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Anthrax Vaccine Urged for Hill Staff
Health Officials Want Inoculations To Start This Week
By Shankar Vedantam and Ceci Connolly
Washington Post Staff Writers
Tuesday, December 18, 2001; Page A01
http://www.washingtonpost.com/wp-dyn/articles/A57229-
2001Dec17.html
Federal health officials yesterday began urging
Capitol Hill workers to take an as-yet unlicensed
anthrax vaccine as part of a plan sparked by fears
that deadly spores may be lurking in the employees'
bodies and could erupt once antibiotic treatments
end.
Two military anthrax experts met with about 70
staffers to outline the rationale for the
unprecedented inoculation proposal, which could
involve as many as 3,000 Senate and U.S. Postal
Service employees in Washington, New York and New
Jersey.
Health officials are anxious to begin the
vaccinations as soon as possible because many of the
10,000 Hill staffers and postal workers who had been
put on 60 days of antibiotics after the bioterrorism
attacks this fall have begun finishing their courses.
That means they could be at risk of falling ill soon
if anthrax spores are lingering in their lungs and
their immune systems have not been primed to respond.
Officials want vaccinations to begin this week after
Health and Human Services Secretary Tommy G. Thompson
approves the plan.
Health officials said they began briefing the Capitol
Hill workers first because Hill officials
specifically requested that they do so. They said
they would be available to brief all employees who
would be affected by the plan.
But the plan is already generating controversy and
confusion. District health officials are unconvinced
the vaccination is necessary, but at the same time,
they are concerned that not enough vaccine may be
available for everyone at risk. The vaccine itself is
controversial because the company that makes it has
had a long history of problems and has yet to receive
final approval by the Food and Drug Administration.
"There are only 10,000 doses of the latest batch of
vaccine -- and that is the lot that the Capitol Hill
physician has requested," said Larry Siegel,
Washington's deputy health director. "We have made it
very clear that if it is released, we want access to
the same lot." Siegel contested claims from federal
officials that only 3,000 people were at high enough
risk to need the vaccine.
"There's no science yet that will allow anybody to
make a determination that any of the 3,500 people in
Brentwood [postal facility] are at any lower risk
than the people in the Daschle suite," he said. "If
anybody is going to be offered vaccine, everybody
should."
On Capitol Hill, a Senate aide said the 90-minute
briefing was calm and informative. The group was told
that "extensive studies" of the anthrax vaccine
showed no serious side effects, although the three
injections can be painful.
Lt. Col. John Grabenstein, head of the anthrax
vaccine program at the Army surgeon general's office,
said vaccinations of 524,000 military personnel had
found only low risks such as sore arms, aches and
fevers. Combining vaccine with antibiotics is the
"best insurance" against developing anthrax,
Grabenstein said.
The Senate staffers considered most at risk are those
who worked in the sixth- and fifth-floor offices of
Senate Majority Leader Thomas A. Daschle (D-S.D.),
which received a letter laden with anthrax spores in
October, and the adjoining fifth-floor office of Sen.
Russell Feingold (D-Wis.), as well as other officials
who visited there after the tainted letter was
discovered, said Greg Martin, chief of infectious
diseases at the National Naval Medical Center.
For congressional staffers who did not come in direct
contact with the tainted letter, officials will offer
the vaccine but not necessarily recommend it, Martin
said yesterday.
The first Capitol Hill staffers exposed to anthrax
spores are completing their allotted 60 days of
treatment.
Postal workers considered most at risk are those who
worked with the four employees who developed
inhalational anthrax, those in buildings where
tainted letters were opened and those with positive
nasal swabs, officials said.
Postal spokeswoman Kristin Krathwohl said no decision
about the vaccination plan had been made by the
Postal Service or unions.
"It's an area that few of us know anything about,"
said Barry Burns, chief shop steward in the motor
vehicle section of the Brentwood facility. "The only
thing we can do is put our trust in [the Centers for
Disease Control and Prevention]. We have very little
trust of postal management and what the post office
was telling us. As of yet, we have no reason to
distrust CDC."
For months, health authorities have been publicly
advising people exposed to anthrax to take only the
two-month course of antibiotics to protect themselves
from developing the life-threatening disease.
But at a meeting Saturday, officials disclosed that
two weeks before the first letter arrived, senior
government physicians on Capitol Hill had met with
officials from the FBI, the CIA, the Justice
Department and several other agencies to prepare for
an anthrax emergency.
"We all agreed" that anthrax vaccinations combined
with antibiotics would be the collective approach,
said John Eisold, the physician for Capitol Hill.
But when the anthrax scare began Oct. 15 and
thousands of workers in the Senate and at postal
facilities were declared at risk, there was not
enough vaccine available to immunize everyone.
"The ramifications of the actions that I would take
on the Hill were far broader than I had originally
anticipated," Eisold said.
The government doctors scuttled their plan, which
would almost certainly have been criticized for
giving vaccines preferentially to lawmakers and
powerful people over mail carriers. So instead, only
antibiotics were recommended for everybody.
About a month ago, the CDC quietly laid the
foundation for a vaccination program by filing a
request for an experimental program with the FDA -- a
necessary step because the proposed vaccine had not
passed all the agency's licensing requirements.
At the time, the CDC said the vaccine was being
stockpiled for health officials who would have to
respond to future bioterrorist attacks, and possibly
for use in people for whom antibiotics did not work.
The Defense Department subsequently released some
vaccine stocks to the CDC, making it possible to
inoculate about 3,000 people.
Over the last few weeks, decades of anthrax research
on animals and a recently declassified Canadian study
reminded doctors that taking people off antibiotics
for 60 days could leave them defenseless afterward
against anthrax spores that lay dormant in their
lungs. When the medicine is stopped, the spores could
germinate, producing disease.
The vaccine has not received final FDA approval
because the company that has an exclusive contract to
make it for the military, BioPort Corp. of Lansing,
Mich., has had a series of problems. As a result, the
new inoculation plan is formally being classified as
experimental.
The vaccine has been generating controversy for years
because of its use by the military to protect
soldiers against possible biological weapons. Some
soldiers refused to get vaccinated, saying they were
concerned about the vaccine's safety. But health
officials maintain that the vaccine has been shown to
be safe. The holdup with the FDA's final approval has
been over BioPort's manufacturing facility, not the
vaccine itself, officials said.
Staff writers Avram Goldstein, John Lancaster and
Rick Weiss contributed to this report.
� 2001 The Washington Post Company
http://www.washingtonpost.com/wp-dyn/articles/A57229-
2001Dec17.html
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