Anthrax vaccinations given in experimental program

WASHINGTON -- Doctors injected four dozen people Thursday with the anthrax vaccine, as thousands began weighing the government's first printed list of the pros and cons of the experimental inoculations.

It's a tough decision -- the required consent forms for the shots warn that the vaccine can cause side effects. And because it has never been used after exposure to anthrax, there's no guarantee the vaccine will help anyone who relapses.

One health department, in the nation's capital, advised against the vaccinations, saying two months of antibiotic treatment already prescribed to people exposed to anthrax during the mail attacks this fall was enough.

At post offices in Washington and New Jersey, employees awaited arrival of government scientists promising one-on-one counseling about the extra therapy. Postal managers asked that the Centers for Disease Control and Prevention delay giving shots until Dec. 27, however, so employees in the holiday crunch have time to decide.

"I still have questions about my own health," said postal vice president Azeezaly Jaffer, a candidate for vaccination who said CDC's consent form didn't give him enough information to decide. "I still may choose, and that's just me, to talk to my own personal physician about what she thinks."

Still, 48 Capitol Hill workers held out their arms for the first shots Thursday.

No names

One aide to Senate Majority Leader Tom Daschle said he took the shot because the military doctors advising him and his colleagues said they would've been vaccinated had they been exposed. Congressional workers agreed to discuss their decision only if their names weren't used, citing security concerns.

For mail workers, the decision became more complex Thursday, when the CDC announced that its October testing of Washington's Brentwood central postal facility uncovered more widespread and intense contamination than previously revealed. Only two areas in the sprawling building were free of contamination after letters to Daschle, D-S.D., and fellow Democratic Sen. Patrick Leahy of Vermont passed through.

Of the nation's 18 confirmed anthrax cases, four were among Brentwood workers. Two of them, plus a Floridian, a New Yorker and a Connecticut woman, died in the bioterror attack.

"The fact that you can find contamination in distant corners in these very large rooms ... makes it really hard to say, 'You 120 people who worked on this machine are at greater risk than the 50 who worked over in that corner,"' said CDC Director Dr. Jeffrey Koplan.

"We fully understand it's frustrating ... that the government can't make a firm recommendation about who should receive vaccine."

Shots or drugs

The CDC is offering voluntary vaccinations or 40 more days of antibiotics to thousands. The reason: Animal studies suggest that in rare cases, anthrax can lurk in the body for more than 60 days, erupting after people finish their antibiotics.

There's no proof the vaccine could save someone who did relapse. It has been used safely for decades to prevent infection prior to anthrax exposure, but never as post-exposure treatment. Thus the inoculations are an experiment that requires patient consent. But an animal study suggests the vaccine might help.

"Make sure that you know the risks and possible benefits before you agree to take part in this program," reads the CDC's consent document. Among information for people to consider:

Side effects include burning at the injection site and soreness, redness, itching and swelling of that arm for up to a week. Up to 35 percent of recipients have muscle and joint aches, malaise, rashes, chills, a low fever or nausea for up to a week.

Serious allergic reactions occur less than once in every 100,000 doses.

Studies of over 500,000 vaccinated people suggest reports of more severe reactions, such as muscle diseases, are not caused by the vaccine.

You cannot get anthrax from the vaccine.

The Food and Drug Administration has not yet allowed vaccine maker BioPort Inc. to routinely ship the shots because of manufacturing problems. But the FDA is allowing the CDC to use 10,000 doses in the experimental vaccination program that have passed manufacturer safety testing.

Recipients will get three shots at two-week intervals, and must take antibiotics until the vaccine kicks in with the third shot. Their health will be tracked for up to two years.

People wanting more information may call the CDC at 1-888-246-2675, or, for Spanish speakers, 1-888-246-2857.