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American Forces Press Service

DoD Clarifies Exemptions to Anthrax Vaccination Program

By Staff Sgt. Kathleen T. Rhem, USA
American Forces Press Service

WASHINGTON, Feb 17, 2000 -- DoD officials are in the process of approving a policy that standardizes exemptions to the anthrax vaccination program. But, they said, they provided exemptions because it's "good medicine," not because of any concerns about the vaccine's safety or efficacy.

The new exemptions fall into two categories, administrative and medical, said Marine Maj. Gen. Randy L. West, special adviser to the secretary of defense for anthrax and bio- defense affairs.

The administrative exemption refers mainly to service members who are within 180 days of separation and are not likely to be deployed to one of the key anthrax-threat areas -- Korea and Southwest Asia. The six-shot anthrax vaccination series takes 18 months to complete.

"If a person is within 180 days of discharge and not likely to be deployed to a high-threat area, it doesn't make sense to start a program that takes 18 months to complete," West said. "We wouldn't be able to complete the series while the person was on active duty.

"However," he continued, "if a person is within 180 days of separation and is in a hostile area or is unexpectedly deployed to a hostile area, we will vaccinate them and give them as much protection as we can under the approved FDA protocol."

The general said the services were looking at the issue of exemptions for separating personnel differently, with recommendations ranging from 90 to 180 days. DoD officials decided to set one standard.

Medically speaking, certain individuals shouldn't receive any immunizations, including anthrax. "Anthrax is a mandatory vaccination, but we want it to be given just like every other vaccine," West said. "If a person has a medical reason not to take the vaccine or to be temporarily exempt from taking it, we want that to happen."

Medical exemptions fall into several categories.

  • Adverse reaction to a previous anthrax immunization. West said a person who has a suspected severe reaction after a shot would be temporarily exempt until the cause can be definitely determined. If the vaccine is the cause, the individual would be exempt from further doses.

  • Pregnancy. "There's no history that would cause us to believe the anthrax vaccine would be harmful. However, there haven't been any tests done to prove that," West said. "Since we know that a woman's body goes through a lot of changes and a lot of challenges during pregnancy, we would just like to avoid adding to those challenges by requiring her to take the anthrax vaccine."

  • Currently taking corticosteroids or other immunosuppressant drugs. Vaccinations are commonly deferred for individuals taking drugs that suppress the immune system because the drugs reduce the effectiveness of the vaccine, not because there would be an adverse reaction to the combination.

    "The purpose of vaccines is to build antibodies in your body," said Army Lt. Col. Gaston M. Randolph Jr., director of the Anthrax Vaccine Immunization Program. "When you're taking immunosuppressant drugs, your body doesn't build antibodies. It's sort of a waste to take the vaccine."

  • Recent illness or surgery. "If individuals had recently been ill or had recently had surgery we wouldn't want them to take a shot until they were fully recovered," West said.

    West said these measures address "common-sense medical situations," but said he felt the exemptions provide clarification because of the public controversy surrounding the vaccine.

    Randolph explained that medical exemptions have always been covered in the healthcare providers' briefing, but until now have not been spelled out in a single clear, concise guideline to service members.



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