In April 2000, the Institute of Medicine of the National Academies convened an expert committee to advise the U.S. Army Medical Research and Materiel Command on the management of natural infectious disease threats to the military. The Committee on a Strategy for Minimizing the Impact of Naturally Occurring Infectious Diseases of Military Importance: Vaccine Issues in the U.S. Military issued its complete report in January 2002.

At its initial three meetings, the committee reviewed the failure of the Department of Defense (DoD) to maintain a supply of the adenovirus vaccine as an example of the problems DoD faces regarding the licensure, manufacture, and maintenance of special use vaccines. Production of this vaccine ceased in 1996 and stocks were depleted in 1999. What the committee heard was extremely disconcerting with respect to the threat that the lack of this vaccine now poses to the health of recruit populations. The committee submits this interim letter report today with a sense of extreme urgency in an effort to reinforce the view that there is a critical need for the DoD to expeditiously reestablish a process for the licensure, manufacture, purchase, and distribution of the adenovirus vaccine to military personnel undergoing recruit training activities.

The committee found:

• that the adenovirus vaccine is urgently needed to control the epidemic respiratory disease that has caused much morbidity among recruits in the past, and now once again threatens the health and even the lives of military trainees; since acute pulmonary infection due to adenovirus is a nearly unique occupational risk of the military trainee, it is imperative that DoD take rapid and effective action to once more eliminate this preventable disease;
• that the short-term, $14 million Defense Health Program commitment to acquiring an adenovirus vaccine is insufficient to stimulate the interest of capable commercial vaccine manufacturers; and
• that the existing acquisition and procurement systems within DoD are not structured to ensure continuing availability of limited use vaccines.

The committee recommends:

• that a much greater sense of urgency be placed on reacquiring an effective adenovirus vaccine;
• that a significantly larger and long-term commitment be made to restore and maintain the ongoing availability of adenovirus vaccine; and
• that the DoD not only evaluate the cause(s) underlying this serious procurement system failure, but also make a clear commitment to the changes necessary to prevent similar breakdowns in the future.

In its final report to you, this committee will address system issues in depth in an attempt to help the Department of Defense define and then resolve the problem. The basis for these findings and recommendations is presented in the full letter report.

Read this letter report