Anthrax Vaccine Causes Gulf War Syndrome



Until 1998, there existed no published papers that explored whether

receiving anthrax vaccine was related to Gulf War illnesses.  Instead,

several expert committees (lacking experience with anthrax) were asked

to comment on whether anthrax vaccine was likely to be a cause of Gulf

War Illnesses.  The committees were given DOD briefings, did not review

the literature (there were no published studies of safety or efficacy

for the licensed anthrax vaccine), concluded that a relationship was

unlikely, and then recommended against further research (1).


Studying American veterans was particularly difficult because many were

not told whether they were given anthrax vaccine, and the vaccinations

were specifically not entered into service members' shot records. Other

centralized vaccine records have been lost.  Despite concerns about the

investigational status of anthrax vaccine when used for biological

warfare, no informed consent was obtained from service members at the

time of the Gulf War, and no waiver of informed consent was sought from

the FDA.


The Canadian Department of National Defense (DND) hired a consulting

company (Goss Gilroy Inc.) to study the health of Canadian Gulf Veterans

and look at various exposures.  Their report was published on the DND

website.  They found a significant relationship between receiving

non-routine (biological warfare) immunizations and developing chronic

fatigue, a very common symptom of GWS (2).


In 1999 a British study examined a large number of Gulf War exposures in

large cohorts of British Gulf War and non-deployed Gulf-era veterans,

and Bosnia veterans.  They found that for both the Gulf War and the

Bosnia veterans, receiving anthrax vaccine was related to developing an

illness consistent with Gulf War Syndrome (GWS). They wrote,

"Vaccination against biological warfare and multiple routine

vaccinations were associated with the CDC multi-symptom syndrome in the

Gulf War cohort (3)."


This group published a follow-up paper in the British Medical Journal

that claimed that only Gulf War veterans who received vaccines after

deployment, not before, showed this relationship.  However, they later

retracted this conclusion, and acknowledged that the timing of

vaccination did not affect the relationship between vaccination and GWS.


A study of Kansas Gulf War veterans was published in 2000 (4).  This

study also found that deployment vaccines were related to GWS: 34% of

Gulf War veterans met the definition for

GWS, while only 4% of non-deployed, non-vaccinated Gulf-era veterans met

the definition.  However, 12% of Kansas Gulf-era veterans who were

vaccinated in preparation for deployment, but then were not sent to the

Gulf, also met the GWS definition.  The paper concluded, "Vaccines used

during the war may be a contributing factor."


A second study of British Gulf War veterans was published in 4/2001.

This study looked at the relationship between various Gulf War exposures

and subsequent health.  It did not look at specific deployment vaccines,

but instead evaluated the number of vaccinations received in relation to

GWS. It said, "Consistent, specific, and credible relations, warranting

further investigation, were found between health indices and two

exposures, the reported number of inoculations and days handling

pesticides (5)."


The Veterans Administration collected data on thousands of Gulf War

veterans who presented for evaluation of Gulf War Syndrome.  Although

unpublished, the data were presented at a conference on GWS in January

2001 (6).   The VA asked veterans if they thought they had received


vaccine at the time of the Gulf War, among many other potential

exposures, and inquired about symptoms of illness.  Those who believed

they had received anthrax vaccine were twice as likely to report a

multitude of symptoms as those who believed they were not vaccinated.


These are all the Gulf War data that are available in the open

literature.  Every study that examined the question of whether vaccines

in general, or specific non-routine vaccines, or anthrax vaccine alone

may have contributed to GWS, has found a positive relationship.


The French Ministry of Defense (MOD) recently convened an advisory

committee to study GWS chaired by Professor Roger Salamon.  This

committee reviewed the existing world literature on GWS, and suggested

that "multiple vaccinations given during the war, particularly those for

anthrax, botulinum and plague, seem associated with an excess of (GWS)

signs and symptoms (7)."


There are no published long-term adverse event data from the anthrax

vaccine immunization program, which began vaccinating servicemembers in

March, 1998.  However, the unpublished study done by Captain Jean Tanner

at Dover Air Force Base suggests that recent anthrax vaccine recipients

face similar medical problems as the Gulf War veterans (8).


Meryl Nass, MD

207 865-7000 



1. Expert committees listed in my Testimony to the House National

Security Subcommittee, April 29, 1999.

2. http://

3. Unwin C et al. Health of UK servicemen who served in the Persian Gulf

War. The Lancet 1999; 353:169-178.

4.  Steele L. Prevalence and patterns of Gulf War Illness in Kansas

veterans: Association of symptoms with characteristics of person, place,

and time of military service. Am J Epidemiol 2000; 152:991-1001.

5. Cherry N et al. Health and exposures of United Kingdom Gulf War

veterans. Part II:

The relation of health to exposure. Occup Environ Med 2001; 58: 299-306.

6.  Mahan CM, Kang HK, Ishii EK et al. Anthrax vaccination and

self-reported symptoms, functional status and medical conditions in the

national health survey of Gulf War era veterans and their families.

Environmental Epidemiology Service, Veterans Health Administration,

Washington, DC. Presented January 25, 2001 @ Research Working Group:

Military and Veterans Health Coordinating Board Conference on Illnesses

among Gulf War Veterans: A Decade of Scientific Research