Anthrax vaccine mandatory again Published Feb. 23, 2007 AFSOC Public Affairs HURLBURT FIELD, Fla. -- The Department of Defense's anthrax vaccine immunization program becomes mandatory for the Air Force again March 19. The Air Force's implementation plan includes mandatory vaccinations for active-duty Airmen who deploy to the U.S. Central Command area of responsibility or South Korea for at least 15 days. Despite the vaccine's thorough safety and effectiveness review, mandatory anthrax vaccinations were temporarily suspended in October 2004 when a U.S. District Court judge ruled the Food and Drug Administration had not sought enough public input before finalizing its conclusion that the Anthrax Vaccine Adsorbed, known as AVA, was safe and protective against inhaled anthrax. Pending a final FDA ruling, the judge allowed DOD to give voluntary anthrax immunizations. After receiving additional input, the FDA again concluded in 2005 that the AVA was safe and effective against all forms of anthrax. This FDA ruling allowed DOD to resume an unrestricted anthrax immunization program. Reinstatement of DOD's mandatory anthrax vaccinations follows a complete review of the program in 2006, which found that the threat posed by anthrax to military personnel far outweighed any risks associated with the immunization. Anthrax, a type of bacterium causing infections in animals or humans, can survive under harsh conditions as a spore. When these spores enter an appropriate environment, such as animal or human bodies, they germinate and cause infection which can lead to death if left untreated. Anthrax spores can enter the human body through three primary ways: through the skin (cutaneous) by handling soil or animal products that contain anthrax spores, by breathing in spores (inhalation) or by eating contaminated meat from animals killed by anthrax (ingestion). Inhalation anthrax used as a weapon represents the main threat to U.S. military personnel and can cause a rapid, severe disease, quickly killing untreated victims. Anthrax's severe symptoms, relative ease of laboratory production and its stability make it an ideal biological warfare weapon. Used as a weapon in the United States in 2001, spores were placed in letters and sent through the U.S. postal system, infecting 22 people, five of whom died. Licensed by the FDA, the AVA has been used in America since 1970. Anthrax immunization consists of six doses given at zero, two and four weeks, then six, 12, and 18 months. Though 95 to 100 percent of people show signs of anthrax-antibody response after just two doses, the full six doses are needed to ensure full protection. Annual booster shots are necessary for continued protection after the sixth dose. AVA is produced from a killed strain of a noninfectious anthrax bacterium and cannot cause infection. A number of past and on-going studies show the anthrax vaccine is safe and effective. After an exhaustive two-year review of the studies and data, the U.S. National Academy of Sciences' Institute of Medicine found "no evidence that people face an increased risk of experiencing life-threatening or permanently disabling adverse events immediately after receiving AVA." Nor did the committee find any "convincing evidence that people face elevated risk of developing adverse health effects over the longer term." The committee found that "AVA as licensed is an effective vaccine for the protection of humans against anthrax, including inhalational anthrax." Though considered safe, like other vaccinations or medical treatments, AVA may have temporary side effects. Approximately 30 percent of men and 60 percent of women can expect muscle soreness and a lump one inch or smaller in diameter around the site of the injection. These lumps usually go away within five days but may take several months to disappear. Less than one percent of those immunized will have effects that are not localized to the injection site. These effects may include fever, tiredness and itching. Through the nation's civilian Vaccine Adverse Event Reporting System, known as VAERS, side effect complaints have been collected, and re-viewed and studied by medical experts. After reviewing almost 2,000 VAERS reports, they found there was nothing unexpected in the number or type of side effects. The number of adverse reactions listed for anthrax is similar to those for other commonly used adult or childhood immunizations. People preparing to deploy to the CENTCOM AOR or South Korea will be required to either start the anthrax vaccine series or continue the series of shots already begun March 19 at Hurlburt's immunization clinic. Those deploying will not be cleared until the anthrax vaccine requirement has been met. For more information, call 844-1373.