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The shots of war

Cristina Kutz thinks the anthrax vaccinations that she and other troops must undergo devastated her health. Her complaints are not unique, but doctors don't back her up.

Published September 17, 2004

[Times photo: Skip O’Rourke]
Cristina Kutz holds her Air Force uniform. Kutz, a senior airman, left the service in July after being ruled too sick to serve.

[AP photo]
The anthrax vaccine is administered to Sgt. Christian Scharfenberg, right, last month at Fort Campbell, Ky.

RIVERVIEW - Cristina Kutz spends too many hours in these silent rooms with the beige walls endemic to starter homes in the Tampa suburbs. She is apprehensive about leaving. She fears her body will betray her.

She eats like an anorexic. Food turns on her, unleashing nausea and diarrhea. She always is tired but cannot sleep. She takes almost a dozen pills, from immunosuppressants to antidepressants, every day.

She used to be strong.

She was Senior Airman Cristina Kutz, who tracked dozens of Air Force pilots and ground crew at Hurlburt Field in the Florida Panhandle, charting their training and readiness for battle. Suddenly, the members of her squadron were no longer rehearsing. They were ordered to the Middle East on the eve of the Iraq war.

Before leaving, they prepared for an enemy they could not see: Viruses and bacteria that Saddam Hussein threatened to unleash in lethal clouds upon the battlefield. Kutz, like some 300,000 others ordered to the war zone, was vaccinated against anthrax.

In the last decade, hundreds of troops insist the anthrax vaccine made them sick. Hundreds more have refused the shots, risking court-martial. Medical experts say it is safe. But the experts cannot definitively exempt the vaccine for a host of health problems reported by servicemen and women. Kutz believes the anthrax vaccinations ravaged her health, making her too weak to work, too precariously well to venture out of her house most days.

She thinks the U.S. government discounts her concerns that the anthrax vaccinations made her unfit to continue as one of its soldiers.

That's an order

More than 1.2-million troops have received anthrax vaccinations since 1998. In March, a year after the invasion of Iraq, the Department of Defense extended anthrax vaccinations to troops bound for South Korea, in addition to those deployed to the Middle East and Asia.

Some soldiers, citizens and congressmen questioned the need for the mandatory vaccinations. Since the mid 1990s advocacy groups have urged the Defense Department to stop them.

"The use of a vaccination which appears to have the potential for serious health consequences for our troops in an effort to counter a threat that may not exist seems to unnecessarily expose our troops to risk," wrote Sen. Jeff Bingaman, D-New Mexico, in a letter to Defense Secretary Donald Rumsfeld.

At least 400 troops have refused the shots. More than 100 have been court-martialed for defying an order since mandatory vaccinations for active-duty personnel and reservists resumed in 1998, according to government documents and congressional hearings.

Hundreds more who got the vaccine blame it for chronic illnesses, from joint and muscle pain to debilitating fatigue, leukemia to blindness.

"There's no question the symptoms are real, but there's no scientific connection to anthrax (vaccine)," says Dr. Richard Lockey, director of the University of South Florida's division of Allergy & Clinical Immunology.

"For the troops, we want them protected," says Col. John Grabenstein, deputy director for military vaccines for the Army's surgeon general. "We can't protect against artillery fire, but we can do this."

Maybe it's the food

On Nov. 15, 2002, two months before traveling to the Middle East, Kutz received her first anthrax vaccination.

She read warnings on the Internet that the shots were unsafe.

"I remember wondering, "Why would these wusses refuse the vaccine?' I remember our commander telling us not to be babies."

Looking back, the now 23-year-old Kutz finds omissions that give her pause.

They received no briefing on health issues.

There was no distribution of package inserts, which list dozens of possible side effects, from minor swelling to death.

The needle burned into her upper right arm. The next day, the site was sore and swollen, with a lump the size of a golf ball, Kutz says.

She was nauseous. Her head ached. The flulike symptoms disappeared in a week but the golf ball remained. On Dec. 13, she got a second shot in her left arm. No rash this time, but the same lump. Her stomach ached. She vomited. She suffered with diarrhea marked by mucus and blood, and heavy menstrual bleeding.

Kutz decided she should get no more shots. But an incomplete series - the schedule calls for three anthrax vaccinations in one to two months and three more within 18 months - would mean she could not deploy. She received the third vaccination on Jan. 22, 2003.

By February, the 15th Special Operations Squadron was overseas at a hastily constructed "barebase." Kutz was in a group of 150 special-ops forces. Their planes dropped leaflets on the Iraqis, urging surrender. Kutz resumed charting flights and crews.

But her body was fighting her, her gut roiling. She thought it was the food: too much curry, questionable chicken. She would nibble on bread and butter, make a meal of crackers and pudding cups from squad members' care packages.

She carried Pepto-Bismol along with bottled water.

She worked when she could. Sometimes her supervisor would tell her to take the day off.

Kutz returned to the United States, as scheduled, in April 2003.

Here I will be well, she thought.

Still sick, she went to a gastrointestinal specialist who told her she was "just a nervous person."

On July 25, 2003, Kutz received her fourth anthrax vaccination.

Bioterror via mail

Vaccinating the troops against anthrax slid down the Pentagon's priority list in the mid 1990s. There were vaccine shortages; its manufacturer failed facility inspections and the production line was shut down for several years.

Then shortly after the 9/11 terrorist attacks, anthrax-laced letters arrived at a media company in Boca Raton, NBC News in New York and U.S. Senate offices. Five people died.

The 9/11 commission would later fault federal agencies for being unprepared, a cautionary tale now compelling broad strokes to defend against terrorism. In July, lawmakers approved the $5.6-billion Project BioShield proposed by President Bush. The legislation will pay millions to private companies for bioterror medicines and vaccines.

"It's a way for the government to say, "I protected America,"' says John Richardson, a fighter pilot in the Persian Gulf War, formerly with the Pentagon and now a leader in the fight against mandatory anthrax vaccinations.

He and other critics worry that soldiers' safety is being short-circuited by politics.

Because of vaccine shortages, Richardson did not get the shots. But about 150,000 Gulf War troops did. When some got sick, they suspected the vaccine.

Medical experts now acknowledge a range of health problems collectively called Gulf War syndrome. They do not know the cause.

"We can pull out a population of those who got the (anthrax) vaccine and those who did not. There is no significant difference" in incidence of illness among soldiers and veterans, says Dr. Renata Engler, director of the Department of Defense's National Vaccine Healthcare Center, which monitors vaccinations and reactions.

"With anthrax, we have a small clustering," she says.

"A number of patients who were healthy before vaccination developed significant muscle and joint pain, fatigue - a reduction in function" after vaccination.

Hundreds of experienced pilots and crews in the Air National Guard and Air Force Reserve are leaving military service because of concerns about the anthrax vaccine, reports the General Accounting Office, which mailed 1,253 surveys in May 2000.

About 16 percent moved to inactive status, transferred or left the military between 1998 and 2000, citing anthrax vaccinations as a key factor, the report says. While those surveyed were positive about immunizations in general, three out of four said they would not get the anthrax vaccine if given a choice.

A gamble too big

Navy Airman Zachary Johnson decided five years ago he would not get the anthrax shots, as ordered, before shipping out to the Persian Gulf. He was the only one to refuse among 200 in his helicopter squadron. Within three months, he was court-martialed for disobeying an order.

"Most people assume you're trying to get out of something. In two years I had spent 13 months at sea. I had great reviews," the 27-year-old Jacksonville sailor says.

The Defense Department significantly understates the numbers of troops such as Johnson who have faced court-martial over anthrax vaccinations, says Lawrence Halloran, staff director for the House Subcommittee on National Security. More than 300 have been charged with refusing an order and either been pushed out or discharged, subcommittee research shows.

A Marine pilot pleaded guilty to disobeying an order after refusing vaccines on religious grounds. A Navy aircraft mechanic was sent to the brig after refusal. An Army Reserve private in New York who worried the vaccine might harm her ability to have children got a bad-conduct discharge.

Johnson was particularly worried by failed facility inspections at vaccine manufacturer BioPort Corp. of Michigan.

He spent eight days in the brig. The military reduced his rank, gave him a bad-conduct discharge and took away his benefits.

"They never even sent me my last paycheck," Johnson says.

For months he was homeless, his car repossessed for nonpayment, his credit ruined.

"I was an outcast, a pariah, in my own squad."

He says he wanted to protect the quality of the rest of his life.

Sick of the system

From June 9, 2000, when Kutz enlisted, through Oct. 7, 2003, she received 17 vaccinations to ward off typhoid to meningitis, yellow fever to smallpox. Multiple vaccinations given to troops make evaluations of what causes subsequent illnesses difficult.

At a squadron picnic, a friend shook her hand.

"You look like a skeleton," he told her.

She lost 30 pounds in three years. The 5-foot-2 Kutz weighed 98 pounds.

More troubling was the mental fogginess. She had three car accidents in six months. In one, she collided with the garage door when she took her foot off the clutch to double-check whether she'd locked the front door. She fainted during a vacation with her husband in Orlando last fall.

"I didn't want to have sex, I didn't want to go out, I didn't want to talk to people. I got really, really depressed," she says.

"The worst part was, no one knew what was wrong with me."

She pushed for a VAERS report. VAERS, or Vaccine Adverse Event Reporting System, tracks vaccination problems for the military. In 10 years through October 2001, VAERS received 1,850 reports. Adverse reactions, says the military, make up a fraction of 1 percent of all those vaccinated. Critics say most servicemen and women won't file a report, fearing career repercussions. There has been no study on long-term health effects, the GAO says, and poor Defense Department record-keeping prevented any tracking of Gulf War recipients.

By the end of 2003, Kutz had been diagnosed with Crohn's disease, a chronic inflammation of the intestines.

Immunological disorders such as Crohn's, lupus and arthritis, reported by veterans of several wars, typically occur when the body will not tolerate certain antigens and turns on itself. Researchers suspect a genetic predisposition and a bacteria or virus may be involved.

"What we need is studies to show there's not a cause and effect between anthrax vaccine and these illnesses," USF's Lockey says.

Troops do not trust the Pentagon for medical information, surveys show. Dozens have testified at congressional hearings on the issue in the last seven years.

In 2003, six unnamed service personnel filed suit, asking the courts to block anthrax vaccinations. They argue that the vaccine is unapproved for inhalation anthrax and is thus an experimental drug. By law, the military is prohibited from giving troops experimental drugs without their informed consent.

District Court Judge Emmet Sullivan in Washington issued a preliminary injunction halting vaccinations, but it was lifted when the FDA in December ruled the vaccine safe and effective for both skin- and inhalation-contracted anthrax. The FDA's approval came a week after Sullivan's ruling. Suspicions about the timing prompted an FDA response:

"FDA made its determinations regarding the anthrax vaccine long before the court's ruling," it said in a news release. The vaccine's labeling does not specify the route of exposure, meaning the vaccine is effective against both skin-contracted and inhaled anthrax.

A final decision in the suit is pending.

A casualty of war

Kutz underwent a series of neuropsychological tests at Walter Reed Army Medical Center in March. She had difficulty remembering a list of words or complex figures after three minutes had elapsed.

"The patient's difficulty with verbal and visual memory suggests subtle brain impairment," read the evaluation. It also said that while anthrax vaccine could not be ruled out as a cause, Kutz's depression, anemia and the sedating effects of her medications may be to blame.

"The patient," the report read, "will likely do better in situations with quiet work environments and limited distractions."

On May 13, Kutz was declared medically unfit for duty.

"She reports a variety of systemic symptoms that have been progressively increasing in number and severity following each of her anthrax shots," reads one of the summaries. "There is no direct objective evidence that the symptoms are immunologically related to her anthrax vaccinations."

Her poor health required access to a hospital. She could never be deployed to a battlefront.

"To me, it would be like a woman never being able to have children," Kutz says of her truncated status.

Each month she goes to Tampa for Remicade infusions, a three-hour procedure in which an IV delivers the drug to treat Crohn's. Phenergan taken for nausea makes her fall asleep for hours. She uses a contraceptive patch to regulate excessive menstrual bleeding.

On July 6, she was officially out of the Air Force. Discharged with 10 percent disability, she received a severance payment of $13,000. Lawyers tell her she will never win full benefits.

"I was going to make the military a career," she says.

"At that point I just wanted it to be over."

-- Susan Aschoff can be reached at 727-892-2293 or

[Last modified September 16, 2004, 12:12:08]

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