Verdict of studies into anthrax vaccine
IT’S SAFE

A microscopic view of the anthrax bacteria in a victim’s blood. Photo from US Army Medical Research Institute of Infectious Diseases

Key points

Chief of Air Force Air Marshal Angus Houston has been voluntarily vaccinated against anthrax. He said, “I think of this vaccination the same way I do about issuing protective clothing – just another measure to ensure our people’s safety.” Of the thousands of people – including service personnel and civilians such as vets and laboratory workers – immunised against anthrax since the development of a vaccine, there is no clinical evidence to suggest that anyone has suffered any long-term ill effects from anthrax vaccination. The ADF employs two virtually identical vaccines – one from the UK and one from the USA. They do not contain live anthrax bacteria. It is impossible to get anthrax from the vaccine. As a biological weapon, anthrax bacteria would be released into the air in invisible clouds.

By CPL Jonathan Garland

SERVICE personnel deploying to the Middle East are being vaccinated against anthrax as part of their preparation for possible exposure to biological agents.

These vaccinations are part of Defence’s duty of care to members and anyone who does not accept the vaccination is not deployable to that theatre of operation.

This does not preclude deployment to other operational theatres and will not result in any administrative action against the member. Chief of Defence Force General Peter Cosgrove said there was no punishment for refusing a voluntary vaccination.

“We will strive to convince the few to join the vast majority who have received this as a necessary adjunct to deployment,” he said.

“We will look to convince those people that this is not only safe and reasonable but necessary. If we fail to convince them, then they will be brought home and re-employed in some other way.

“The bottom line … is that we must make sure they [deployed personnel] are safe and that the integrity of our teams and missions can be met.”

Commonwealth Chief Medical Officer Professor Richard Smallwood said studies had shown the vaccine to be safe and effective.

“The US Institute of Medicine found last year there was no long-term deleterious effect from use of the vaccine,” he said.

Director-General Defence Health Air Commodore Tony Austin said the primary concern from a health perspective had always been, and remained, the well-being of ADF members.

“A decision as to what types of protective measures we use is the culmination of an enormous amount of work in identifying the occupational, environmental and operational threats they may be exposed to during a particular military activity,” he said.

“We have a whole range of tools available to us to define the nature of those threats, their severity and ramifications. Once the threats have been identified, we try to neutralise, modify or ameliorate the adverse effects.”
In the case of Operation Bastille, the ADF conducted a comprehensive threat assessment on the likelihood of members being exposed to anthrax.

Anthrax is a potentially lethal disease with serious consequences for anyone infected, particularly if they are unaware of the infection.

“The most effective mechanism available to us to protect our men and women is the use of the anthrax vaccine,” AIRCDRE Austin said.

Anthrax vaccines being dispensed by the ADF originate from either the UK or the USA, where they are licensed for use by the respective health authorities.

These vaccines are not widely in use in Australia because of the low incidence of the disease here.

“The demand for the vaccine here is extremely low – certain professional groups may be at risk but it isn’t an issue for the broader community,” AIRCDRE Austin said.

“The vaccines have, however, been extensively used overseas in a military and civilian context.

“Like all vaccines, there is some degree of side effects but these are usually mild and in no way different to what you would see with routine vaccinations.”

He said the incidence of long-term side effects from the vaccines was extremely low.

“Unfortunately, there seem to have been rumours circulating of serious side effects, such as a detrimental effect on the reproductive system.

“We’ve searched the international literature as widely as we can and we can find absolutely no references to this being a complication in the use of anthrax vaccine.”

Every service member is entitled to ADF medical care but no member is compelled to receive any health care against his or her will.

“Being mindful of the psychological well-being of our people, we realise that when confronted with taking a vaccine with which they are not familiar and which is not in widespread use in Australia, they may have some concerns about its safety,” AIRCDRE Austin said.

“This is a perfectly reasonable reaction, so we decided to put together a comprehensive briefing package to ensure they received extensive education about the vaccine before they were invited to receive it.

“If, after absorbing the information about the vaccine, the member does not wish to take it, he or she will not be compelled to do so.”

What exactly is anthrax?

Anthrax is an infectious disease caused by the bacteria Bacillus anthracis.

It primarily affects animals such as sheep and cattle but can also infect humans.

As a biological weapon, anthrax bacteria would be released into the air in invisible clouds.

The first symptoms of this type of “inhalational” anthrax would generally appear within a week (typically two or three days).

Symptoms include general lethargy, mild fever and flu-like symptoms.

Without treatment, these would quickly progress to serious breathing difficulties, collapse, shock and, in almost all cases, death.

About the vaccine

The ADF employs two virtually identical vaccines – one from the UK and one from the USA.

Those receiving the UK vaccine will receive injections at zero, three and six weeks and then a fourth injection at six months.

Those receiving the USA vaccine will receive injections at zero, two and four weeks, then three more at six, 12 and 18 months.

Vaccination should be completed with one type of vaccine, as they are not interchangeable.

Points to note:

There are no live anthrax bacteria in the vaccine

It is impossible to get anthrax from the vaccine.

The vaccine provides some protection after the second injection and good protection after the third.

About the vaccination process

Members receive a briefing package about the vaccination before the injection takes place.

If they have concerns after reading that material, they should raise them with medical officers or seek further background information.

If, after this process, they do not wish to take the vaccine they will not be compelled to do so.

To protect members from threats in that area of operation, members not vaccinated against anthrax will be removed from the area or not deployed to that area.

This will be done without prejudice.

The members will be placed in appropriate areas of employment that do not prejudice them or their career.

If operationally warranted, a vaccinated member will be deployed in place of a non-vaccinated member.

Members may reconsider their decision either to take or refuse the vaccination at any time.

Possible side effects

• Redness
  
• Swelling
  
• Tenderness in affected area
  
• Mild fever
  
• Headache
  
• Significant side effects are extremely rare
  
  
  Your questions answered
  
  How long has the anthrax vaccine been used to protect humans?
  
  The first anthrax vaccine was developed in the 1950s and licensed in the USA in 1970.
  
  Why am I being asked to sign a consent form?
  
  The form ensures you have been fully informed of what being vaccinated against anthrax entails. It does not affect any right to treatment or compensation from the ADF or Veterans Affairs.
  
  Can anthrax be spread from person to person?
  
  No.
  
  Can receiving the anthrax vaccine affect my ability to have children?
  
  To date, no study has shown that anthrax vaccination has any adverse affect on men being able to father children.
  Pregnant women should not be routinely vaccinated against anthrax. There is no evidence that the vaccine is harmful to a pregnant woman or her unborn child – this is merely a precaution. Vaccination may be recommended for pregnant women who have been exposed, or are likely to be exposed to the disease.
  
  Is Gulf War Syndrome caused by anthrax vaccination?
  
  Of the thousands of people – including service personnel and civilians such as vets and laboratory workers – immunised against anthrax since the development of a vaccine, there is no clinical evidence to suggest that any has suffered any long-term ill effects from anthrax vaccination.
  
  More information is available from the Defence web page at www.defence.gov.au

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