By Linda D. Kozaryn American Forces Press Service WASHINGTON -- They offered no options -- the lives of their soldiers, sailors, Marines and airmen are not negotiable. Their message was clear: Anything less than DoD's mandatory anthrax vaccination program is unacceptable. Senior military leaders recently delivered that firm message to Congress. Late September hearings were held because of congressional concerns about the impact on military readiness of service members refusing vaccinations. These concerns were fueled by controversial reports, many of them sprouting up on small Internet sites, that claim DoD's vaccine is untested and dangerous. Deputy Defense Secretary John J. Hamre testified on the issue Sept. 30 before the Military Personnel Subcommittee of the House Armed Services Committee. He was followed by U.S. Marine Corps Gen. Anthony Zinni, commander, U.S. Central Command and Dr. (Lt. Gen.) Ronald E. Blanck, surgeon general of the Army. The Army is the immunization program executive agent. Hamre stressed that DoD's Anthrax Vaccine Immunization Program, implemented in March 1998, is a vital part of the military's force protection strategy. Over the next seven years, the department plans to immunize 2.4 million active duty and reserve component personnel against the threat posed by at least 10 nations suspected of having weaponized anthrax. The Defense Department received unequivocal evidence in 1997 that Iraq had weaponized anthrax, Hamre said. Anyone in the U.S. Central Command's theater of operations is especially at risk, and the anthrax vaccine is as necessary for force protection as a flak jacket or a helmet, he said. "If you don't get inoculated, you're going to die," he said. Weapons-grade anthrax is as deadly as the Ebola virus and virtually always fatal if inhaled. Anthrax normally is a livestock disease transmitted to humans by skin contact and though dangerous is not usually fatal if treated in time. The DoD vaccine is the same one licensed in 1970 by the U.S. Food and Drug Administration and used ever since by the U.S. livestock industry. Internet misinformation and rumormongering about the vaccine has alarmed some service members, Hamre said. "I would admit we have not done a good enough job explaining to all of the people at home," he said. Emphasis was put on education of service members in Central Command, where the threat was the most urgent, he said. The deputy noted that the Pentagon's top leaders, including himself, Defense Secretary William S. Cohen and other top Pentagon leaders including every service chief, service secretary and commander in chief have all taken the shots. "I am not going to ask a soldier to put something in his arm if I'm not prepared to take it first," Hamre said. Zinni acknowledged that anthrax vaccinations are voluntary among allied and coalition forces, but he rejected a voluntary program for the United States. "On battlefields, we overwhelm our medical capability," he said. "If we accept voluntary inoculation, I accept additional casualties." As a commander, Zinni said, he would not place U.S. forces in a position where they would be reliant on unvaccinated coalition forces. "I think I would make that promise to any American, mother, father or leader of this country," he said. Blanck reported that the vaccination program as of Sept. 30 had immunized more than 340,000 personnel, including 27,000 guardsmen and reservists. Very few of those personnel have experienced significant and serious side effects, he said, and the numbers are consistent with the results of extensive safety studies done over the years in humans. The anthrax vaccine is a biological product -- as are the vaccines used for the seven other required immmunizations troops receive, he said. "That means when they're injected, there are often local side effects that include tenderness, soreness, redness, a lump at the site, fever, muscle aches and pains," he explained. The effects are mild and go away on their own, he said. Blanck said 72 cases of serious side effects have been reported that required hospitalization or missed duty for greater than a day. Of those cases, FDA and Department of Health and Human Services officials could attribute only 55 to the anthrax vaccine, he said, and all 55 service members involved have returned to full duty. The surgeon general noted that there are no known long-term health consequences to the vaccine, which can counter more than 30 anthrax strains. About 500 employees at the Army's Medical Research and Materiel Command at Fort Detrick, Md., have received the vaccine since the 1970s and have evidenced no signs of illness related to the vaccine, he pointed out. Blanck attributed problems in some units to a lack of education. "In those organizations," he said, "the command information program to get the soldiers and the troopers the exact facts of the situation has not been what it should be." He stressed that commanders' total involvement is called for in educating service members about the threat and the vaccine. As a physician, Blanck concluded, the bottom line is very clear. "If we're attacked with this agent and we have a force that's vaccinated and protected, our soldiers, sailors, airmen and Marines will largely survive. If they're not vaccinated, they will inevitably die." Gen. John Keane, Army vice chief of staff, who accompanied Hamre, said the threat of exposure to U.S. forces is real, and he believes the vaccine is safe and effective. "We have a moral obligation to do everything in our power to protect our troops from the anthrax threat," he said. "Despite reports to the contrary, results so far have been overwhelmingly positive. We have very few refusals, by comparison, to the number of troops that we have inoculated." Although the military does not specifically track the number of refusals, Keane said, they are ultimately gleaned from military justice channels. Service members who refuse the shots first go through education and counseling to ensure they know all the facts and are making an informed decision. If they still refuse, the commander can then impose nonjudicial punishment, separation from the service or court-martial. Keane said there have been few courts-martial, and all have convened at the service members' insistence on a trial.