Adult adenovirus infections: Loss of orphaned vaccines precipitates military respiratory disease epidemics

Adenovirus vaccines have greatly reduced military respiratory disease morbi dity since the 1970s, However, in 1995, for economic reasons, the sole manu facturer of these vaccines ceased production. A population-based adenovirus surveillance was established among trainees with acute respiratory illness at 4 US military training centers as the last stores of vaccines were depl eted. From October 1996 to June 1998, 1814 (53.1%) of 3413 throat cultures for symptomatic trainees (78% men) yielded adenovirus. Adenovirus types 4, 7, 3, and 21 accounted for 57%, 25%, 9%, and 7% of the isolates, respective ly. Unvaccinated trainees were much more likely than vaccinated trainees to be positive for types 4 or 7 (odds ratio [OR] = 28.1; 95% CI, 20.2-39.2), Two training centers experienced epidemics of respiratory disease affecting thousands of trainees when vaccines were not available. Until a new manufa cturer is identified, the loss of orphaned adenovirus vaccines will result in thousands of additional preventable adenovirus infections.