As the U.S. gears up for a potential
confrontation with Iraq, the U.S. Food and Drug Administration has
halted use of older lots of the military's anthrax vaccine, and
officials acknowledge that the vaccine is riskier than once thought.
In August, the FDA acknowledged that the vaccine manufacturer's
license needed to be updated. That was seven months after the agency
ordered that new warnings for consumers be included in the vaccine's
insert package. It said the vaccine could harm people with immunity
disorders, could cause a host of serious long-term adverse reactions
and could already be responsible for six deaths and a number of
birth defects.
The warnings, developed from complaints by military vaccine users
since 1998, state that adverse reactions are expected in 5 percent
to 35 percent of people who take the injection. That compares with
the previous expected rate of 0.2 percent, established many years
ago.
But the label represents more than a simple warning. It is
tantamount to an FDA admission of a licensing problem that began in
1985 and remains unresolved today.
The Department of Defense has said it is developing a new anthrax
vaccine to respond to the concerns connected to the one in use now,
but it asserts that the vaccine is both safe and effective.
In 1985, the FDA began reviewing the anthrax vaccine's manufacturing
process to ensure it complied with federal rules for drugs.
Recently, the FDA conceded to two Connecticut Air Force Reserve
pilots that the review was never completed. The FDA told Maj.
Russell Dingle and Maj. Thomas Rempfer that it would accomplish
this, but didn't set a deadline to do so.
Dingle, of East Hartford, and Rempfer, of Suffield, who jointly
filed a citizen petition with the FDA and a federal lawsuit against
the manufacturer challenging the vaccine, said they don't truly
expect the FDA to review the process again. That is because if the
agency does, they said, it will have to stop licensing the drug. The
central problem is that the drug was never properly tested, said the
two pilots, who have been researching the drug since they were
ordered to take it while in the Air National Guard in 1998.
Manufacturers apply for drug licenses with the FDA after testing
their products on volunteers. The FDA reviews the tests, the
vaccine's safety and effectiveness and the manufacturing process
before approving the license to manufacture the vaccine.
In 1970, Merck, a pharmaceutical company, obtained the initial
federal license to produce the anthrax vaccine. It eventually
stopped manufacturing the drug.
In the 1970s and 1980s, the Pentagon began sponsoring the
manufacturing of the vaccine through the state of Michigan's health
department. It used the old Merck testing data, collected from
volunteers working in sheep wool mills, to justify the safety and
effectiveness of the Michigan-manufactured vaccine.
Because the FDA never properly scrutinized this testing, and because
the manufacturing process was changed in 1990, said Dingle and
Rempfer, the drug simply is not properly licensed.
And its latest adverse reaction rate, they said, shows the vaccine
is indeed different from the one tested by Merck.
In 1998, BioPort Corp. of Lansing, Mich., purchased the state of
Michigan's manufacturing operation and all of its vaccine, then used
it to inoculate the first 500,000 of the 2.4 million service members
ordered to take it. In the meantime, BioPort sought approval to
produce its own new batches of the vaccine.
In January, the FDA approved BioPort's facilities and its vaccine
manufacturing processes after four years of failed federal
inspections and infusion of millions of more taxpayer dollars for
plant improvements.
As a result of Dingle's and Rempfer's challenge to the vaccine, the
FDA said only the new BioPort batches can be used. In June, the
Pentagon had ordered both the old and BioPort's newer vaccine to be
used, in high threat areas only.
Because of the FDA's concession that the old vaccine, manufactured
by the state of Michigan and sold by BioPort, was not properly
tested for safety and effectiveness, Rempfer and Dingle said, the
Defense Department should now promptly pardon hundreds of service
members punished for refusing to be inoculated with that vaccine.
They insist the department should also properly care for the
hundreds who became ill from adverse effects of the vaccine.