The bacterial disease anthrax dates back to 1500 B.C., when first recorded by the Egyptians as the cause of the fifth Egyptian plague. Anthrax normally afflicts animals, especially cattle and sheep, but anthrax spores can be produced in a dry form that can be incorporated into biological warfare weapons. When inhaled by humans, anthrax spores can cause death within a week. Anthrax is 99 percent lethal to unprotected individuals exposed to battlefield concentrations of the agent (U. S. Air Force, 1998).  

More than 10 countries are suspected of having biological warfare capability. During the 1980s, inspection teams discovered that Iraq produced 8,000 liters of anthrax spores -- an amount believed capable of killing every man, woman and child on earth. (Department of Defense, 1998a). 

During the Gulf War in 1990 and 1991, more than 150,000 U.S. troops were given anthrax vaccinations. The anthrax vaccine given to military forces has been licensed by the U.S. Food and Drug Administration  since 1970 for human use (U.S. License No. 99, 1970). This vaccine has been routinely administered to professionals who may come in contact with anthrax spores occupationally (veterinarians, laboratory workers, livestock handlers, etc.) (Department of Defense, 1998a). 

Since the Gulf War, the Department of Defense increased the level of attention given to biological warfare defense and other force protection measures. The world threat environment and the unpredictable nature of terrorism were primary considerations in the Department of Defenseís force protection planning (Department of Defense, 1998a). 

In November 1993, the DoD established the policy, responsibilities, and procedures for stockpiling biological agent vaccines and determined which personnel should be immunized and when the vaccines should be administered. The policy, DoD Directive 6205.3, specifically states that personnel assigned to threat areas and those pre-designated for immediate contingency deployment to these areas should be vaccinated in sufficient time to develop immunity prior to deployment (Department of Defense, 1998a). 

The Advisory Committee for Immunizations Practices, recommends anthrax vaccine be given to individuals are engaged in occupational activities that may bring them into contact with anthrax spores (Centers for Disease Control, 1998). 

On December 15, 1997, the DoD announced preliminary plans leading to the systematic and mandatory vaccination of all U.S. military personnel against anthrax.  Defense Secretary William S. Cohen set four conditions before starting inoculation. First, he ordered supplemental testing of the vaccine produced by the Bioport Corporation, formerly known as the Michigan Biologic Products Institute. Second, the services had to assure tracking of every vaccination. Third, DoD and the services had to devise a plan to educate service members about the inoculation program. Finally, DoD would proceed only if an external medical review showed the program was safe and would protect service members (Department of Defense, 1998a).  

Cohen directed that the anthrax immunization program be independently assessed by Dr. Gerald N. Burrow of Yale University before implementation. The immunization program consists of a series of six inoculations per service member over an 18-month period, followed by an annual booster. The anthrax vaccine is a formalen inactivated vaccine that uses dead bacteria rather than live bacteria (Department of Defense, 1998a). 

In December 1997, DoD released an anthrax public affairs plan outlining an overall strategy for informing service members, media, and legislators about the anthrax immunization program (Appendices). The trigger event for the public affairs plan was Cohenís announcement in December 1997. A critical component of the public affairs plan was to first inform the internal audience (military and their families) about the anthrax immunization program (DoD Public Affairs Anthrax Plan, 1997). 

The goal of this anthrax public affairs plan was to answer accurately and completely any queries from the media and the public regarding anthrax vaccination.  The plan also lists goals to: support the DoD decision to vaccinate, publicizing the program in professional, trade and general interest publications, and providing speakers on the topic. The planís overall objectives are to ensure the public understands the need to vaccinate the military and to increase the publicís awareness of DoDís anthrax vaccination policy (DoD Public Affairs Anthrax Plan, 1997). 

Specific responsibilities for DoD public affairs directorates are outlined in the plan, including which office will provide particular public affairs products, coordinate press briefings, and monitor results. For dealing with the mass media, the directorate for defense information was responsible for responding to media requests, coordinating press briefings and distributing press releases. The directorate of programs and community relations was responsible for coordinating interviews with external and internal media for senior defense officials, arranging speaking engagements for key officials, and  coordinating press conferences for regional and nationwide radio coverage.   

The American Forces Information Service was tasked with supporting the military internal audiences by publishing print articles, providing copies of civilian media coverage, producing television news stories and supporting still and motion media documentation (DoD Public Affairs Anthrax Plan, 1997).  

On March 3, 1998, Cohen announced his decision to accelerate the already-planned anthrax immunization program. This action was requested by Gen. Anthony Zinni, U.S. Central Command commander in chief, and recommended by Gen. Henry H. Shelton, chairman of the Joint Chiefs of Staff, as one of a number of force protection measures for troops in the Gulf region. A further announcement stated that U.S. military people deployed to the Arabian Gulf region would begin to receive their first anthrax vaccinations in April 1998 (Department of Defense, 1998a). 

After the four pre-conditions were met, on May 18, 1998, Cohen approved the plan to vaccinate all U.S. service members for anthrax. Several months later, the first phase of the total force anthrax  vaccine immunization program was announced August 14, 1998, for service members deploying to Southwest Asia and Korea. Immunizations for these Phase I active-duty people and selected reservists began in early September 1998 (Department of Defense, 1998a). 

The Secretary of the Army is the executive agent for the military anthrax immunization effort, including procurement of the vaccine, tracking and oversight of the vaccination program, and coordinating with other service secretaries on the execution of the program. When all associated costs (transportation, storage, administration, etc.) are included, DoD estimates the cost to immunize all 2.4 million personnel at approximately $130 million (Department of the Army, 1998).  

Since military personnel are faced with life-threatening biological warfare agents, the DoD public affairs plan must use all means available to provide extensive, accurate, and timely information. Based on diffusion of innovation and uses and gratification theories, the DoD plan might have anticipated Internet misinformation and been proactive with using the medium as a method to disseminate accurate and comprehensive information to its diverse audience. 

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