Bioterrorism and compulsory vaccination

Editor—Jefferson questions military use of anthrax and smallpox vaccines licensed as safe and effective by the US Food and Drug Administration (FDA).¹ The Department of Defense is concerned about the safety of US service members, so we vaccinate them to keep them healthy. Vaccination provides the only round the clock protection against the malicious use of microbes as weapons.

Our vaccination programmes are based on a credible military threat, recognised by multiple government agencies and administrations. Given that a few cubic metres could hide a grievous quantity of anthrax spores or variola virus, the unsuccessful hunt for weapons of mass destruction in Iraq has done little to reassure us. That anthrax and smallpox infections are not circulating naturally is irrelevant when these microbes can be targeted wilfully at our troops. Anthrax spores are all too easy to deliver, as our nation learnt in fall 2001.

The values of anthrax vaccine and smallpox vaccine are established in the medical literature, which is more extensive and more accurate than cited in the editorial. The National Academy of Sciences published a comprehensive review of anthrax vaccine safety and efficacy in March 2002.² The FDA recently affirmed that human and animal evidence show that anthrax vaccine protects regardless of route of exposure.³ The modern military safety surveillance system first identified the rare risk of myopericarditis after smallpox vaccination,⁴ something otherwise unrecognised in America, and then described the extent of recovery from this condition.⁵ The rigorous screening programme adopted in the US civilian and military smallpox vaccination programmes resulted in serious adverse event rates at or below historical expectations.^{w1 w2}

Until improved vaccines are licensed we will not risk our troops' lives against lethal biological weapons. We use today's vaccines to shield our service members so they can succeed in their mission to protect our nation, and return home healthy.