Possible study of anthrax vaccine’s effectiveness in children stirs debate
Apparently, a "key working group of federal advisers" endorsed testing in September, to see whether the anthrax vaccine would safely protect healthy children against a bioterrorism attack.
What bioterrorism attack? The possibility of the use of anthrax by (foreign) terrorists was one of the fears addressed post 9/11. However, the only documented use of anthrax in the United States with the intention to harm in the past 10 years happened a week after the 9/11 attacks, when "letters containing anthrax spores arrived at several media offices and two Senate offices, killing five people and sickening 17 others. The FBI eventually concluded that the letters were mailed by Bruce Ivins, a disgruntled scientist at Fort Detrick in Maryland who committed suicide in 2008, although some experts question the FBI’s findings."
As a consequence of the anthrax bioterrorism fears, 2.6 million US military personnel were vaccinated with the anthrax vaccine, and the federal government has spent $1.1 billion to stockpile the vaccine to protect Americans in the event of an attack. This is in addition to treatment option by antibiotics.
The Washington Post reports:
Unlike with measles, mumps and other diseases, the chance that children will be exposed to anthrax is theoretical, making the risk-benefit calculus of testing a vaccine on them much more questionable.
“It’s hard to believe that it’s something that makes a great deal of sense,” said Joel Frader, a pediatrician and bioethicist at Northwestern University’s Feinberg School of Medicine. “It would be difficult to justify testing it on kids simply on the hypothetical possibility that there might be an attack.”
In addition to these ethical considerations, I have several other concerns, this paper sums one up well:
In response to the attacks on Sept 11, 2001 (9/11), and the related security concerns, the USA and its coalition partners began a war in Afghanistan and subsequently invaded Iraq. The wars caused many deaths of non-combatant civilians, further damaged the health-supporting infrastructure and the environment (already adversely affected by previous wars), forced many people to migrate, led to violations of human rights, and diverted resources away from important health needs. After 9/11 and the anthrax outbreak shortly afterwards, the USA and other countries have improved emergency preparedness and response capabilities, but these actions have often diverted attention and resources from more urgent health issues. The documentation and dissemination of information about the adverse health effects of these wars and about the diversion of resources could help to mitigate these consequences and prevent their recurrence.
Given the publicly available data, there is only a "theoretical" anthrax threat to US children. The current disease burden for them, for all we know, is zero. Anthrax vaccine trials and/or general vaccination programmes for children would be a very hard sell to the general public and would significantly support anti-vaccine sentiments. Ultimately, it would detract funds from essential health care research and provision in areas of actual need (i.e. where a measurable disease risk and burden exists), and it may erode vaccination compliance for the essential childhood vaccinations (measles, anyone? Pertussis?).