The White House announced a new policy on anthrax vaccinations Friday, preserving a third of the U.S. supply for civilians and continuing to vaccinate military personnel considered to be at high risk (see GSN, May 31).

Under the new policy, the U.S. Defense Department in two weeks is expected to begin vaccinating personnel who will spend at least 15 days per year in high-risk regions, according to the New York Times.  Those regions include the Middle East, the Korean peninsula and possibly Afghanistan, officials said.

One-third of the U.S. anthrax vaccine supply will be set aside for civilian use in the event of an anthrax attack, the Times reported.  Doses will be stored in secret locations as part of the National Pharmaceutical Stockpile administered by the Health and Human Services Department, Bush administration officials said (see GSN, Jan. 29).  In the event of a domestic anthrax attack, first responders such as police and firefighters, as well as those near the areas exposed to the disease, would be vaccinated, Bush administration officials said.

“This is a shift from our earlier policy, which was to vaccinate everyone,” said William Winkenwerder, assistant defense secretary for health affairs.  “This is a policy that’s focused on those in higher-threat areas.”

The change in policy, which previously had been to vaccinate all military personnel, could have been caused by concerns over a potential shortage, the Times reported.  There have been concerns that BioPort, the sole U.S. producer of the vaccine, would not be able to produce enough vaccine needed in the event of a major military operation, some Bush administration officials said (see GSN, May 17).

BioPort officials, however, said they would be able to produce as much vaccine as needed, adding they are disappointed that the Pentagon appeared to link the change in policy to supply concerns (see GSN, April 12).

“We can make millions on an annual basis,” BioPort President Robert Kramer said.  “We were disappointed to hear at the press conference that the vaccination schedule is supply driven, that policy was being driven by supply.  We’re ready, willing and able to partner with anyone to produce enough doses under our license.”

Some White House officials said the change in anthrax vaccination policy is meant to preserve more of the stockpile for civilians.

“At this point in time we do not have a large enough stockpile to prevaccinate, so the stockpile will be reserved for post exposure,” said Jerome Hauer, Health and Human Services acting secretary for emergency preparedness.  “The stockpile for civilians will be used for postexposure vaccination and as the stockpile grows we will re-evaluate our policy as to whether certain first responders should be prevaccinated” (Dao/Miller, New York Times, June 29).

1990 Study

A 1990 study examining the effectiveness of various anthrax treatment regimens helped provide support for the change in vaccination policy, the Times reported Saturday.

The study, which was conducted on 70 rhesus monkeys, indicated those that received anthrax vaccine and antibiotics together had a higher survival rate against the disease than those monkeys that were only administered either the vaccine or antibiotics, according to the Times (see GSN, March 7).

The study first exposed three groups of monkeys to anthrax and then gave one group both treatments, another group only the vaccine and another group only antibiotics, said Arthur Friedlander, a senior researcher at the U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick, Md.  After the first exposure to anthrax, some of the monkeys in each group died, Friedlander said.  When the monkeys were exposed again to anthrax three months later, only those in the group that had been both vaccinated and given antibiotics suffered no additional casualties, he said.

U.S. officials provided few details about how the anthrax vaccine would be used with antibiotics in the event of an outbreak.

“Stockpiling the vaccine is the most prudent course for protecting our citizens’ health and well-being,” Deputy Health and Human Services Secretary Claude Allen said.

Experts also agreed with the Bush administration’s decision to use the vaccine along with antibiotics based, in part, on the study, according to the Times.

“There’s no way in the world you could do a clinical trial of this in humans,” said Philip Brachman, an anthrax expert at Emory University (see GSN, June 4).  “We use the best scientific judgments we have” (Sheryl Gay Stolberg, New York Times, June 29).

For further information, see:

CDC Frequently Asked Questions on Anthrax

Journal of the American Medical Association Background 

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