Last Updated

14 Jun 2003

Source: Washington Post, December 21, 2001.

Anthrax Exposure Estimates Increased

First Capitol Hill Aides Receive Vaccine Shots

By Ceci Connolly and Avram Goldstein, Washington Post Staff Writers

Four dozen congressional aides began receiving an experimental anthrax vaccine yesterday, as federal officials announced that Capitol Hill employees and postal workers had been exposed to much higher levels of the deadly bacteria than had been previously known.

Both the Hart Senate Office Building and the Brentwood postal station were contaminated with far greater amounts of anthrax spores than earlier estimates had shown, with some workers inhaling perhaps 3,000 times the lethal dose, government physicians said.

The new details came as federal authorities raced to defend their vaccination plan, dispatching medical teams to counsel likely participants and rushing out just-completed protocols and consent forms to workers in five jurisdictions hit by a series of anthrax attacks this fall.

But the moves did little to quell the outcry from local officials, members of Congress, postal workers and their leaders, who expressed frustration that government officials were providing too little guidance on who should receive the vaccine.

"It is troubling me because I really believe our employees have a crisis in confidence with the federal health authorities right now," said postal spokesman Azeezaly Jaffer, who along with 6,000 other workers in New Jersey and Washington is grappling with the decision.

The anthrax vaccination plan has caused a resurgence of concern about the health threat posed by the anthrax attacks, and reignited criticism that occurred in the early days of the scare that the government's response was disjointed, biased and ineffective.

"We fully understand that it's frustrating for those who've been exposed and the people who take care of them, that the government can't make a strong recommendation about who should receive vaccine," said Jeffrey Koplan, director of the Centers for Disease Control and Prevention. "We have inadequate science upon which to base such a strong directive recommendation."

Health and Human Services Secretary Tommy G. Thompson announced Tuesday that he would make the vaccine available to about 3,000 people in the District, New York, New Jersey, Connecticut and Florida who may still be at risk of developing anthrax disease after taking antibiotics for two months. Eleven people developed pulmonary anthrax when they were exposed to letters containing anthrax bacteria powder last fall, including five people who died. Another seven victims developed the less serious skin form of the illness. Health experts fear it is possible for spores to survive in the lungs for up to 100 days.

"Obviously, we think that this is a concern enough to make the vaccine available and suggest a couple of options that need to be considered," Koplan said.

The first option is inoculation. Anyone deciding to get the three shots must take an additional 40 days of antibiotics, sign a form accepting the risks, keep a medical journal and submit to two years' of follow-up by doctors. If they do not want the vaccine, those potentially exposed may receive the extra antibiotics or simply monitor for symptoms of anthrax illness.

After enduring two months of unpleasant antibiotics and anxiety, thousands of postal and government employees found themselves caught yesterday between widely divergent medical opinions.

The Capitol physician, John Eisold, had strongly urged about 70 people on Capitol Hill to receive the vaccine. Federal health officials say the vaccine is safe even though it has not received final approval from the Food and Drug Administration. Forty-eight employees were vaccinated yesterday. The remainder opted against it. Those who were vaccinated will receive the second of three shots in two weeks.

Walks and other District officials, meanwhile, continued to advise against inoculation, citing the vaccine's possible risks and lack of proof of its benefit.

"If the world's best scientists can't figure it out, how is the public supposed to figure it out? What they're doing now is inappropriate. We don't make other vaccines available where there is no recommendation or no indication and say, 'If you want it, come get it,' " said D.C. Health Department Director Ivan C.A. Walks.

"I see Walks on TV saying one thing then I hear the feds want us to do something else," said Barry Baxter, a 50-year-old letter carrier at the V Street annex in Northeast Washington. "I just don't know who to listen to anymore."

Sally Davidow, spokeswoman for the American Postal Workers Union, said her "jaw dropped" when she heard the conflicting opinions. "It kind of reinforces that there is still tremendous uncertainty in the medical community about everything," she said.

"They're trying to fool the workers into taking this vaccine instead of cleaning our buildings and protecting our lives and safety," said William Smith, president of the New York Metro Area Postal Workers Union. Citing fears about adverse effects, he is encouraging 2,500 Manhattan postal workers to reject the vaccine.

Many postal workers, including 51-year-old Brentwood worker Donovan Ricks, described feeling like "guinea pigs" in a government experiment. "After a while you just get tired of the whole thing," said Ricks, who has decided to skip the shots. "After you've taken medicine for 60 days you just want to get it over with."

Every Hill employee who received a shot yesterday first got a briefing from military doctors and was required to sign a five-page consent form that catalogued the possible risks and benefits. The form warned in boldface that the Department of Health and Human Services "is not making any recommendation whether you should or should not take this vaccine."

The consent form, which has undergone extensive revisions in the two months since CDC began developing the vaccine program, had a series of dramatic warnings added this week.

With bullets, bold print and underlining, the document warns that the vaccine "has not been shown to prevent infection when given to people after exposure to anthrax spores," that the vaccine "has not been approved by the Food and Drug Administration," and that it may produce "undesirable side effects."

The CDC also removed language from the original document that said the combination of antibiotics and vaccine "could save your life. If you stop taking the antibiotics, the infection could return and could kill you."

In informational sessions before vaccination, some Capitol Hill workers learned for the first time that their exposure to anthrax spores was far greater than they had initially been told.

"They said it was larger than the event in Russia," one congressional aide said, referring to a 1979 accidental anthrax release that killed at least 79 people in Sverdlosk.

In a meeting with Greg Martin, chief of infectious diseases at the National Naval Medical Center, freelance photographer Lana Lawrence discovered her risk was greater than thought. "He said, 'I have no doubt you inhaled spores,' " Lawrence recalled. "I don't think they have been very forthcoming."

Similarly, a study published yesterday by the CDC detailed how mail sorters, blowers and even perhaps foot traffic spread anthrax bacteria far more extensively throughout the Brentwood plant than initially thought. Because of that, the CDC is urging those workers to consider the "more aggressive" treatment options.

Staff writers John Lancaster, Dale Russakoff, Mary Pat Flaherty and Andrew DeMillo contributed to this report.