News & Information - The Mercury - August 2009 Mercury

by Chris Orose
MILVAX

Protecting service members and Department of Defense beneficiaries and how to communicate the importance and safety of immunization was the main focus of the Military Vaccine (MILVAX) Agency’s annual refresher training at the Sheraton National Hotel in Arlington, Va.

“We have the lowest rate of death due to vaccine-preventable diseases in the history of all mankind,” said Dr. Gregory Poland, director of vaccine research at the Mayo Clinic in Rochester, Minn. “BUT, we have more concerns about using vaccines than ever before. What to do?”

Morbidity reports for nine diseases show a 99.4 percent drop in deaths from the pre-vaccine era through 1999.

“Vaccines have saved more lives, prevented more disability, than any other medical maneuver,” Poland said.

The prevailing theme emerging from the MILVAX training sessions was that health-care providers need to better communicate the effectiveness of vaccines and combat anti-vaccine concerns with knowledge of the facts on safety.

This communication is even more imperative given the upcoming influenza season and the outbreak of Novel H1N1 influenza that spurred the World Health Organization to declare the first pandemic in 41 years.

DoD has been at the forefront of the H1N1 outbreak, having been the first to identify several of the early cases in the U.S. As DoD pandemic influenza expert LTC Wayne Hachey said at the refresher training, the H1N1 influenza is the most credible pandemic threat, but a vaccine may be available this fall to combat its spread.

Attendees were brought up to speed on recent safety studies and the progress of some ongoing studies. MILVAX Deputy Director for Scientific Affairs LTC Patrick Garman detailed several post-licensure safety studies, including one on ACAM2000, the new smallpox vaccine.

Navy Commander Jennifer Wright, study director of the anthrax vaccine research program at the Centers for Disease Control and Prevention, gave details of a recent study, conducted to find out if the anthrax vaccine would still be safe and effective if given in fewer doses and by a different route of administration. That study resulted in the FDA approving a five-dose regimen and intramuscular route of administration in December 2008.

Several studies comparing Live Attenuated and Trivalent Influenza Vaccines were discussed, as well as information about a new Adenovirus vaccine, which could be licensed later this year, and plans for other bio-defense vaccines in the future. “We’ve made some significant progress over the past several years, with the future looking very bright to continue vaccine-related advances,” said COL Michael J. Krukar, director of MILVAX, citing the upcoming influenza season and the design and implementation of a DoD-wide, universal immunization tracking system as main goals for the near future. “We’ve learned many lessons in helping to serve those we aim to protect.”

Attendees also got a firsthand look at the threat of anthrax, as Navy Captain Gregory Martin, director of the infectious diseases clinical research program at the Uniformed Services University of the Health Sciences, detailed his personal connection with the anthrax attacks at the U.S. Capitol in October 2001. When a letter containing anthrax bacteria was opened in Senator Tom Daschle’s 6th-floor office in the Hart Building, 28 people tested positive for anthrax infection. Of 63 people exposed to anthrax, 58 opted to be immunized with the anthrax vaccine. Martin credited the communication, education and outreach of emergency responders to those exposed for making these immunizations possible.

Navy Captain Kevin Russell, director of the DoD Global Emerging Infections Surveillance (GEIS) and Response System at the Armed Forces Health Surveillance Center, detailed how integral DoD surveillance was in identifying the first cases of H1N1, and the impact GEIS has had on countries throughout the world.

The importance of proper risk communication with stakeholders was also illustrated by Bethany Davidson, a health risk communication specialist at the Army Center for Health Promotion and Preventive Medicine (CHPPM), who detailed a situation at Fort Leonard Wood, Mo., in February when two people died of meningitis within a few days.

Davidson stressed that taking care of people is our number one concern, and that we are committed to being open, honest and transparent about our stakeholders’ concerns. If we are not communicating effectively, she cautioned, then uncertainty spreads and leads to fear and panic.

Equally important is the work of the Vaccine Healthcare Centers (VHC) Network, which provides clinical support to those who have adverse reactions to being vaccinated. COL Renata Engler, director of the VHC, detailed efforts by her team to treat immunized people and to better understand safety and efficacy issues through research and education.

The MILVAX annual refresher training showed how vital vaccination programs are to protecting service members and DoD beneficiaries against both routine illnesses and bioweapon threats, but also showed an understanding of the vaccine concerns some have and the need to use scientific facts and compassion to ensure that patients are aware of vaccines’ safety and effectiveness, and of the benefits they provide to stakeholders.

From the August 2009 Mercury, an Army Medical Department publication.