Rachael Lacy of Lynwood, Ill., a nursing student and combat medic with the 452nd Combat Support Hospital at Fort McCoy in Milwaukee, got five different vaccinations March 2 as her unit prepared to deploy to the Persian Gulf.

Ten days later, she went to the post clinic with shoulder pain and vomiting and was treated for what health workers thought was a bronchial infection. Over the next three weeks, she was treated at three different civilian facilities, one of which diagnosed her with pneumonia, said Fort McCoy spokeswoman Linda Fournier.

Lacy died at the Mayo Clinic in Rochester, Minn., on April 4 of lung damage.

Dr. Eric Pfeifer, the Minnesota coroner who performed the autopsy, said the smallpox and anthrax vaccines “may have” contributed to Lacy’s death.

“It’s just very suspicious in my mind … that she’s healthy, gets the vaccinations and then dies a couple weeks later,” Pfeifer said in an interview.

During blood tests, Pfeifer found evidence of an underlying auto-immune disorder that previously had not been detected. He has been working with the Army and Centers for Disease Control and Prevention in the investigation, he said.

“One of the theories is the vaccine … may have exacerbated this immune problem she had,” Pfeifer said.

Lacy also had pericarditis, inflammation of the sac surrounding the heart, according to her death certificate. That is an expected reaction to smallpox vaccine in some people, according to medical studies.

Lacy’s father insists she was perfectly healthy until she received mandatory smallpox and anthrax vaccinations. Moses Lacy claims those vaccines caused the auto-immune illness, and her symptoms were then misdiagnosed.

“My daughter was a health fanatic,” said Lacy, a Vietnam veteran. “My daughter had no auto-immune disorder. … My daughter didn’t have to die. My daughter was killed.”

Officials with BioPort Corp., maker of the anthrax vaccine, were surprised that the death certificate listed the vaccine as a possible contributing factor.

“There were five immunizations given at the same time,” BioPort spokeswoman Kim Root said. “To call one or two of them out would be the thing that concerns us.”

The anthrax vaccine has a safety profile similar to other adult vaccines, she said.

“We have no reason to believe the anthrax vaccine should have been called out based on its safety profile,” Root said.

Nearly three years ago, a Michigan medical examiner suggested the vaccine as a possible contributing factor in the death of a BioPort employee.

A review of that case by civilian physicians who comprise the government’s Anthrax Vaccine Expert Committee, however, determined the vaccine did not lead to his death, said Army Col. John Grabenstein, deputy director of the Military Vaccine Agency.

In rare cases, the smallpox vaccine can be fatal. Its history shows that one or two vaccinated people per million may die, according to the CDC.

Meanwhile, more than 70 plaintiffs have filed a lawsuit against BioPort and the former vaccine manufacturer, the Michigan Department of Public Health. The suit, filed in U.S. District Court for the Western District of Michigan, alleges the vaccine caused three deaths, including the infant of a vaccinated soldier, and various health problems in scores of others.

Root said she could not comment on pending litigation.

Dr. Meryl Nass, an internal-medicine physician in Maine who has closely followed the anthrax vaccine program, said vaccinated people “are developing auto-immune diseases such as rheumatoid arthritis, reactive arthritis and lupus, which cause musculoskeletal pain. Others develop fibromyalgia and chronic fatigue syndrome whose causes are unknown but also may cause similar musculoskeletal pain and fatigue.”

Nass said further study on the vaccine by an independent organization outside the Defense Department is needed.

Root said BioPort supports ongoing research into the safety and efficacy of the vaccine.

Moses Lacy said he needs no further evidence. His daughter called him in March to tell him she had chest pains and breathing problems and had been diagnosed with pneumonia.

“I talked with her a day or two later and she said, ‘Dad, I’m hurting all over. I’m walking like an old person,’ “ he recalled.

Rachael “absolutely loved” serving in the reserves, he said, and had talked of re-enlisting. He had been the one to suggest she join the reserves and was pleased she enjoyed it so much.

Now, however, he feels guilty.