http://www.anthraxvaccine.org/AnthraxGWS.htm
Until 1998, there existed no
published papers that explored whether
receiving anthrax vaccine was
related to Gulf War illnesses. Instead,
several expert committees
(lacking experience with anthrax) were asked
to comment on whether anthrax
vaccine was likely to be a cause of Gulf
War Illnesses. The
committees were given DOD briefings, did not review
the literature (there were no
published studies of safety or efficacy
for the licensed anthrax vaccine),
concluded that a relationship was
unlikely, and then recommended
against further research (1).
Studying American veterans was
particularly difficult because many were
not told whether they were given
anthrax vaccine, and the vaccinations
were specifically not entered
into service members' shot records. Other
centralized vaccine records have
been lost. Despite concerns about the
investigational status of anthrax
vaccine when used for biological
warfare, no informed consent was
obtained from service members at the
time of the Gulf War, and no
waiver of informed consent was sought from
the FDA.
The Canadian Department of
National Defense (DND) hired a consulting
company (Goss Gilroy Inc.) to
study the health of Canadian Gulf Veterans
and look at various
exposures. Their report was published on the DND
website. They found a
significant relationship between receiving
non-routine (biological warfare)
immunizations and developing chronic
fatigue, a very common symptom of
GWS (2).
In 1999 a British study examined
a large number of Gulf War exposures in
large cohorts of British Gulf War
and non-deployed Gulf-era veterans,
and Bosnia veterans. They
found that for both the Gulf War and the
Bosnia veterans, receiving
anthrax vaccine was related to developing an
illness consistent with Gulf War
Syndrome (GWS). They wrote,
"Vaccination against
biological warfare and multiple routine
vaccinations were associated with
the CDC multi-symptom syndrome in the
Gulf War cohort (3)."
This group published a follow-up
paper in the British Medical Journal
that claimed that only Gulf War
veterans who received vaccines after
deployment, not before, showed
this relationship. However, they later
retracted this conclusion, and
acknowledged that the timing of
vaccination did not affect the
relationship between vaccination and GWS.
A study of Kansas Gulf War
veterans was published in 2000 (4). This
study also found that deployment
vaccines were related to GWS: 34% of
Gulf War veterans met the
definition for
GWS, while only 4% of
non-deployed, non-vaccinated Gulf-era veterans met
the definition. However,
12% of Kansas Gulf-era veterans who were
vaccinated in preparation for
deployment, but then were not sent to the
Gulf, also met the GWS
definition. The paper concluded, "Vaccines used
during the war may be a
contributing factor."
A second study of British Gulf
War veterans was published in 4/2001.
This study looked at the
relationship between various Gulf War exposures
and subsequent health. It
did not look at specific deployment vaccines,
but instead evaluated the number
of vaccinations received in relation to
GWS. It said, "Consistent,
specific, and credible relations, warranting
further investigation, were found
between health indices and two
exposures, the reported number of
inoculations and days handling
pesticides (5)."
The Veterans Administration
collected data on thousands of Gulf War
veterans who presented for
evaluation of Gulf War Syndrome. Although
unpublished, the data were presented
at a conference on GWS in January
2001 (6). The VA
asked veterans if they thought they had received
anthrax
vaccine at the time of the Gulf
War, among many other potential
exposures, and inquired about
symptoms of illness. Those who believed
they had received anthrax vaccine
were twice as likely to report a
multitude of symptoms as those
who believed they were not vaccinated.
These are all the Gulf War data
that are available in the open
literature. Every study
that examined the question of whether vaccines
in general, or specific
non-routine vaccines, or anthrax vaccine alone
may have contributed to GWS, has
found a positive relationship.
The French Ministry of Defense
(MOD) recently convened an advisory
committee to study GWS chaired by
Professor Roger Salamon. This
committee reviewed the existing
world literature on GWS, and suggested
that "multiple vaccinations
given during the war, particularly those for
anthrax, botulinum and plague,
seem associated with an excess of (GWS)
signs and symptoms (7)."
There are no published long-term
adverse event data from the anthrax
vaccine immunization program,
which began vaccinating servicemembers in
March, 1998. However, the
unpublished study done by Captain Jean Tanner
at Dover Air Force Base suggests
that recent anthrax vaccine recipients
face similar medical problems as
the Gulf War veterans (8).
Meryl Nass, MD
207 865-7000
mnass@anthraxvaccine.org
________________________
1. Expert committees listed in my
Testimony to the House National
Security Subcommittee, April 29,
1999.
http://www.house.gov/reform/na/hearings/testimony/nass2.htm
2. http:// www.dnd.ca/menu/press/Reports/Health/health_study_eng_1.htm
3. Unwin C et al. Health of UK
servicemen who served in the Persian Gulf
War. The Lancet 1999;
353:169-178.
4. Steele L. Prevalence and
patterns of Gulf War Illness in Kansas
veterans: Association of symptoms
with characteristics of person, place,
and time of military service. Am
J Epidemiol 2000; 152:991-1001.
5. Cherry N et al. Health and
exposures of United Kingdom Gulf War
veterans. Part II:
The relation of health to
exposure. Occup Environ Med 2001; 58: 299-306.
6. Mahan CM, Kang HK, Ishii
EK et al. Anthrax vaccination and
self-reported symptoms,
functional status and medical conditions in the
national health survey of Gulf
War era veterans and their families.
Environmental Epidemiology
Service, Veterans Health Administration,
Washington, DC. Presented January
25, 2001 @ Research Working Group:
Military and Veterans Health
Coordinating Board Conference on Illnesses
among Gulf War Veterans: A Decade
of Scientific Research
7. www.gulflink.org/france/RAPPORTa.doc
8. www.anthraxvaccine.org/Report.pdf
www.anthraxvaccine.org/data.pdfwww.anthraxvaccine.org/remarkst.pdf
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