaccine vials can only be used or discarded once opened.
So far, 455,378 people have started vaccinations and have received a total of about 1.8 million shots. Some 56,725 have received all six shots, West said. During the slowdown, dosing will fall from about 75,000 vaccinations monthly to around 14,000. At that rate, DoD has enough vaccine to last up to 10 months, he estimated.
The mandatory six shots provide full protection as required by the FDA, West noted. He pointed out that receiving fewer than six shots causes no damage or harm to individuals, but does mean they lack the additional immunity protection provided by the complete series.
Clinton said the first three shots are given in two-week intervals and the last three, six months apart. An annual booster shot keeps troops fully protected. Although a person gains some protection by the second or third shot, it takes the full six for full, sustained immunity, he said.
Persons who have started the series but not finished will only need to pick up where they left off once their vaccinations resume, Clinton said. That's the guidance, he said, of the Centers for Disease Control's expert Advisory Committee for Immunization Practices.
West attributed the slowdown to the inability of the sole contractor, Bioport of Lansing, Mich., to gain Food and Drug Administration approval for its production facility. He said immunizations will resume at full speed when the FDA approves and certifies a sufficient supply of vaccine as safe and effective, but he emphasized Bioport's own timetable doesn't call for its new vaccine to be available before the end of the year.
"We're disappointed because we wish we were vaccinating the whole force now. We're running about a year behind our planned schedule in this program," West said.
"When we began the program, there was an existing supply and there was one company that had a license," he noted. "In retrospect, I wish that we would have immediately advertised for a second source. We did not. We recently have." BioPort will cooperate with that second-source contractor, he said, and the FDA says that company could earn certification in two to four years.
He said Britain and Russia have anthrax vaccines, but neither has FDA approval. The British vaccine is similar to the U.S. vaccine, but also in limited supply, and DoD has no interest in the Russians' live-bacteria vaccine, West noted.
The number of people who are refusing shots and the number of adverse reactions have declined, West noted.
"We've had 351 people that have refused to take the shot and have remained adamant enough about that to receive disciplinary action or be discharged or released from service," he said. "There have been 848 Vaccine Adverse Event Reporting System forms reviewed as of last month. That's out of 1.8 million-plus shots." He said 163 people have missed a day of work because of adverse reaction to the shots and 38 have been hospitalized.
He said intelligence reports indicate that the threat has increased since the anthrax vaccination program started in 1998. "There has also been an increase in the number of both state actors and nonstate actors that have done things that have prompted our intelligence committee to believe they are trying to obtain the capability (for biological weapons)."
But, West emphasized, "We're less at risk than we were in 1998, because we have more than 455,000 people that have some protection and 56,725 are fully protected. But we're less protected than we want to be."