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Subject: The Anthrax Vaccine Scandal
Date: Tue, 16 Oct 2001 22:40:11 -0700

This is truly an excellent summary article of the issues surrounding the anthrax vaccine.... News | The anthrax vaccine scandal

The anthrax vaccine scandal

Why did the Pentagon allow BioPort Corp. to remain the sole U.S. supplier of a crucial weapon against bioterror despite years of failure to deliver the vaccine?

By Laura Rozen
Oct. 13, 2001

With each new confirmed anthrax infection raising fears of a wider bioterror attack in the U.S., pressure is mounting on the Defense Department and the Food and Drug Administration (FDA) to give the green light to Michigan-based BioPort Corporation, the nation's lone anthrax-vaccine manufacturer, to ship new lots of the vaccine to the Pentagon.

Anthrax vaccine shipments from BioPort have been suspended by the FDA since 1998 because of questions about the facility's quality control, forcing the Pentagon to dramatically reduce its program to vaccinate all 2.4 million U.S. soldiers and reservists against anthrax. Now the lack of the vaccine threatens to become a scandal, as the U.S. is sending thousands of soldiers overseas, calling up reserves, and as the public is clamoring for access to protection from the deadly bacterium.

After three years of getting bailed out by the Defense Department, BioPort could be poised to make a fortune -- as its CEO Fuad El-Hibri did working with the British seller of anthrax vaccine, Porton International, during the Gulf War a decade ago. But only if the FDA approves the company's renovated plant, as expected, sometime in the next week. The decision could open the door for BioPort to market the drug to a worried public, as new anthrax scares are reported daily.

The story of the troubled U.S. anthrax-vaccine program is a tangled saga of science, politics, private-sector deal-making and national security. There have been persistent questions about the vaccine's safety and effectiveness. Critics say Defense Department studies have never proven the vaccine works against the more dangerous inhaled form of anthrax, only against cutaneous, or skin anthrax. Some military personnel have complained of mysterious illnesses after taking the vaccine, and at least 400 have been disciplined for refusing the mandatory inoculation. But the Pentagon insists the vaccine is both effective and safe. Even now, some researchers say the vaccine is seriously outdated, as BioPort gears up to ship more.

Then there are questions about BioPort's role as the nation's only anthrax vaccine maker. How did Fuad El-Hibri, 43, a German-born entrepreneur and former director of British vaccine-maker Porton Products, come to have so much control over the West's supply of anthrax vaccine? Why didn't the Pentagon turn to a larger, more established drug-maker for the crucial anti-biowarfare weapon? And how could it let BioPort remain the sole maker of the vaccine after it failed repeatedly to gain FDA approval for its renovated facility?
>From 1999
To print this page, select "Print" from the File menu of your browser > Health & Body May 13, 1999

Guinea pigs?

Our troops are being vaccinated against anthrax, but are the shots a dangerous waste of money?

- - - - - - - - - - - - By Arthur Allen

In 1988, at a remote Siberian laboratory, a 44-year-old Russian germ warfare researcher named Nikolai Ustinov was preparing to jab a guinea pig with a syringe full of Marburg virus when he slipped and pricked his thumb instead. That was the end for Comrade Ustinov. For two weeks, helpless doctors watched as the pullulating, Ebola-like organism overwhelmed Ustinov, until he died with blood oozing out of his pores. For his colleagues, Ustinov's gruesome demise was a preview of the deaths they were manufacturing -- by the millions -- in violation of global bans on biological warfare development. But if they were horrified by what they saw, it did not deter the scientists from capitalizing on Ustinov's accidental experiment. The virus, which had mutated in its host, was harvested and purified into a new, even deadlier strain for the Soviet arsenal. In honor of the scientist who died to create it, the new weapon was called Marburg Variant "U."

The weaponization of Ustinov is one of the more harrowing episodes in "Biohazard," a new book by Kanatja Alibekov, who worked for two decades at the biological weapon conglomerate Biopreparat and was deputy director before his defection in 1992. Having changed his name to Ken Alibek, he now works for a northern Virginia consulting firm, devising ways to enhance immunity to the weapons he once designed. Alibek's book reveals the secrets of the enormous Soviet germ warfare program, and implies that many of its scientists may still be at work. As such, it's a good advertisement for the Clinton administration's $1.4 billion bioterrorism initiative, whose most visible component is a program to inoculate all 2.4 million active and reserve service members against deadly anthrax bacteria. It comes as something of a surprise, then, to learn that Alibek thinks the $130 million anthrax vaccination program is not very sound.

In this, he is by no means alone. At Dover Air Force Base in Delaware on May 5, Col. Felix Grieder, the wing commander, temporarily suspended vaccinations on the 3,600-strong base because the performance of a Pentagon briefer sent to explain the shots had been "inadequate to dispel rumors and misinformation" about the vaccine's safety, Grieder's spokesman said. The incident at Dover reflects growing skepticism in and outside the military over the safety and reliability of the anthrax shots. A movement to make the shot voluntary has been orchestrated by an extremely loose coalition of critics -- everyone from Clinton-bashing militia types to left-wing activists, along with a General Accounting Office investigator in Washington and a day-care provider in suburban Denver who serves as electronic den mother for thousands of disgruntled soldiers, sailors and airmen. In the past six weeks, top brass and Food and Drug Administration officials have twice been called before Congress to answer critics of the program. In the middle of a war, the Pentagon is being accused of reckless disregard for the health of its men and women. "It would seem that troops are being used as guinea pigs," says Mark Zaid, a lawyer who represents several sailors disciplined for refusing the vaccine.

The careful observer is inclined, initially, to interpret the uproar as a farrago of half-baked claims and misapprehensions. It began early last year when, in the course of filing a lawsuit on behalf of a former CIA agent, Zaid turned up documents revealing irregularities in the Michigan laboratory that produces the anthrax vaccine used during the Gulf War and in the current vaccination campaign. Another vector of opposition was a group of anti-war activists, including a Freeport, Maine, emergency room doctor named Meryl Nass, who has contended for many years that the United States was conducting its own biowarfare program. The documents suggested that the anthrax vaccine, licensed in 1970 but used by only about 20,000 people prior to the Gulf War, had been inadequately tested and was being sloppily produced. Furthermore, the critics claimed, some troops were suffering devastating illness after taking the shots -- and six shots in all were required for full protection.

By early 1999, doubts about the vaccine had spread to several members of Congress. A report in late March by the GAO -- the investigative arm of Congress -- called on the Pentagon to investigate questions about the vaccine raised in work by Pam Asa, a freelance scientist in Tennessee, and Robert Garry, a retrovirologist at Tulane University medical school. During the silicone breast implant controversy, Asa and Garry presented evidence purporting to show that silicone leaks were causing autoimmune disease -- in which the immune system attacks the body's own benign tissues. Garry subsequently devised a test to detect antibodies to silicone and similar fatty substances. He now says he has detected antibodies to one of these substances -- called squalene -- in the blood of most members of a group of 75 severely ill veterans and recent anthrax vaccines he tested. About 200 people in control populations tested negative for the antibodies, Garry says. He hypothesizes that there was squalene in the vaccines injected into the service members, or that their disease, which he contends is an autoimmune disorder, somehow results in the production of antibodies to squalene, an unhealthy state of affairs since squalene is a naturally occurring substance in cell membranes.

The conspiratorially inclined have noted that squalene is used as an adjuvant -- an immune booster -- in several experimental vaccines. In the May Vanity Fair, Gary Matsumoto put this jumble of evidence together to claim, in an article titled "The Pentagon's Toxic Secret," that Gulf War vets and active soldiers had been vaccinated with experimental substances without informed consent, in violation of the Nuremberg Principles. But the Pentagon, along with several retired and active officers involved in the Gulf War vaccination program, flatly denies that vaccines containing squalene were ever used on troops, except in small trials for HIV and malaria vaccines. "Short of evidence to the contrary, I guess we have to believe that," Garry says. Ironically, squalene and other experimental adjuvants may be key to a new generation of safer vaccines. These vaccines, containing small particles designed to produce very specific immune responses in the body, are more pure than most current vaccines, but must be administered in conjunction with adjuvants to bolster their capacity to stimulate the immune system. I spoke to half a dozen scientists who work with squalene adjuvants and all of them denied the substances were intrinsically dangerous. They reacted quizzically to Garry's hypotheses. "It's plausible, but I'd like to see the data," says Dr. Andria Langenberg, director of clinical research at the California biotech firm Chiron, whose squalene adjuvant has been administered to 18,000 people in trials, and was commercially licensed last year for a flu vaccine in Italy.

The Pentagon, reasonably, says it is waiting for Garry's results to be published before it does anything about the squalene issue. Both the Pentagon and the FDA claim the anthrax lots approved for the troops are safe and that adverse reaction rates are low. They point out that about 4,500 employees in the U.S. germ warfare defense program have been vaccinated against anthrax since 1973, and although hundreds have probably been exposed to anthrax spores, none are known to have gotten the disease -- or suffered a long-term reaction to the vaccine. Researchers at Fort Detrick, Md., have bombarded 45 vaccinated monkeys with powdered anthrax in recent years, and all but one survived. For ethical reasons, this method can't be tested on humans. If the vaccine failed, most of them would die after a few days of coughing, vomiting and internal bleeding.

On the other hand, the Gulf War troop population was two orders of magnitude larger than the previous group exposed to the anthrax vaccine -- and critics believe the Pentagon should have designed follow-up studies on the 150,000 or so Americans who got multiple vaccinations during that brief war. A few studies, including one published by British researchers in the Lancet in January, have suggested that multiple vaccinations are the factor that most closely correlates with the symptoms of Gulf War illness. On March 30 of last year, a sailor aboard the USS Independence, Erik Julius, sent an e-mail to his mother asking her to find out if the anthrax vaccine was safe. Julius' mother, Lori Greenleaf, told her son that reports on the Internet linked it to Gulf War illness. When Julius refused the vaccination, he was reduced in rank, she says. Under threat of more serious punishment, Julius relented, and got three shots over the following year that his mother says caused headaches, muscle pains, exhaustion and diarrhea, the typical constellation of non-specific ailments that has bedeviled thousands of Gulf War veterans. Greenleaf, convinced the vaccine has hurt her son, and angered at the military's insistence he take the shot, began campaigning against the obligatory vaccine on the Web. She claims to be in contact with more than 7,000 worried troops and veterans. "We're still not getting honest answers," she says.

The Pentagon, mindful of Iraq's known anthrax stocks, has so far stood by the vaccine as a key element of force protection. "Anthrax is the biological weapon most likely to be encountered by U.S. forces," Brig. Gen. Eddie Cain, who is in charge of the Pentagon's biological defense, testified before a congressional hearing on April 29. "If anthrax is used as a biological weapon ... death is the usual outcome once clinical symptoms appear, regardless of any post-exposure treatment." At Fort Detrick, there is frank puzzlement over opposition to the vaccine. "We're not vaccinating people for pleasure," says Col. Arthur Friedlander, M.D., a top anthrax researcher. "We're talking about trying to protect troops. Do you want your son to go into Iraq when Saddam has weaponized anthrax sitting out on the airfield?"

But even if the anthrax vaccine is safe and has nothing to do with Gulf War or other illnesses, is mandatory vaccination a smart policy? Alibek, for one, thinks not. Any errant Russian biowarfare expert with a briefcase full of germs could help any of a dozen states weaponize any of a dozen killers besides anthrax -- plague, Marburg, Venezuelan equine encephalitis, you name it. "If an enemy of the United States knows that our army is vaccinated against anthrax, they'll try to develop some other weapon -- they have many to choose from," Alibek said in an interview. What's more, the licensed anthrax vaccine "probably wouldn't work," he believes, against at least one strain of anthrax genetically altered by Soviet scientists.

One of the stories recounted in Alibek's book is the 1979 disaster at Sverdlovsk, now Yekaterinburg, in which a bungling technician at a germ factory failed to replace an air filter, releasing billions of anthrax spores into the night air. At least 66 people died in this, the worst confirmed germ warfare incident. The strain of anthrax released at Sverdlovsk -- Anthrax 836 -- was put into the tips of hundreds of Russian warheads. This virulent strain, Alibek notes, was itself a genetic mutant derived from sewer rats that contracted anthrax from a spill. When I asked Friedlander if his monkeys had been "challenged" with 836, he said, "We'd like to, but we can't get it [from the Russians]." He added, "We have tested 30 other strains, and have no reason to believe it is fundamentally different." Friedlander and others in the military have no convincing counter-argument, however, to the suggestion that U.S. enemies could easily use another germ agent. "If you use the anthrax vaccine, you're shutting down one of the enemy's capabilities," Friedlander says. Not a hugely reassuring statement.

In the current constellation of global power, it is hard to imagine any state that would be foolish enough to fire germ-filled shells against American soldiers, since retaliation would certainly be massive. Terrorist attacks seem more likely, against troops or civilians. The FBI, one well-placed source told me, already knows of at least 12 terrorist groups that have tried to procure killer germs. But you can't inoculate the entire population against all of these organisms. Alibek thinks the answer lies in designing new drugs to enhance nonspecific immunity -- drugs that could be used once an attack has begun to accelerate the body's natural response to a range of foreign particles. But while growing knowledge of the immune system makes the future of such compounds more plausible, they don't exist now. "I think we could produce these in a decade," Alibek insists.
"Vaccines are not the answer." | May 13, 1999

From 2000
A cure worse than the disease?

Fearing sickness and debilitation, startling numbers of American troops are refusing to take mandatory anthrax vaccinations.

- - - - - - - - - - - -
By Arthur Allen

Oct. 27, 2000 | Ramona Savoie flew rocket launchers into Kuwait and tanks into Mogadishu, Somalia. She flew the enormous C-5 transport planes for the Air Force reserves when she wasn't flying passenger jets for American Airlines. She was tough, buff and patriotic.

But in July 1999 she was also a 44-year-old woman trying to get pregnant for the first time. And like so many middle-aged members of the military reserves, she wasn't wild about complying with an order to get six shots against anthrax, a deadly bacterium she doubted she'd ever have the misfortune to inhale. Savoie had heard that the shots, given over a two-month period, could have the type of side effects a pilot couldn't afford -- joint pain, vertigo, headaches. She worried they might interfere with her in vitro fertilization treatments -- or damage the child she hoped for.

And so, after 26 years in the Air Force and reserves, Maj. Savoie decided she was not going to get the shots. Her husband, Maj. James Hechtl, and more than half of the other 54 pilots in their reserve unit, the 301st Airlift Squadron at Travis Air Force Base in Northern California, avoided the shot as well, the couple says. Savoie was particularly outspoken in her opposition to the mandatory vaccine, attending hearings in Congress and talking to reporters.

"We've been accused of being disloyal and all kinds of things because we left over the vaccine," says Savoie. "Well, I'm sorry, but you can't use the military as a guinea pig anymore. We're much wiser, and with the Internet we're better informed."

The resignations at Travis Air Force Base are part of a pattern of resistance to the anthrax vaccine that has rippled across the country over the past two years. A quarter of all 176,000 pilots and other flight crew members in the Air Force Reserve and Air National Guard, which is also a reserve service, have either resigned or transferred out of their units in the past year, the General Accounting Office found in a study released Oct. 11. Another 18 percent said they planned to leave or transfer out in the next six months. In both cases, avoidance of the anthrax vaccine was by far the leading explanation the departing airmen gave GAO investigators, who sent questionnaires to a sample of 1,253 reservists. In a normal year, turnover of 10 to 15 percent might be expected. But if the GAO report is to be believed, mistrust of the military over the anthrax issue is high. Two-thirds of the respondents said the shot was a bad idea. And "despite DOD's (Department of Defense) high-visibility attempts to educate servicemembers about the anthrax inoculation program," the GAO report says, "only about 17 percent of those we surveyed believe the information on its Web site is accurate."

The anthrax protection program has been marked by controversy since the Pentagon, in May 1998, announced it would inoculate all 2.4 million servicemembers, active and reserve, in the first step of a multibillion-dollar biowarfare defense program. So far, fewer than 500,000 have received the anthrax vaccination, and the military, much to its embarrassment, was forced to suspend most vaccinations on July 17 because its stocks had gotten low. The only factory that makes anthrax vaccine has been closed for several years and has yet to win Food and Drug Administration approval to start making the shots again.

Reservists, who can opt out of military jobs easier than active-duty troops, have put up the most resistance to the vaccine. Pilots appear to have been particularly leery because they have to be in tiptop shape to fly. At some bases, including Travis, airmen transferred to other assignments in hopes that they could stay one step ahead of the vaccination campaign without being forced to refuse a direct order.

Reps. Dan Burton, R-Ind., and Chris Shays, R-Conn., have spearheaded a two-year investigation of the anthrax vaccination program as members of the Government Reform Committee. They ordered the GAO study, saying the vaccine campaign is misguided and seriously undermining the nation's military readiness, a sentiment shared by some pilots. Politics plays a role here, but even Democrats on the committee, and staunch advocates of the health bureaucracy such as Rep. Connie Morella, R-Md., have joined in questioning the value of the campaign.

Guard and reserve units are an increasingly key part of America's all-volunteer military. These weekend warriors have been at the front lines of all the major U.S. military operations of the past decade, from the Mideast to Rwanda to Kosovo.

The anthrax vaccination program is the lead element of a strategic shift in U.S. doctrine, moving away from the threat of mass retaliation as a deterrent to biowarfare attacks and instead embracing the goal of providing immunological protection for individual soldiers. That makes the reservists' skepticism of the program all the more serious. An estimated 65 officers and enlisted men have been court-martialed for refusing the shots, and hundreds of others have allegedly been threatened or punished in less serious ways.

"The anthrax vaccine program has clearly resulted in the loss of more personnel than the very thing it was designed to protect against," says Dan Marohn, an American Airlines and Air National Guard F-16 pilot, who was punished with an Article 15 -- a fine and suspension -- in June for refusing the vaccine. Marohn says more than half the pilots in his 163rd Fighter Squadron, based in Indiana, left over the anthrax vaccine. As was the case at other bases, military spokespersons declined to discuss the squadron's readiness.

According to the military, approximately 500 active-duty soldiers have refused vaccination orders. Just how many reservists have been spurred by dissatisfaction with the vaccination program to leave military service overall is difficult to know. The GAO survey is preliminary and the Pentagon doesn't specifically ask departing reservists whether anthrax vaccination contributed to their decisions.

At an Oct. 11 congressional hearing, Maj. Gen. Paul Weaver, the Air National Guard chief, acknowledged that pilots, on average, have left the guard earlier in the past two years than they did prior to the anthrax campaign, but said he had no data showing a definitive link. The reserves have fallen severely short of enrollment targets in the past two years, and the anthrax campaign has presumably played some role in this. Although he and other brass deny reports of massive resignations, Maj. Gen. Randall West, the Pentagon's point man on the anthrax program, admitted during the hearing that he was "very concerned" about the GAO report.

West and other officials say they had no choice but to deploy the anthrax vaccine after discovering that Iraq, North Korea and other nations have "weaponized" anthrax that could be used against American troops in battle or terrorist attacks.

"If the enemy uses it, and I haven't provided protection, I've got a lot of letters to write to a lot of mothers and fathers telling them why their sons and daughters died on the battlefield when I could have protected them," West said during the hearing.

That's the worst-case scenario. But many experienced airmen, who are typically in their late 30s and 40s, don't buy it.

"OK, I haven't looked at the intelligence reports, but you're telling me that an administrative clerk in Enid, Okla., needs to get an anthrax shot for force protection?" asks Marohn, of Plymouth, Ind.

"Was there anthrax in that bomb in Yemen?" rhetorically asks Savoie, the former Travis reservist.

Pilots, whose training typically can cost the military up to $6 million each, appear to be the group of reservists least willing to accept the anthrax vaccination. Most of those who have left are Air Force and Navy reservists, more than half of whom also fly commercial jets. Although the airlines are telling their pilots that the FDA has advised the FAA that the vaccine is safe, some, like Savoie and Hechtl, worry that an adverse reaction to the shot could ruin their civilian flying careers. Typically, these pilots may earn a $100,000 salary flying 10 hours a week for an airline, and less than $20,000 flying 10-15 hours a week for the reserves.

"We don't fly (in the reserves) for the money," says Savoie. "We do it for the fraternity. And because we're patriots." But in a peacetime military, the risk of vaccine side effects for a well-paid commercial pilot doesn't balance up well against the intangible benefit of service to one's country, particularly given the mistrust of the military that has been engendered by a series of congressional hearings on the issue.

"It's not so much the vaccine as the trust that's the issue here," says one pilot.

One adverse reaction that anthrax vaccinees have reported is vertigo -- "and that's a real career killer," says Hechtl.

"It's very hard to get your [pilot's] medical certificate, and these guys don't want to risk it," says Maj. Tom Rempfer, a former Connecticut Air Guard F-16 pilot who also flies for American Airlines out of Boston. Rempfer, 35, transferred to a nonflying reserve unit to avoid taking the shots.

Older pilots are both more aware of their rights than the average enlisted man, and more cynical about the military's history of dealing with medical problems, says a 40-year-old U.S. Navy pilot who flies P-3 observation planes over the Caribbean as part of the drug war.

"We know that the military is notorious for disavowing any knowledge of anything," says the reservist, who is also an American Airlines pilot but didn't want to be identified. "Their attitude is, 'We say this shot is completely safe, damn it, now take it.' And if you're a pilot, that scares you, because there does seem to be a problem out there. Are they going to replace your $100,000 salary if you grow a third arm or something? Or are they going to brand you as some kind of mental case and say, 'You're on your own.'? Because that's what they did with Agent Orange and the Gulf War Syndrome, which they haven't resolved yet."

The P-3 pilot said everyone in his command ended up taking the shots after the commander passed out 3-inch-thick binders with pro and con articles about the vaccine. "They were very open about the process and that made a difference," he says. "They didn't go around threatening people with courts-martial."

In hindsight, the anthrax vaccine seems to have been an unwise choice with which to launch a biological warfare defense program. There is only one maker of the vaccine, a crude potion designed in the 1970s. The vaccine was created and tested in military labs well before technical advances that permit greater dosage uniformity, and was intended mainly to protect a few hundred commercial wool sorters -- who face a threat from naturally occurring anthrax spores in animal hides -- and biological warfare experts at secret U.S. research units.

Clusters of bad reactions to the vaccine seem to have occurred on particular bases. Many of the ailments reported by airmen at these bases were similar to those seen after the Gulf War -- severe headaches or joint pain, chronic fatigue, thyroid problems. The anthrax shots were administered to about 180,000 Gulf War-era vets, and some of them have blamed the shots for Gulf War Syndrome.

Some opponents of the mandatory program are claiming that the military secretly put squalene, a fatty substance that has been widely studied as an immune system booster, into some of the anthrax vaccines. Squalene was detected in vaccine tests earlier this year, but in quantities that are probably too minute to be medically significant, and certainly too small to have been intentional. But because the Pentagon initially denied that the shots contained any squalene, opponents of the program seized upon the discrepancy as support for their claims -- even though there's no proof that the substance can cause this type of adverse reaction.

Trust in the Pentagon program has been undermined by repeated shutdowns and fines at the Lansing, Mich., factory, owned partly by senior retired military officers, that produces all the anthrax vaccine. The FDA, which ordered the sanctions, has cited manufacturing problems that included bacterial contamination of a few vaccine lots. None of the known contaminated batches were given to soldiers, however, and the contamination would not be expected to cause the type of autoimmune reactions that have been reported.

Whether or not these mysterious ailments can be legitimately linked to the vaccine, reports of reactions have had a dramatic impact. Pilot walkouts occurred at the Air National Guard units at Fort Wayne, Ind., and Battle Creek, Mich., according to pilots from those units who have testified in Congress, after people at those bases got sick during the vaccination series.

At Dover Air Base, where C-5s lumber out over the salt marshes and the Delaware Bay en route to the world's hot spots, 50 of the 120 pilots in the base's two reserve units quit rather than be vaccinated against anthrax last year, according to Lt. Col. Jay Lacklen, chief pilot of the base's 326th Airlift Squadron.

In January 1999, after the first round of shots at Dover, one pilot developed vertigo; another got severe arthritis; and a loadmaster -- the person in charge of loading the plane -- was diagnosed with lupus, an autoimmune disease, says Lacklen, 41. He attributes a nagging medical problem of his own -- osteoarthritis of the hands -- to the vaccinations he received.

"The airline guys [commercial pilots also flying in the reserves] took one look at these people and said, 'I'm out of here,'" says Lacklen, who stresses that he's not speaking in an official capacity.

Maj. Sonnie Bates, an active-duty pilot, felt he had entered some kind of twilight zone when he transferred to Dover from a base in Texas last August.

"Here was this group of pilots, who are usually a healthy bunch, and they were all sick with this stuff no one had heard of," he says. One evening before leaving work, Bates grabbed a squadron sick list known as the DNIF (as in "duties not to include flying"), took it home and started calling everyone on it.

"All 15 had had similar reactions after the third or fourth shot," says Bates' wife, Roxane, who has become an activist in the anti-vaccine campaign. "After he noticed all these weird illnesses, we definitely knew something was wrong."

Bates took it upon himself to raise the issue with the base commander. When Bates refused to get the vaccine series himself, the Air Force announced court martial proceedings. Eventually, the charges were dropped, but Bates lost his pension and was ordered to pay $9,000 in fines, he says. Now he trains pilots at a flight school in Wilmington, Del.

He mourns his former life. "There will never be a job that can replace what I was doing," Bates says.

Maj. Frank Smolinsky, spokesman for the Air Force on the Dover base, said that 115 of the 1,838 airmen who got the shots have reported bad reactions. However, few of those reactions were debilitating, and none of the serious conditions that did occur has been clearly linked to the vaccine, he said. But senior airman Cathy Milhoan, spokeswoman for the reserve unit on the base, acknowledges that anthrax concerns hurt staffing. Congress authorizes 116 pilots for the unit, but 55 left in fiscal 2000, she says -- and 22 of those positions have still not been filled. "There is no question there were members of the wing who left the reserve in response to the anthrax vaccine," she says. "Morale was affected by the controversy." She adds, however, that those who remain have put the controversy behind them.

At the time, though, the Dover uprising made waves. When Savoie and Hechtl, who is a Southwest Airlines pilot, heard from their friends about the situation at Dover, they made up their minds to refuse the shots. Their commander was not sympathetic.

"We got blank stares from our commander and a brochure saying the shots were safe," Hechtl said, speaking on the phone from his home. Local commanders, he and other pilots said, have been forced to pass along the Pentagon's damn-the-torpedoes insistence that the program continue.

"What we were saying was, 'Guys, can we stop flying this plane into the side of the mountain?'" says Savoie. "That's what you do in the cockpit. If something's going wrong you stop, take a timeout and work out the situation. But they were unwilling to do that."

Savoie eventually became pregnant and in September gave birth to twins that the flying couple named after two favorite planes -- Hunter, a boy, and Piper, a girl. Although Hechtl ended up having to leave the service just months before completing his 20th year, the new family members were all the vindication they needed.

"I ended up having twins," Ramona Savoie says, "and they're perfect."

About the writer
Arthur Allen writes on health, science and other issues for Salon. He lives in Washington.

Sheri Nakken, R.N., MA
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