From the time he was four years old, Sonnie Bates's "life-long dream" was to be a military pilot. Today, he's a decorated commander at Dover Air Force Base in Delaware.
But Major Bates has recently put his career on the line, by refusing to be vaccinated against anthrax - a deadly substance that could be used in biological weapons. He is the most senior service person yet to challenge military authorities on the issue. Hundreds of others are getting early discharges and facing court-martial for refusing the vaccine.
In an organization with some 2.4 million people, it may seem like a minor revolt. But it raises two fundamental issues: medical ethics and military discipline. How much say do servicemen and women have regarding their health care? And to what extent should they be allowed to question authority - to refuse to carry out what their superiors insist are lawful orders?
Mr. Bates asserts that the vaccine has not been properly tested, and he believes that many of his Air Force colleagues have experienced health problems - some of them serious - because of the drug.
"The risk is too great. If I lose my health, I am no good to my country and I become an extra burden to my family," he says. "I believe it is wrong to inject anyone against his or her will."
Bates faces a hearing Feb. 3 on charges that he violated the Uniform Code of Military Justice in his "failure to obey the lawful order of a superior officer." He may be court-martialed, which could lead to loss of rank and pension, as well as time in prison.
Among those who have already been punished for refusing the vaccine are five enlisted marines at Twentynine Palms, Calif., who received bad-conduct discharges. An airman in Texas was sentenced to 21 days in confinement, his pay was docked $500, and he was given an administrative discharge from the Air Force. And five members of the Ohio National Guard were recently discharged over the issue.
Supporters of the vaccine point out that it was approved by the Food and Drug Administration and has been in use for 30 years, primarily by veterinarians to prevent their being infected by animals. The Pentagon warns that biological weapons containing anthrax (a bacteria found in animals) may be in the arsenal of potential enemies such as Iraq and North Korea. Defense officials insist the vaccine is effective without being unduly harmful.
"We feel it is very safe," says Sue Bailey, assistant secretary of defense for health affairs, who had the series of six shots herself.
But Congress has held a series of hearings at which the vaccine's safety has been called into sharp question. Long-term effects of the vaccine have never been studied, and lawmakers heard from many active-duty and former military people who say that many of those who have had the shots experienced serious medical problems.
"It appears the [inoculation] program glosses over potential side effects, fails to offer legitimate medical exemptions from the inoculation, and resists attempts to associate adverse reactions with the vaccine," says Rep. Christopher Shays (R) of Connecticut, who chairs the House Government Reform subcommittee on national security issues
The impact on military readiness may be especially acute among reserve and National Guard units. At a time when senior officials worry about recruiting and retaining enough pilots, as many as 400 have resigned or chosen not to reenlist because of the vaccine. Many of these weekend warriors are airline pilots who fear their careers will be harmed if their health is impaired.
Lt. Col. Thomas Heemstra of the Indiana Air National Guard says symptoms include dizziness, blackouts, and memory loss, among others. "Now I ask you to choose which one of those symptoms you would enjoy experiencing when you are flying your F-16.... Not one of those scenarios sounds very good to me," he says.
The exact number of uniformed personnel who have experienced health problems because of the vaccine is unclear. The Pentagon asserts that of some 380,000 who have received the shots so far (including Secretary of Defense William Cohen), only about 500 have reported adverse effects.
But some experts question the reliability of the Defense Department's information. "The track record for record-keeping, follow-up, and disclosure might generously be described, I think, as abominable," says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.
On Capitol Hill, lawmakers are considering two bills that would make the vaccinations voluntary (as is the case with several US allies) or halt the program until sufficient testing on humans can be conducted.
Meanwhile, the only facility that produces the vaccine has been temporarily shut down due to safety questions. This does not mean the vaccinations will be halted, however.
"We have enough safe, reliable vaccine stockpiled to continue this for another year," Secretary Cohen said during a tour of Dover Air Force Base last month. To do otherwise while military personnel continue to be ordered to the Middle East and to Korea, Cohen added, would be "irresponsible."
Most men and women in uniform believe that following orders - whether to hold a piece of battle-contested ground, to fly a fighter jet into harm's way, or to submit to vaccinations - is essential to military discipline.
But the controversy over the anthrax vaccine is now testing this belief. "The anthrax-vaccine policy has turned into a biological loyalty test," says Major Thomas Rempfer, an Air Force Academy graduate. "They have placed military commanders at all levels in an untenable position: either implement a questionable policy or sacrifice their careers."
(c) Copyright 2000. The Christian Science Publishing Society