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Just 25, Kearns has suffered two heart attacks, including one he didn't notice, and a second that was nearly fatal; a stroke that left him disabled, with a slight limp; and blood clots, over the past few years, that have swollen his arms and legs. His regular regimen of medicine, displayed on a shelf in his mother's Long Island kitchen, includes shots of a blood thinner called Lovenox, which he injects into his abdomen four times a day, leaving a painful trail of black and blue ringing his midriff.
Kearns said he thought nothing of taking the vaccines when doctors aboard his minesweeper in the Persian Gulf told the crew they were required. "I was 20 years oldI didn't know anything about it," he said, and added that refusing the vaccine would have put him at quick odds with his superiors and earned him nothing but derision from fellow sailors.
Back in the U.S, concerns over the safety and effectiveness of the anthrax vaccine, which has been mandatory since March 1998 for service members, started to slowly churn in the military. Precise numbers aren't available, but hundreds of soldiers are thought to have left for fear of side effects from the vaccine. At least a hundred more were court-martialed for refusing. A lore grew up around the shots, and critics claimed the anthrax vaccine, manufactured by a Michigan company called BioPort, might be responsible for ailments ranging from the still mysterious Gulf War Syndrome to death.
Today, those protests have grown strong enough to halt the DOD program that administers the anthrax vaccine. In October, a Washington, D.C., district court judge, responding to a lawsuit brought by six John Doe soldiers, issued an injunction against the Anthrax Vaccine Immunization Program (AVIP), saying the process that allowed the shots to be licensed in the first place had been flawed.
"Congress has prohibited the administration of investigational drugs to service members without their consent," wrote Judge Emmet G. Sullivan. "The men and women of our armed forces deserve the assurance that the vaccines our government compels them to take into their bodies have been tested by the greatest scrutiny of allpublic scrutiny." The soldiers' lawyers contended that, among other things, since the Food and Drug Administration had not allowed a sufficient public comment period before licensing the vaccine as effective against a certain type of anthrax exposureso-called "inhalationanthrax"the required shots were unlawful.
In December, the Pentagon struck back and obtained emergency authorization to resume the program for military personnel on a voluntary basis. That move has also been controversial, and marks the first time a provision from the Project BioShield Act, a law passed three years after the 9-11 attacks intended to help federal agencies respond to terrorist emergencies, has been invoked.
The FDA has opened a public comment period on the vaccine, which is set to expire at the end of this month. Pentagon lawyers are then expected to argue that the injunction against the vaccine should be lifted, and again make it required of all soldiers.
A Pentagon spokesperson, responding to questions by e-mail, elaborated the reasons his agency thinks the vaccine should be mandatory. "The Department of Defense recognizes that military teams depend on each other to survive on the battlefield. That is why all vaccinations have traditionally been mandatory. The mutual dependence of each team member means each needs to be protected against preventable infections."
If the Defense Department prevails in courtand many observers think this is likely it could mean a new round of defections, at a time when the U.S. military finds itself stretched between overseas engagements and is missing recruitment goals. Young people like Nick Lilienstern and Skip Mullersailors who struggled to find honorable ways out of their service rather than receive the shotscould be the new victims of a vaccine that nobody seems to know too much about.
Muller and Lilienstern, who met when they served together briefly on a navy destroyer, found different ways to avoid taking the shots when they became required. Lilienstern refused outright, and immediately received a nonjudicial punishment. He was restricted to his ship for 45 days and received half-pay for two months. During that time, he said, the number of friends he had on his ship began to dwindle. When the captain threatened him with further sanctionsthe same punishment for each of the six anthrax shots soldiers take in an 18-month serieshis mother contacted their local congressman, and Lilienstern was discharged from the navy.
Skip Muller's superiors told him that refusing the vaccine would mean a court-martial, and possibly a dishonorable discharge. So he took some advice from a sympathetic senior officer and wrote a letter to the ship's captain explaining that he is gay. Within months, he received an honorable discharge.
The activists working against the anthrax vaccination program are a zealous bunch and include doctors, soldiers, lawyers, and former journalists. Their attack on the vaccine proceeds today more or less on two fronts. They argue, first, that there is not yet solid proof that the vaccine works against inhalation anthrax, the aerosol form of the agent that would likely be used to attack U.S. troops, and second, that side effects from the vaccinewhich might include deathmean the shots should be voluntary and offered with a brochure that describes the risks. Or better, given that there has never been an anthrax attack directed against the U.S. military, that anthrax treatment shift to post-exposure antibiotics instead.