Defense Leaders Commentary: Protecting Our Military

One of the clearest responsibilities of any secretary of defense is to protect the men and women the United States deploys in harm's way around the world to safeguard our national interests. That is why I, acting on the advice of the Joint Chiefs of Staff, decided to start vaccinating every member of the military against exposure to anthrax, a highly lethal biological agent that at least 10 countries possess in their arsenals or are in the process of acquiring.

In 1996, the Joint Chiefs of Staff identified anthrax as the number one biological threat to our troops. After the Gulf War, United Nations inspectors confirmed that Iraq had produced thousands of gallons of anthrax and deployed it in missile warheads, artillery shells and spray tanks for use from airplanes. As a weapon of mass destruction, anthrax is cheap and much easier to develop than nuclear munitions. When dispersed in aerosol form, the colorless, odorless bacteria covers a wide area and kills people within several days of inhalation. In 1979, approximately 70 Russians died after breathing anthrax spores that escaped from a Soviet biological research facility.

Fortunately, Iraq did not use anthrax against our troops during Desert Storm in 1991, but we can't expect that future adversaries, including terrorists, would not do so. At a time when the U.S. maintains clear conventional military superiority, enemies will be tempted to turn to unconventional weapons, such as anthrax, as a way to defeat our troops.

Although anthrax is highly deadly, we have developed protective equipment and medicines to secure the safety of our troops. In 1970, the Food and Drug Administration licensed a vaccine to protect humans who might be exposed to anthrax. This vaccine has a proven safety record over 30 years of use by thousands of veterans, woolworkers and veterinarians. Protective gear provides only temporary protection, while the vaccine constantly protects troops who might breathe anthrax spores spread on the battlefield.

After evaluating the anthrax threat and the safety of the vaccine, the general who commands U.S. troops in the Middle East requested that all troops deployed to the Arabian Gulf area be vaccinated for anthrax protection. Every day approximately 20,000 U.S. soldiers, sailors, airmen and Marines stationed in the Gulf awake knowing that they could encounter an anthrax attack. The commander of the 37,000 U.S. troops in South Korea, who face an anthrax threat from North Korea, also requested vaccinations for his forces.

The Joint Chiefs reviewed these proposals in light of their conclusion that anthrax is the foremost biological threat to our troops. They recommended mandatory anthrax vaccination for all 2.4 million active and reserve members of our military, with the first shots going to troops in or scheduled to go to the Middle East and Korea. They reasoned that force protection should not be optional; just as it is inconceivable to allow a soldier to fight without a helmet, it makes little sense to send a soldier into battle without protection against a known threat like anthrax. Because our military must be able to deploy anywhere on short notice, they recommended vaccinations for all active and reserve personnel.

I supported the recommendation of our military leaders. But before launching the vaccination program, I took steps to make sure that we were prepared. Complaints that the Department of Defense mishandled exposure to Agent Orange and the illnesses suffered by some veterans following the Gulf War in 1991 damaged the military's credibility on medical issues. We have worked hard to correct and learn from these experiences, and one of the lessons is that our medical programs to protect soldiers in battle must be planned and implemented with an emphasis on safety.

As a result, I decided to delay vaccinations until four conditions were met. First, I ordered supplemental testing, consistent with FDA standards, to assure that the vaccine supplies are sterile, safe, potent and pure. Second, I instructed the services to design a system that accurately tracks personnel who received the six shots required in the vaccination program. Third, I required the services to develop plans for educating people about the program and administering the immunizations. Finally, I ordered an independent review of the health and medical protocols of the program. This was performed by Dr. Gerald Burrow, the highly respected former dean of the Yale Medical School, who assisted the Presidential Advisory Committee on Gulf War Veterans' Illnesses.

The vaccinations began in 1998 after these four conditions were met. Gen. Hugh Shelton, the Chairman of the Joint Chiefs, and I were among the first to receive the shots. We experienced the same mild side effects, such as temporary soreness or a small bump on the arm, that many others feel. Indeed, the side effects are frequently less than those caused by other routine vaccinations that most Americans routinely receive. Our careful monitoring of the program reveals no unexpected side effects. Nevertheless, if our troops experience a negative reaction, we provide quality medical care.

More than 400,000 active duty soldiers, sailors, airmen and Marines have started receiving the series of six shots, while only about 300 have refused vaccinations. We take seriously the concerns that people have raised about the program, and we are in the process of distributing additional educational material to explain the program to military members and their families. We have bolstered our website (http://www.anthrax.osd.mil) to counter some of the erroneous assertions about the vaccine that are circulating on the internet. We are continuing to monitor the safety of our vaccine supplies.

The military does not want to lose a single member because of his or her concerns over this program. But most of all, we don't want to run the risk of losing thousands of men and women in uniform from an anthrax attack for which we are unprepared. The threat is real, and we are carrying out a prudent, safe program to counter the dangers our troops face.