Cape Cod Times: Military rushes to resurrect vaccine

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Military rushes to resurrect vaccine

A Pentagon official says a funding lapse for pills that stop a virus that has

killed recruits was a " major screw-up. "

By MICHAEl J. BERENS

The Seattle Times

SEATTLE - More than three decades ago, the Pentagon created two pills to ward

off a lethal virus infecting boot-camp recruits. But defense officials

abandoned the program in 1996 as too expensive. Now recruits are dying,

thousands

are falling ill, and the military is desperately racing to bring back a vaccine

it once owned.

A top Pentagon official called it " a major screw-up, " hobbling U.S. efforts

to rapidly deploy troops abroad.

The respiratory virus now infects up to 2,500 service members monthly - a

staggering 1 in 10 recruits - in the nation's eight basic-training centers, an

analysis of military health-care records shows.

Since the oral vaccinations stopped, the flulike germ, adenovirus, is

associated with the deaths of at least six recruits, four within the past year,

according to military records and internal reports obtained by The Seattle

Times.

In addition, hundreds of bed-ridden recruits miss critical training and have

to be sent through boot camp again, at a cost of millions of dollars each

year. Some are dismissed with medical disabilities.

The virus is expected to kill an additional six to 10 recruits before a

vaccine is again available, according to a classified Defense Department

briefing

this year.

Most people rebound from the infection within four days, but if untreated, it

can turn ferocious, with fever, sore throat and labored breathing leading to

severe respiratory problems.

Adenovirus spreads by cough or touch, thrives in confined places such as

overcrowded barracks, and targets those with weakened immune systems.

Overstressed

recruits, trying to get in shape and adapt to the military, turn out to be

ideal incubators for the virus.

Nationally, the virus has killed more than two dozen civilian children and

adults in outbreaks in medical facilities in Illinois, Louisiana, Iowa,

Tennessee and New York, the federal Centers for Disease Control and Prevention

reports.

Military foot-dragging and high turnover of procurement officers have caused

the replacement vaccine to fall behind schedule, making pills unavailable

until at least 2007, possibly 2009, military records show.

Dr. Margaret , a commander at the Naval Health Research Center in San

Diego and an expert on the virus, calls the vaccine lapse " indefensible. "

Original vaccine manufacturer Wyeth Laboratories warned as early as 1984 that

it would stop churning out pills costing $1 each unless defense officials

allocated $5 million to repair a deteriorating production plant.

Wyeth executives shuttered the facility in 1996. A military health budget

later gave a reason: " suppression of program to pay higher priority items. "

The Pentagon's unwillingness to spend $5 million on health care is now

costing taxpayers tens of millions of dollars to remedy.

In September 2001, plagued by boot-camp outbreaks, defense officials finally

agreed to spend $35.4 million to develop a new vaccine through Barr

Laboratories of Forest, Va.

Shortly afterward, Assistant Secretary of Defense Winkenwerder Jr.

ordered vaccine efforts accelerated, according to transcripts of a Feb. 19,

2002, meeting at North Island Naval Air Station in San Diego.

" This is one of the most disappointing facts and stories that I've learned

upon coming into my position, " he said. " I don't want to cast aspersions on

anybody who had responsibility in the past, but to be blunt this is a major

screw-up. "

Few vaccinations have proved as easy or free of adverse reactions. Recruits

swallow two off-white pills, which cause a mild intestinal infection that in

turn creates protective antibodies against the two most virulent strains, Type 4

and 7.

The military began using the vaccine in 1971 after adenovirus blanketed

military bases during the 1950s and '60s, killing an undisclosed number of

troops.

Later, doctors ruefully noted that a newer, younger cadre of Pentagon leaders

failed to understand that the latent virus was controlled - not eliminated -

and that it could escape once again if vaccine restraints were loosened.

As vaccine production came to a halt in 1996, vaccine stockpiles were

rationed to extend partial protection for three more years, with the vaccine

being

dispensed only between September through March.

After Wyeth's shutdown, defense officials scouted for a new manufacturer.

There were no bidders for a $14.million contract offer. In the interim, the

military pushed for better hygiene, such as hand washing, records show.

Other Pentagon officials, particularly in the Air Force, questioned the need

to restart a costly vaccine program, according to records at the Army Surgeon

General's Office.

At Lackland Air Force Base in San , officials, acting on their own,

had quietly stopped giving recruits the pills in 1987. There had been no

outbreaks and scant infections since, Air Force commanders assured the Pentagon

in

April 1997.

As a result, defense officials adopted a wait-and-see strategy. They waited

just seven weeks.

On May 22, 1997, a feverish soldier staggered into the medical clinic at Fort

, S.C., the Army's largest basic-training center. Within months, he

was followed by 673 confirmed adenovirus diagnoses of Type 4, peaking at 70

hospitalizations weekly.

But the military responded sluggishly after learning of the outbreak. It took

seven months to ship the vaccine from its dwindling supply to Fort as

the infection raged, according to records at the Army Surgeon General's

Office. The epidemic stopped once the pills were in use.

Before long, adenovirus struck another boot camp, this time at the Lackland

base, starting in October 1999. Over the next eight months, with no pills

available, 1,371 cadets ended up flooding the base hospital, Lackland records

show.

It wasn't long before adenovirus killed a recruit, the first one in 28 years.

On May 19, 2000, a healthy 21-year-old man arrived at the Great Lakes Naval

Recruit Training Center, just north of Chicago.

The trainee developed a fever June 20 and sought medical treatment and

returned to his barracks. He revisited the clinic June 23 and was given an

antibiotic for suspected bronchitis. On June 24 he was found unconscious in the

barracks. He never regained consciousness and died July 3, according to case

reports

from the CDC.

Within three months, the virus killed another young recruit at Great Lakes.

The 18-year-old had gone to the clinic three times complaining of respiratory

difficulties, and had been given a decongestant and acetaminophen. On Sept. 18,

he went back a fourth time, suffering from severe indigestion, severe

weakness and a purplish rash on his legs, suggesting hemorrhaging. He died nine

hours

later, according to CDC records.

After the two highly publicized Navy deaths, the Institute of Medicine, an

independent advisory committee of civilian doctors in Washington, D.C., began to

investigate the abandonment of the adenovirus vaccine. In a scathing report,

the doctors pointed to seven adenovirus epidemics at bases that could have

been prevented had the vaccine been properly funded.

Spurred by the report and the rising infection rates, the Defense Department

signed the $35.4.million contract with Barr in September 2001.

(Published: October 3, 2004)

 

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