The Ethics Of Administering The Anthrax Vaccine

Earlier this week, The Washington Post reported that the Obama administration is trying to decide whether scientists should administer an anthrax vaccine to healthy children. The vaccine may protect them against a bioterrorism attack, but scientists wonder if it's an unnecessary, and potentially dangerous, precaution. Melissa Block talks to Rob Stein of The Washington Post about the medical, and ethical, debate.

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MELISSA BLOCK, HOST:

Vaccinations for children are controversial to begin with, so imagine the concerns surrounding a vaccine for anthrax. The Obama administration is in the midst of a debate over whether to test the existing anthrax vaccine on kids. It's already been tested on adults and administered to millions of members of the military, especially those involved in bioterrorism defense.

Well, tomorrow, a government advisory group is scheduled to vote on a recommendation that the vaccine be tested on kids. Washington Post science reporter Rob Stein is following the story. And Rob, first of all, remind us just what anthrax is, what it can do.

ROB STEIN: Yeah. Anthrax can be a life threatening infection that's caused by a bacterium that produces a toxin and it can be very, very dangerous and very serious. There are several ways to get exposed to it. You can get exposed to it through your skin, by ingesting it or by inhaling it, which can be the most serious way of getting infected.

And it's considered to be among the most likely choices that a bioterrorist might use because, relatively speaking, it can be produced relatively easily and it can be spread relatively easily. And also, because it can go into a spore form, which is kind of a dormant state, it can sort of hang around and pose a threat for a long period of time in a contaminated area.

BLOCK: OK. And the anthrax vaccine was developed when?

STEIN: The anthrax vaccine has been around for a long time. It was approved back in 1970, but the military started to use it much more in more recent years as part of the broad efforts to defend the country against any kind of bioterrorism attack.

BLOCK: And why has that vaccine never been tested on children, only on adults?

STEIN: You know, like a lot of things, testing any kind of drug or vaccine in children is much more problematic than testing in adults because the children, of course, can't give consent on their own. And so a lot of vaccines and drugs tend to be tested in adults first and are only tested in children later when there's a real need to do so for some reason.

BLOCK: And the question here is is there a real need to do so now? And obviously, all the concerns that come up with childhood vaccinations.

STEIN: Yeah. This is a very tricky situation because, when you're talking about other types of childhood vaccines, like vaccines for measles or for mumps, the risk/benefit calculus there is very different because that's a real risk. I mean, kids could be exposed to mumps or measles at any time that a disease is out there circulating. In this case, it's really a theoretical risk that we're talking about.

BLOCK: And when you talk to scientists and pediatricians involved in this discussion, what do you hear? Who's in favor and who's opposed?

STEIN: It's a real mixed bag out there. There are some real reservations among some bioethicists and some researchers that think that we don't really need to do this and it's not worth the risk of exposing kids, even though the risks are probably relatively small.

And on the other side, there are folks who think, look, you know, we'd better be safe than sorry and the only other alternative is just to wait until there's an attack. And then what do we do? Because we won't be able to tell parents, you know, how well it works, how safe it is and even what doses to give to children.

BLOCK: We should mention, too, that the anthrax vaccine was controversial, also, when it was administered to the military.

STEIN: Yeah, yeah. There was a decision to make the vaccine mandatory for certain members of the military and that created a lot of concern and a lot of opposition. There were lawsuits filed to try to stop it, but for the most part, it's considered to be a very safe vaccine.

Now, that said, there are always reports of more serious complications that are reported among people who get any kind of vaccine and some people are not convinced that this vaccine is indeed safe.

BLOCK: How do you see this playing out, Rob? What happens after this?

STEIN: Well, what will happen is the National Biodefense Science Board, which is the federal group of advisors that advises the federal government on issues related to bioterrorism and biodefense, is going to meet tomorrow afternoon and decide whether to endorse the recommendation from its working group. And if they devote to endorse that recommendation, then the Department of Health and Human Services will get together with the FDA, with the NIH, and try to work out the details about exactly how to go about doing some sort of study on kids with this vaccine.

BLOCK: OK. Rob Stein, science reporter with the Washington Post. We were talking about the debate over testing the anthrax vaccine on children. Rob, thanks so much.

STEIN: Thanks for having me. [eof999]

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