Anthrax

The same day scientists at Johns Hopkins School of Public Health (alias the "Bloomberg School"; good thing Tampax didn't give the money) announced the best way to prevent anthrax cases after an intentional exposure of weaponized material would be to use antibiotics, Deputy Defense Secretary Paul Wolfowitz sent the Department of Health and Human Services (DHHS) a memo asking it to initiate the process of resuming anthrax vaccination for military personnel, suspended since October 27, 2004 under a court order by DC circuit Judge Emmet Sullivan. The mandatory vaccinations, which have been blamed for a variety of adverse health effects by some soldiers, have been subject of much controversy within and outside the services and are the subject of a lawsuit. The existing vaccine is used by veterinarians as protection against the cutaneous form of the disease and in its current form is a crude preparation, administered over 18 months in six separate applications. It is not approved as a preventive for pulmonary anthrax, DoD's intended use.

The Hopkins work suggests that 70% of cases could be prevented by rapid (within 6 days) distribution of antibiotics. Concommitant use of vaccine and antibiotics might reduce the length of time antiobiotics are needed, but providing protection for the entire population by pre exposure vaccination is not considered practical. Anthrax is not a contagious disease and there is no way to predict where it would be used as a weapon. The only people who should be vaccinated, therefore, are those who are or have a high likelihood of being exposed.

In related news, the government has let a $877.5 million contract to a California biotech company to manufacture 75 million doses of a new recombinant version, allegedly for use in the civilian population in the event of a mass exposure. It would require "only" three applications.

Which leads to two questions:

• Why is DoD pushing this when they could easily distribute antibiotics to troops they knew were exposed? The unlicensed mandatory use amounts to a large population experiment;
• Why did the government order 75 million doses of a vaccine they only need for a post-exposure scenario? This is enough for 25 million exposed persons. There is no plausible scenario where 25 million people will be exposed to weaponized anthrax in a short period of time. And if it happens, the Hopkins results indicate the best course of action would be rapid mass prophylaxis with antibiotics.

They can pay a small company $877.5 million for a superabundance of anthrax vaccine but can't get the population protected against influenza, a disease that kills 36,000 Americans in a "normal" year? What am I missing, here?