Collaboration in Civic Spheres

Report: U.S. Military Must Fix Vaccine Program

by Matt Rosenberg April 6th, 2011

SUMMARY: A new report by a prominent U.S. military medical official, published in an Air Force policy journal, faults the Department of Defense for failing to sufficiently protect the health of U.S. military forces with vaccines for common naturally occuring infectious diseases. The author asserts, and documents that a growing emphasis on perceived threats of biological warfare has drained DoD resources and attention away from the everyday occurrence of infectious diseases – which can diminish the readiness and effectiveness of U.S. military units. He recommends a better cost-benefit calculus be developed, more resources granted to infectious disease vaccines for the military, and management of the two programs merged to support better, more integrated decision-making.

BACKGROUND:

Streamlining the U.S. military entails less personnel serving in more specialized roles, often in locations where stress and infectious threats are high and health care support is scant. Implementing lean management and resources in the military requires an even greater emphasis on force health protection, including immunizations against naturally-occuring diseases. Primary prevention – exemplified by immunizations – remains key, even as concerns about biological warfare have grown.

KEY LINK: “The Dangerous Decline In The Department of Defense’s Vaccine Program For Infectious Diseases,” Air and Space Power Journal, March/April 2011, Air University, U.S. Air Force. Author, Col. Kenneth E, Hall, USAF, Deputy Command Surgeon, Headquarters US Air Forces In Europe, Ramstein Air Base, Germany.

KEY FINDINGS:

  • In recent years, the U.S. Department of Defense has prioritized vaccines to counteract feared biological warfare threats to the U.S. military and public, far ahead of vaccines to prevent naturally occurring infectious diseases. The growing imbalance in favor of vaccines to counter biological agents “has significantly eroded the DoD’s ability to ensure the acquisition and availability of the right vaccines at the right time to optimally protect U.S forces from established and emerging natural infections now and in the future.”
  • Roughly a dozen nations and a number of non-state players have or are seeking to develop biological weapons, and the threat should be taken seriously, as demonstrated by the deaths of five U.S. citizens from anthrax tainted letters, although those may have been sent by a “lone American researcher.”
  • But so far, DoD hasn’t experienced a single instance of “weaponized disease,” and there are several indictors of a far greater impact on military personnel from naturally occurring infectious diseases.
  • DoD’s loss of the adenovirus vaccine is telling. Due to crowding and other stress factors, adenovirus can cause acute respiratory symptoms in unvaccinated military recruits. Prior to the introduction of the vaccine in 1971, adenovirus outbreaks among recruits in basic training neared a 50 percent rate and hospitalizations 10 percent, with occasional deaths as well. The disease was all but eliminated once the vaccine was introduced, but by 1999 the vaccine became permanently unavailable after the sole manufacturer ceased production due to added costs from compliance with new U.S. Food and Drug Administration mandates, and the failure of related cost-sharing negotiations with DoD. The loss of the vaccine has been tied to an estimated 10,560 preventable adenovirus infections, 4,260 medical clinic visits and 852 hospitalizations each year, for active duty and reserve trainees.
  • In a tri-service survey of 15,459 troops deployed for Operation Iraqi Freedom and Operation Enduring Freedom, 75 percent reported at least one occurrence of diarrhea, 69 percent had at least one incidence of acute respiratory illness, and one quarter felt that unit effectiveness had been compromised as a result of infectious diseases. Of those surveyed, 10 percent were hospitalized due to infectious diseases and 25 percent required intravenous fluids; 13 percent of ground forces and 12 percent of aircrew members missed at least one shift.
  • Sufficient emphasis on development and distribution of infectious disease vaccines to U.S.military personnel is hindered by major funding disparities and two stove-piped bureaucracies. Since fiscal year 1997, annual funding for biological warfare prevention and vaccines has grown by a factor of more than 47, from $137 million to $6.5 billion in fiscal 2008, while funding for prevention of naturally-occuring infectious diseases has grown only from $42 million in fiscal 1994 to $47 million in fiscal 2009.
  • The report makes several recommendations. 1) Assign more weight to historical data and cost-benefit analysis in allocating limited resources between programs for biological warfare and naturally occurring infectious disease threats; 2) merge management of the two programs to create a more holistic approach to strategy; 3) make acquisition of infectious disease vaccines a higher priority.

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