Military vaccine program ailing

WASHINGTON -- The Department of Defense's vaccine acquisition program is underfunded and poorly organized, limitations that put military operations, the health of personnel and national security in jeopardy, an Institute of Medicine panel said Friday.

The panel, convened in April 2000, urged the Pentagon in a 133-page report to make vaccine acquisition a higher priority and create a single authority responsible for acquiring vaccines for the military.

"Limitations in the acquisition process make the path from basic research to the procurement and use of vaccines both inefficient financially and cumbersome," the report said. "This approach risks the success of military operations and the health of personnel and potentially places national security at risk."

Infectious diseases have historically been a concern in military campaigns, and recent threats have raised concerns about U.S. vaccine supplies.

The panel said the biggest problems in the Department of Defense vaccine programs are that too many agencies have overlapping responsibilities. One part of the department purchases and maintains licensed medical products including vaccines, while a number of different Department of Defense agencies oversee research and development.

In addition, the department has divided its programs in a way the committee says "makes no sense." The U.S. Army Medical Research and Materiel Command acquires vaccines for infectious diseases, while the department's Joint Vaccine Acquisition Program, acquires vaccines for biological agents used as weapons.

The panel recommends combining the programs because naturally occurring infectious diseases and infectious agents used as biological weapons can be the same, such as smallpox.

With a single program, budgets also could be consolidated, making more money available.

Spokesmen for the Pentagon and Army could not be reached by phone. In an e-mail, Department of Defense spokesman Jim Turner said: "We appreciate the thoughtful work of the IOM on this important matter and will be studying their recommendations carefully."

To illustrate the failure of the military's modern vaccine programs, the committee cited the example of widespread acute respiratory illnesses, caused by adenovirus infections, at military basic training facilities over the decades.

The military developed vaccines in the 1980s, but the sole vaccine manufacturer stopped producing them in 1996 after failing to reach agreement with the Department of Defense on improvements required at the manufacturing facility by the Food and Drug Administration.

The illnesses re-emerged causing hospitalizations among trainees and at least two deaths. The committee said many recruits today have to repeat their training because of the sickness.

"After many years, what was not a problem, became a problem," said Dr. Stanley Lemon, committee chairman and dean of medicine at the University of Texas Medical Branch, Galveston.

Lemon said development of a single vaccine usually costs hundreds of millions of dollars.

"In 1950 and 1960, we as a nation were better prepared to use the knowledge we had available to us for protection against infectious disease than is the case today in 2000," he said.

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