Medical After Action Report

File: doc04_09.txt
Page: 09
Total Pages: 23
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antibiotics and vaccine were presented in Washington, D.C. On 13
November 1990.   This study resulted in a recommendation for the
issue of antibiotics to every soldier in theater to be taken in the
event of BW exposure.  This recommendation was briefed to the CINC
US CENTCOM on 6 December 1990 and resulted in another request by
the  CINC  to the  CJCS  for an  intelligence assessment  of   the
population at risk and a clarification of the doctrine for vaccine
and antibiotic utilization.   On 17 December 1990 the Armed Forces
Epidemiology Board formally recommended the issue of antibiotics to
every   soldier   in   theater   and  pre-exposure   vaccination.
Recommendations of BW working group at the JCS were disseminated in
the form of a CJCS message to the CINC US CENTCO~ on 29 December
1990.    This message   continued to  leave  the decision  as  to
prioritization to the Theater Commander.    A US CENTCOM working
group  to  establish priorities based  on  the best  intelligence
assessments resulted in a Theater vaccination determination on 31
December 1990.

     Vaccine  and a coordination team arrived in theater     on  3
January 1990 and the vaccination program was initiated on 5 January
1990.  BW Defense Medical Guidelines were disseminated by the US
CE~TCOM Surgeon's office to components on 5 January 1990.  The US
Army Office of the Surgeon General forwarded a preliminary Medical
BW Defensive Doctrine for Operation Desert Shield on 10 January
1990  followed  by a  formal  Interim Medical Doctrine,  Tactics,
Techniques,   and  Procedures,  Biological  Warfare  Defense   for
Operation Desert Storm on 26 Januar    1991.


     Although the Food and Drug Administration   (FDA)  had given
authorization to administer Botulinum Toxoid (an Investigational
Drug)  without informed consent, the US CENTCOM Surgeon1s office
made the decision to obtain written consent and to make the program
voluntary to those individuals considered to be at risk.       The
decision was made based on the limited serotypes included in the
vaccine, the twelve weeks necessary to administer the three shots,
and the partial response to the vaccine even after three doses.
This program was initiated by a message to the components on 17
January 1991.   60,330 doses were distributed by 19 February 1991.
Several thousand personnel declined to be vaccinated.


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                   . taboratory capa ility 0 identify BW agents in
clinical and environmental samples was available as early as 13

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