In a letter to U.S. Senator John McCain and U.S. Representative Jim Kolbe of Tucson, Ramirez described trying to find out whether he should be taking the shot while he was still recovering from the surgery.
"I asked the surgeon that had done the operation if this would be a problem, and he basically said that he didn't know anything about the vaccine, but since it was mandatory, that I better take the vaccine."
He received his first inoculation in October 1998 and the second two weeks later. It was after that dose, Ramirez says, that he began experiencing severe pain in his hip. His doctor said it was likely caused by some sort of nerve problem related to his surgery. Ramirez says the doctor treated him with steroid injections.
Later, Ramirez learned that the vaccine carries a warning that it should not be given to anyone on steroids. But overseas, his steroid therapy continued. And he got his third anthrax injection.
The pain worsened in his hips and traveled down his knees. He says he was told then that he likely had an arthritic hip and would need hip replacement surgery. Before the surgery, Ramirez says, he was in top physical condition, usually running five or six miles a day plus putting in two to three hours working out at the gym.
Ramirez requested a transfer to Davis-Monthan Air Force Base in Tucson, where he has lived with his wife and three children since March. He has been given a medical waiver, postponing the resumption of the shot series. And he has been sent to a variety of specialists, both on and off base, to determine what is wrong with him. Valley fever, arthritis and other ailments have been ruled out, he says. But a rheumatologist has determined that he has some sort of degenerative disease and that it is now in his spine.
In another letter mailed recently to more members of Congress, he asked for their advice on whether he should resume the shots once his medical waiver ends:
"Should I risk more medical problems and stay in until I retire or do I speak up and risk all the years of dedicated service and say no? Please help me with this."
Dr. Meryl Nass, the internist and anthrax expert from Maine, says that in 1998, when the vaccination program began, she wasn't sure whether people should submit to the series of vaccinations.
"But now I tell them you are really playing Russian roulette with your health," she says. "You have to be aware of it because there is a very good chance you're going to develop things like sleep disturbances, neurological problems, muscle joint aches and headaches, significant memory loss, seizures or spacing out where you wake up 50 miles away from where you're supposed to be."
Nass, who has testified twice before Congress on anthrax, says when she first heard the Department of Defense was considering ordering mandatory vaccinations, she thought it was a bad idea. Her chief argument then was simply that the plan wouldn't work. Vaccinating everyone against one particular strain of anthrax, or one particular biological weapon, for that matter, would only protect them against that one thing. The enemy forces could then merely develop a new strain of the disease or another type of biological weapon, she reasoned, making the whole effort moot.
Her opinions, which were published in a U.S. infectious-disease publication and later cited in a British medical journal, apparently didn't have much influence. She continued to oppose the idea, but "I did not anticipate that it would make people sick," she says.
But within months after the first shots were given in early 1998, Nass started getting calls. People reported a host of problems that began after they took the vaccine. Nass says she talked to more than 1,000 people and now believes that the vaccine is indeed making people sick. She has set up a Web site (www.anthraxvaccine.org) with her conclusions.
Her research has shown that the vaccine can cause chronic symptoms that often worsen after the fourth shot is administered. Initially, she says, many experience abdominal cramping, diarrhea, fever, chills and a headache. Later symptoms can include chronic fatigue, dizziness, joint and muscle pain, headaches, memory loss, sleep disorders, chest pains and recurring rashes.
According to a list of actual cases presented during a congressional hearing, some of these symptoms can be disabling. One specialist reported vertigo so severe she couldn't walk, a major suffered crippling joint pain, a flight engineer had numerous seizures.