A cure worse than the disease?

Fearing sickness and debilitation, startling numbers of American troops are refusing to take mandatory anthrax vaccinations.


Arthur Allen
October 27, 2000 11:30PM (UTC)

Ramona Savoie flew rocket launchers into Kuwait and tanks into Mogadishu, Somalia. She flew the enormous C-5 transport planes for the Air Force reserves when she wasn't flying passenger jets for American Airlines. She was tough, buff and patriotic.

But in July 1999 she was also a 44-year-old woman trying to get pregnant for the first time. And like so many middle-aged members of the military reserves, she wasn't wild about complying with an order to get six shots against anthrax, a deadly bacterium she doubted she'd ever have the misfortune to inhale. Savoie had heard that the shots, given over a two-month period, could have the type of side effects a pilot couldn't afford -- joint pain, vertigo, headaches. She worried they might interfere with her in vitro fertilization treatments -- or damage the child she hoped for.

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And so, after 26 years in the Air Force and reserves, Maj. Savoie decided she was not going to get the shots. Her husband, Maj. James Hechtl, and more than half of the other 54 pilots in their reserve unit, the 301st Airlift Squadron at Travis Air Force Base in Northern California, avoided the shot as well, the couple says. Savoie was particularly outspoken in her opposition to the mandatory vaccine, attending hearings in Congress and talking to reporters.

"We've been accused of being disloyal and all kinds of things because we left over the vaccine," says Savoie. "Well, I'm sorry, but you can't use the military as a guinea pig anymore. We're much wiser, and with the Internet we're better informed."

The resignations at Travis Air Force Base are part of a pattern of resistance to the anthrax vaccine that has rippled across the country over the past two years. A quarter of all 176,000 pilots and other flight crew members in the Air Force Reserve and Air National Guard, which is also a reserve service, have either resigned or transferred out of their units in the past year, the General Accounting Office found in a study released Oct. 11. Another 18 percent said they planned to leave or transfer out in the next six months. In both cases, avoidance of the anthrax vaccine was by far the leading explanation the departing airmen gave GAO investigators, who sent questionnaires to a sample of 1,253 reservists. In a normal year, turnover of 10 to 15 percent might be expected. But if the GAO report is to be believed, mistrust of the military over the anthrax issue is high. Two-thirds of the respondents said the shot was a bad idea. And "despite DOD's (Department of Defense) high-visibility attempts to educate servicemembers about the anthrax inoculation program," the GAO report says, "only about 17 percent of those we surveyed believe the information on its Web site is accurate."

The anthrax protection program has been marked by controversy since the Pentagon, in May 1998, announced it would inoculate all 2.4 million servicemembers, active and reserve, in the first step of a multibillion-dollar biowarfare defense program. So far, fewer than 500,000 have received the anthrax vaccination, and the military, much to its embarrassment, was forced to suspend most vaccinations on July 17 because its stocks had gotten low. The only factory that makes anthrax vaccine has been closed for several years and has yet to win Food and Drug Administration approval to start making the shots again.

Reservists, who can opt out of military jobs easier than active-duty troops, have put up the most resistance to the vaccine. Pilots appear to have been particularly leery because they have to be in tiptop shape to fly. At some bases, including Travis, airmen transferred to other assignments in hopes that they could stay one step ahead of the vaccination campaign without being forced to refuse a direct order.

Reps. Dan Burton, R-Ind., and Chris Shays, R-Conn., have spearheaded a two-year investigation of the anthrax vaccination program as members of the Government Reform Committee. They ordered the GAO study, saying the vaccine campaign is misguided and seriously undermining the nation's military readiness, a sentiment shared by some pilots. Politics plays a role here, but even Democrats on the committee, and staunch advocates of the health bureaucracy such as Rep. Connie Morella, R-Md., have joined in questioning the value of the campaign.

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Guard and reserve units are an increasingly key part of America's all-volunteer military. These weekend warriors have been at the front lines of all the major U.S. military operations of the past decade, from the Mideast to Rwanda to Kosovo.

The anthrax vaccination program is the lead element of a strategic shift in U.S. doctrine, moving away from the threat of mass retaliation as a deterrent to biowarfare attacks and instead embracing the goal of providing immunological protection for individual soldiers. That makes the reservists' skepticism of the program all the more serious. An estimated 65 officers and enlisted men have been court-martialed for refusing the shots, and hundreds of others have allegedly been threatened or punished in less serious ways.

"The anthrax vaccine program has clearly resulted in the loss of more personnel than the very thing it was designed to protect against," says Dan Marohn, an American Airlines and Air National Guard F-16 pilot, who was punished with an Article 15 -- a fine and suspension -- in June for refusing the vaccine. Marohn says more than half the pilots in his 163rd Fighter Squadron, based in Indiana, left over the anthrax vaccine. As was the case at other bases, military spokespersons declined to discuss the squadron's readiness.

According to the military, approximately 500 active-duty soldiers have refused vaccination orders. Just how many reservists have been spurred by dissatisfaction with the vaccination program to leave military service overall is difficult to know. The GAO survey is preliminary and the Pentagon doesn't specifically ask departing reservists whether anthrax vaccination contributed to their decisions.

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At an Oct. 11 congressional hearing, Maj. Gen. Paul Weaver, the Air National Guard chief, acknowledged that pilots, on average, have left the guard earlier in the past two years than they did prior to the anthrax campaign, but said he had no data showing a definitive link. The reserves have fallen severely short of enrollment targets in the past two years, and the anthrax campaign has presumably played some role in this. Although he and other brass deny reports of massive resignations, Maj. Gen. Randall West, the Pentagon's point man on the anthrax program, admitted during the hearing that he was "very concerned" about the GAO report.

West and other officials say they had no choice but to deploy the anthrax vaccine after discovering that Iraq, North Korea and other nations have "weaponized" anthrax that could be used against American troops in battle or terrorist attacks.

"If the enemy uses it, and I haven't provided protection, I've got a lot of letters to write to a lot of mothers and fathers telling them why their sons and daughters died on the battlefield when I could have protected them," West said during the hearing.

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That's the worst-case scenario. But many experienced airmen, who are typically in their late 30s and 40s, don't buy it.

"OK, I haven't looked at the intelligence reports, but you're telling me that an administrative clerk in Enid, Okla., needs to get an anthrax shot for force protection?" asks Marohn, of Plymouth, Ind.

"Was there anthrax in that bomb in Yemen?" rhetorically asks Savoie, the former Travis reservist.

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Pilots, whose training typically can cost the military up to $6 million each, appear to be the group of reservists least willing to accept the anthrax vaccination. Most of those who have left are Air Force and Navy reservists, more than half of whom also fly commercial jets. Although the airlines are telling their pilots that the FDA has advised the FAA that the vaccine is safe, some, like Savoie and Hechtl, worry that an adverse reaction to the shot could ruin their civilian flying careers. Typically, these pilots may earn a $100,000 salary flying 10 hours a week for an airline, and less than $20,000 flying 10-15 hours a week for the reserves.

"We don't fly (in the reserves) for the money," says Savoie. "We do it for the fraternity. And because we're patriots." But in a peacetime military, the risk of vaccine side effects for a well-paid commercial pilot doesn't balance up well against the intangible benefit of service to one's country, particularly given the mistrust of the military that has been engendered by a series of congressional hearings on the issue.

"It's not so much the vaccine as the trust that's the issue here," says one pilot.

One adverse reaction that anthrax vaccinees have reported is vertigo -- "and that's a real career killer," says Hechtl.

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"It's very hard to get your [pilot's] medical certificate, and these guys don't want to risk it," says Maj. Tom Rempfer, a former Connecticut Air Guard F-16 pilot who also flies for American Airlines out of Boston. Rempfer, 35, transferred to a nonflying reserve unit to avoid taking the shots.

Older pilots are both more aware of their rights than the average enlisted man, and more cynical about the military's history of dealing with medical problems, says a 40-year-old U.S. Navy pilot who flies P-3 observation planes over the Caribbean as part of the drug war.

"We know that the military is notorious for disavowing any knowledge of anything," says the reservist, who is also an American Airlines pilot but didn't want to be identified. "Their attitude is, 'We say this shot is completely safe, damn it, now take it.' And if you're a pilot, that scares you, because there does seem to be a problem out there. Are they going to replace your $100,000 salary if you grow a third arm or something? Or are they going to brand you as some kind of mental case and say, 'You're on your own.'? Because that's what they did with Agent Orange and the Gulf War Syndrome, which they haven't resolved yet."

The P-3 pilot said everyone in his command ended up taking the shots after the commander passed out 3-inch-thick binders with pro and con articles about the vaccine. "They were very open about the process and that made a difference," he says. "They didn't go around threatening people with courts-martial."

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In hindsight, the anthrax vaccine seems to have been an unwise choice with which to launch a biological warfare defense program. There is only one maker of the vaccine, a crude potion designed in the 1970s. The vaccine was created and tested in military labs well before technical advances that permit greater dosage uniformity, and was intended mainly to protect a few hundred commercial wool sorters -- who face a threat from naturally occurring anthrax spores in animal hides -- and biological warfare experts at secret U.S. research units.

Clusters of bad reactions to the vaccine seem to have occurred on particular bases. Many of the ailments reported by airmen at these bases were similar to those seen after the Gulf War -- severe headaches or joint pain, chronic fatigue, thyroid problems. The anthrax shots were administered to about 180,000 Gulf War-era vets, and some of them have blamed the shots for Gulf War Syndrome.

Some opponents of the mandatory program are claiming that the military secretly put squalene, a fatty substance that has been widely studied as an immune system booster, into some of the anthrax vaccines. Squalene was detected in vaccine tests earlier this year, but in quantities that are probably too minute to be medically significant, and certainly too small to have been intentional. But because the Pentagon initially denied that the shots contained any squalene, opponents of the program seized upon the discrepancy as support for their claims -- even though there's no proof that the substance can cause this type of adverse reaction.

Trust in the Pentagon program has been undermined by repeated shutdowns and fines at the Lansing, Mich., factory, owned partly by senior retired military officers, that produces all the anthrax vaccine. The FDA, which ordered the sanctions, has cited manufacturing problems that included bacterial contamination of a few vaccine lots. None of the known contaminated batches were given to soldiers, however, and the contamination would not be expected to cause the type of autoimmune reactions that have been reported.

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Whether or not these mysterious ailments can be legitimately linked to the vaccine, reports of reactions have had a dramatic impact. Pilot walkouts occurred at the Air National Guard units at Fort Wayne, Ind., and Battle Creek, Mich., according to pilots from those units who have testified in Congress, after people at those bases got sick during the vaccination series.

At Dover Air Base, where C-5s lumber out over the salt marshes and the Delaware Bay en route to the world's hot spots, 50 of the 120 pilots in the base's two reserve units quit rather than be vaccinated against anthrax last year, according to Lt. Col. Jay Lacklen, chief pilot of the base's 326th Airlift Squadron.

In January 1999, after the first round of shots at Dover, one pilot developed vertigo; another got severe arthritis; and a loadmaster -- the person in charge of loading the plane -- was diagnosed with lupus, an autoimmune disease, says Lacklen, 41. He attributes a nagging medical problem of his own -- osteoarthritis of the hands -- to the vaccinations he received.

"The airline guys [commercial pilots also flying in the reserves] took one look at these people and said, 'I'm out of here,'" says Lacklen, who stresses that he's not speaking in an official capacity.

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Maj. Sonnie Bates, an active-duty pilot, felt he had entered some kind of twilight zone when he transferred to Dover from a base in Texas last August.

"Here was this group of pilots, who are usually a healthy bunch, and they were all sick with this stuff no one had heard of," he says. One evening before leaving work, Bates grabbed a squadron sick list known as the DNIF (as in "duties not to include flying"), took it home and started calling everyone on it.

"All 15 had had similar reactions after the third or fourth shot," says Bates' wife, Roxane, who has become an activist in the anti-vaccine campaign. "After he noticed all these weird illnesses, we definitely knew something was wrong."

Bates took it upon himself to raise the issue with the base commander. When Bates refused to get the vaccine series himself, the Air Force announced court martial proceedings. Eventually, the charges were dropped, but Bates lost his pension and was ordered to pay $9,000 in fines, he says. Now he trains pilots at a flight school in Wilmington, Del.

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He mourns his former life. "There will never be a job that can replace what I was doing," Bates says.

Maj. Frank Smolinsky, spokesman for the Air Force on the Dover base, said that 115 of the 1,838 airmen who got the shots have reported bad reactions. However, few of those reactions were debilitating, and none of the serious conditions that did occur has been clearly linked to the vaccine, he said. But senior airman Cathy Milhoan, spokeswoman for the reserve unit on the base, acknowledges that anthrax concerns hurt staffing. Congress authorizes 116 pilots for the unit, but 55 left in fiscal 2000, she says -- and 22 of those positions have still not been filled. "There is no question there were members of the wing who left the reserve in response to the anthrax vaccine," she says. "Morale was affected by the controversy." She adds, however, that those who remain have put the controversy behind them.

At the time, though, the Dover uprising made waves. When Savoie and Hechtl, who is a Southwest Airlines pilot, heard from their friends about the situation at Dover, they made up their minds to refuse the shots. Their commander was not sympathetic.

"We got blank stares from our commander and a brochure saying the shots were safe," Hechtl said, speaking on the phone from his home. Local commanders, he and other pilots said, have been forced to pass along the Pentagon's damn-the-torpedoes insistence that the program continue.

"What we were saying was, 'Guys, can we stop flying this plane into the side of the mountain?'" says Savoie. "That's what you do in the cockpit. If something's going wrong you stop, take a timeout and work out the situation. But they were unwilling to do that."

Savoie eventually became pregnant and in September gave birth to twins that the flying couple named after two favorite planes -- Hunter, a boy, and Piper, a girl. Although Hechtl ended up having to leave the service just months before completing his 20th year, the new family members were all the vindication they needed.

"I ended up having twins," Ramona Savoie says, "and they're perfect."


Arthur Allen

Arthur Allen writes on health, science and other issues for Salon. He lives in Washington.

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