-Caveat Lector-

> "You must give the person who is giving consent all the relevant
> information so they can make a wise decision whether to take the
> experimental drug," she said.

>>>Now, I know nothing except what I read in the news or in
commentaries.  However, I was one who MIGHT have been induced to take
this vaccine under former Sec'y of Offense Cohen's program, the same
program -- I might add -- that has caused some to be considered for
courts martial for declining the shots and others to resign from
otherwise promising careers the military to avoid further conflicts
of any kind.

But now we have the Congress and the Postal workers being "offered"
this vaccine as an option, the same vaccine from the same heretofore
FDA UNapproved BioPort company.  For some reason, the Postals don't
like being used as Guinea pigs.  So goes my introduction.

Here's my rationale for the anthrattax, solely based on events as
they have unfolded in the media:

** The military was originally chosen to test the vaccine, with
Willie Cohen leading the charge, his one contribution to and
participation in the requirements of military service.
** Some of those who were needle and vaccine pokers or pokees became
somewhat enraged by their complicity as Guinea pigs.
** Coincidental to the 9-11 extreme vandalism events, someone in the
system decided that it was time to heighten the nation's sensitivity
and awareness to the issue of misuse of vaccine and military
personnel for medical (aux Nazis) experimentation.
** Ergo, the lettres were sent to members of Congress, realising that
the "cure" (Cipro-cating) would be short term, with the only supposed
long-term "cure" would be the vaccination.
** Knowing that the vaccine was still an unapproved, experimental
substance, the onus was now on Congress to either accept or decline
it as a course of treatment or prophylaxis.
** Now, Congress has issued a delay on inoculations due to the risks
of the vaccine.  Note the next statement provides only part of the
story.

> On Capitol Hill yesterday, inoculation of congressional workers was
> postponed a day because federal officials had not completed the
> necessary consent forms laying out the risks associated with taking a
> vaccine that has not been approved as a post-exposure treatment.

I could be wrong but in any event, Have A Nice Day (HAND).  A<>E<>R

>From http://www.washingtonpost.com/wp-dyn/articles/A3541-
2001Dec19.html

}}}>Begin
Anthrax Vaccine Plan Sows Confusion
D.C. Advises Workers Against Treatment

By Ceci Connolly and Avram Goldstein
Washington Post Staff Writers
Thursday, December 20, 2001; Page A01

Postal workers expressed frustration and confusion yesterday over the
federal government's plan to offer them anthrax vaccine on an
experimental basis, complaining they do not have the medical
information to make such a difficult decision.

Even as the Bush administration scrambled to meet the legal
requirements of such an unprecedented proposal, lawmakers and local
officials reacted bitterly to the lack of guidance they were
receiving eight weeks after the Centers for Disease Control and
Prevention began formulating the plan.

"First it was Cipro; then it was the other pill. Now it's this," said
Willard Tucker, an employee at the Brentwood postal facility. "Why do
we have to be guinea pigs for them? They don't even know what's going
on."

Adding to the confusion, Mayor Anthony A. Williams said in a
statement released last night that District officials were advising
against vaccination and recommending that workers contact the CDC.

"After discussing this issue at several scientific meetings, and the
careful review of the scientific data, and absent a recommendation
from the CDC, the District . . . affirms its previous public health
advisory which recommends strict compliance with the 60-day course of
antibiotics," the statement said. "As such the District Department of
Health does not recommend investigational post-exposure prophylactics
with anthrax vaccine at this time."

"No one has recommended the vaccination yet. We're not ready to do
so," said District Health Director Ivan C.A. Walks. He met with
postal workers for about two hours last night and told them of the
mayor's recommendation.

Antoine Barry, 40, a letter carrier at the Friendship Station post
office, said he felt more confident about not taking the vaccine
after hearing Walks speak.

"My concerns were basically just 'Am I safe?' " he said. "We're just
handling this one day at a time. I feel a little better now. I feel
like I know a little more about what's going on."

Postal workers in New Jersey, still waiting to be contacted by
federal officials, said they are relying on news reports for
guidance.

"We don't know how to protect ourselves," said Dianne Fazekas, who
worked beside two co-workers at a Hamilton, N.J., postal facility who
contracted inhalational anthrax. "We read in the paper that the
spores can reactivate themselves after we stop the medicine. We also
read that the vaccine has problems and we'd have to sign a release if
we take it. Nobody knows what to think."

On Capitol Hill yesterday, inoculation of congressional workers was
postponed a day because federal officials had not completed the
necessary consent forms laying out the risks associated with taking a
vaccine that has not been approved as a post-exposure treatment.

At the same time, inspectors from the Food and Drug Administration
gave a partial endorsement to the vaccine maker, BioPort Corp., after
conducting an evaluation at the plant in Lansing, Mich., as part of
the company's efforts to win final approval for the vaccine.

The FDA made seven "observations," issues that BioPort must address,
said Kathyrn Zoon, the agency's top vaccine evaluator. Many of those
issues were addressed while inspectors were at the facility, she
said, such as the company's procedures and rules.

But it was the fresh wave of uncertainty that dominated discussions
in post offices, a conversation that was often tinged with an element
of race and resentment over how postal workers were treated during
the anthrax attacks.

"We've been pushed to the side and that frustrates me," said George Bryant, who said 
he has felt from the start that postal workers have been treated differently from 
congressional aides. "I think they know more than they
're telling us. I'm really scared. I just want to know what's going on."

Bailus Walker, a professor of public health and health policy at Howard University, 
said the government's handling of the anthrax attacks has only reinforced long-held 
suspicions.

"There is a long-standing, deeply ingrained concern in the black community about being 
used as guinea pigs," he said. "As much as we try, we have not been able to remove 
from the minds of the black community the Tuskegee
episode. . . . We confront it almost monthly as we try to get blacks to participate in 
clinical trials. This just feeds it." Tuskegee refers to a notorious federal study in 
which treatment was withheld for 40 years from h
undreds of poor black sharecroppers with syphilis.

On Tuesday, Health and Human Services Secretary Tommy G. Thompson announced that the 
anthrax vaccine would be made available to about 3,000 people on the East Coast who 
may have been exposed to spores. The decision was pr
ompted by concerns that the spores may survive longer in the lungs than had been 
thought and could still make people sick once their 60-day courses of antibiotics end.

In the announcement, Thompson did not make a recommendation on who should receive the 
vaccine but said individuals could opt instead to take antibiotics for an additional 
40 days or simply monitor their health and watch f
or symptoms of anthrax disease.

"It appears that once again federal officials do not have a comprehensive plan of 
action," said Rep. Christopher H. Smith (R-N.J.), recalling the confusion that arose 
when 1,000 postal workers were told one Friday afterno
on in October to get antibiotics to protect against anthrax. "In the first go-round we 
tried to exercise some patience as the experts found their way. This time there is no 
excuse."

Last night CDC Director Jeffrey P. Koplan offered some insight on who should consider 
receiving the three-shot vaccine regimen. They include individuals who were in 
proximity to tainted mail, such as the 70 people in and
near Senate Majority Leader Thomas A. Daschle's Hart Building offices, anyone who had 
contact with one of the five people who died of inhalational anthrax and anyone who 
was in an area that was "heavily contaminated" with
 anthrax bacteria, such as the Brentwood and Hamilton postal facilities, he said.

"Those are the individuals at higher risk who may want to consider these more 
aggressive options," he said in an interview.

Yet one day after Thompson announced his decision, it was clear many critical aspects 
of the plan remained unresolved or strayed from standard practice.

Although anthrax vaccine has been licensed in the past for inoculating high-risk 
groups such as soldiers, it has never been used as a treatment for people who may have 
been exposed to the bacteria. Because of that, the CD
C must submit a detailed request outlining why and how it will conduct the treatment. 
This is known as an investigational new drug (IND) program.

"INDs are used when you are experimenting on people," said Mary
Pendergast, former deputy commissioner of the FDA. Two key documents,
she said, are the scientific protocol and the consent form that all
participants must sign. Both must be approved by independent panels
concerned with the safety of patients.

"You must give the person who is giving consent all the relevant
information so they can make a wise decision whether to take the
experimental drug," she said.

Koplan said the agency's institutional review board was still
revising the consent form and the scientific protocol last night.

Prominent physicians, meanwhile, disagreed publicly over what
patients should do.

Capitol physician John Eisold, in an e-mail to congressional workers,
said that while federal officials remained neutral, he was
recommending the vaccine for about 70 people exposed to an anthrax-
laden letter sent to Daschle (D-S.D.).

"If the federal government leaned toward Eisold and said we really
should be giving it and recommending it, the other people would say,
'Why are you doing that? Why are you exposing us to risk?' " said
Anthony S. Fauci, director of the National Institute of Allergy and
Infectious Diseases. "If you lean the other way, the Eisold people
would say, 'Wait a minute -- we want it.' "

Staff writers Andrew Demillo and Dale Russakoff in New Jersey
contributed to this report.

� 2001 The Washington Post Company
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