Air Force physician refuses to submit to anthrax vaccine

Captain is first military doctor to reject shot

by Deborah Funk

AIR FORCE TIMES

January 15, 2001 edition

The first military doctor to refuse to take the anthrax vaccine could face a court-martial.

Air Force Capt. John Buck, an emergency medicine physician at Keesler Air Force Base, Miss., faces a hearing this month on whether he will have to stand trial on charges of disobeying an order.

Buck was preparing to leave for Bahrain when he refused to take the anthrax shot in October. His main concern: the lack of information on whether the vaccine will cause long-term health problems.

He had read the congressional testimony of people complaining of autoimmune disorder symptoms, such as fatigue and joint pain, which the witnesses suspect is caused by the vaccine.

"A red lump on the arm is not something that scares me," Buck said. "But an autoimmune disorder for the rest of my life is."

What’s more, he said, because he was to get the shot two hours before deploying, he didn’t know whether it would have provided any immunity.

The mandatory anthrax vaccination program is the Pentagon’s attempt to protect service members against a biological warfare threat. Anthrax is a zoological disease. Licensed in 1970, the vaccine is administered in six doses over 18 months. It has been used by people whose work in textile mills, laboratories or with cattle might expose them to anthrax. But the vaccine was never used in a large scale until the military employed it for biological warfare defense. Both the Defense Department and the Food and Drug Administration say the vaccine is safe and effective.

While most service members ordered to take the shot have submitted, more than 440 have refused. Some military people and members of Congress question whether the vaccine is safe or whether it will protect against the type and strength of anthrax that would be used in war or acts of terrorism.

Besides questions about safety and efficacy, the Pentagon faces supply shortages as BioPort Corp. of Lansing, Mich., the only maker of the vaccine, struggles to get production approval from the FDA. Until more supplies of vaccine are available, fewer service members are required to get the shots, and the dose regimen has been interrupted for most who have begun the series.

Buck is the first military health care professional to refuse to take the shot, said Army Col. Randy Randolph, director of the Anthrax Vaccine Immunization Program Agency. Randolph does not expect Buck’s refusal to have any greater impact than other service members who refuse, "although we’re certainly disappointed by it because he is a physician and people look up to physicians," Randolph said. Buck told the Military Times newspapers he was not encouraging others to refuse the shot.

"The consequences of refusing the shot are great," Buck said. "Each individual should evaluate his own risks and benefits, and remember that the Department of Defense is doing this in what they believe to be in the best interest of the service member."

Buck opposes the mandatory nature of the program because it is unknown who in the military — or among civilians — would be exposed to a biological agent. "There is a role for vaccines, and potentially bio-defense vaccines," Buck said. "But I do not agree with that role being across the board for everybody in the service and National Guard."

Buck, 32, attended the University of Texas Health Science Center at San Antonio medical school on a military scholarship. His father, an orthodontist, offered to pay for his education but Buck opted for the military, saying he believes every young man should serve his country. He has been on active duty for 2 ¸ years and his four-year commitment expires in June 2002.

"I begged and pleaded for them not to put me in this situation," Buck said. "I said I would go without the vaccine. I would sign a waiver to free the military of any responsibility. I would backfill so somebody else could go or I would go to Antarctica, but please don’t put me in the middle of it."

After he was charged in October with disobeying an order, Buck declined an Article 15 non-judicial punishment, short of a court-martial but more serious than an administrative reprimand. He weighed several factors in making his decision. He argues that submitting to the anthrax vaccine shots is not a lawful order. Moreover, it is possible he could be issued an Article 15 each time he was given the order to take the shots.

If he is convicted in a court-martial, he risks a maximum penalty of dismissal, five years in prison and forfeiture of all pay and allowances. Air Force Capt. Jim Winner, chief of military justice for the 81st Training Wing at Keesler, said the military would not make an example of the doctor. "Motives like that just don’t exist here," Winner said.

Buck may be the first military doctor to refuse the shots, but he is not the first to speak out against the anthrax vaccine.

Dr. Craig M. Uhl was a Navy lieutenant in San Diego when he began questioning the safety of the vaccine. His job did not require him to submit to the shots but he would have had to order corpsmen to administer it. "My issue was, as a physician, I couldn’t condone the use of it," said Uhl.

Uhl left the Navy in August 1999 after fulfilling his medical scholarship obligation, and reverted to reserve status. He received an honorable discharge from the reserves in March 2000, he said.