Service members deploying on Individual Augmentee and Expeditionary Combat Readiness Command billets to areas in U.S. Central Command including Djibouti, Iraq, Afghanistan and Kuwait are required to have an Anthrax vaccination if they are scheduled to be in theater for 15 or more consecutive days.

Service members in the past have debated and protested the anthrax vaccine on suspicion that research was not sufficient for Federal Drug Administration approval.

Grace Aaron, head of Bethesda’s immunizations clinic, said in the past, service members may have had the choice to receive the vaccine, but due to the mandated changes they no longer have the choice. Anyone who is deploying must have the vaccine, she said.

‘‘In 2006 that choice was lifted and it became mandatory again,” she said. ‘‘With that, [service members] must have it if they are deploying to [Central Command].”

Aaron said in the past there were certain guidelines followed and patients had to meet certain criteria. Now, the only criterion that a member must meet is if they are deploying to an area in Central Command, she said.

‘‘Part of the guidelines stated that we couldn’t start to administer the vaccine until the member had less than 90 days until they were to deploy,” Aaron said. ‘‘Now, once we know [the service member] is deploying [to Central Command] and already has their orders, we can begin the series as early as 120 days.”

Julie Harris, a family nurse practitioner in Bethesda’s Deployment Health center said, when the vaccine became part of the deployment process again service members were timid about having the immunization. Patients still have a lot of questions about it when they are preparing to deploy, she said.

‘‘Patients were like ‘we’re doing that again, when did that came back,’” she said. ‘‘Once they realized it was back they would ask about the side effects and how many inoculations they were going to have.”

Aaron said after further review from the Federal Drug Administration, the anthrax vaccine had again been determined as an effective defensive tool against the threat of an anthrax attack. Information about the vaccine is given to the service member when they come to receive their immunization, she said.

‘‘Now that the [Federal Drug Administration] has reexamined the vaccine, federal law has established the immunization for anthrax mandatory for service members,” Aaron said. ‘‘We give [service members] the information [literature] for anthrax that is from the Military Vaccine Agency.”

Tonya Seay, a nurse’s assistant from Bethesda’s deployment health center, said all deploying service members must have the vaccine and will once they arrive in theater.

‘‘Everyone deploying from Bethesda is required to have the vaccine, if they don’t get it here they will at their training commands,” she said.

Seay said deploying service members need to start the immunization process as early as underlying issues often pop up and may keep many from receiving immunizations or even deploying. However, with an early start, members are able to get everything taken care of, she said.