We thank the author for his letter and are in agreement that this investigation represents just a start toward understanding whether or not anthrax vaccination is related to specific health end points. We are currently conducting other studies on this topic, which may add to this body of knowledge.1
Our decision to analyze an 18-week period following vaccination followed the guidance of epidemiologists, clinicians, and a neuro-ophthalmologist who participated in this optic neuritis study. We describe this decision as a major strength of the study2 as it decreases the likelihood that an alternate causation was introduced during the study period. Many neurological disorders do have substantial latency periods; however, a long latency period does not appear to be characteristic of potentially vaccine-mediated optic neuritis.3
Payne DC, Rose CE, Kerrison J, Aranas A, Duderstadt S, McNeil MM. Adverse Reactions to Anthrax Vaccine (eg, Optic Neuritis) May Be More Complex or Delayed Than Reported Initially by Payne et al (2006)—Reply. Arch Neurol. 2007;64(3):458. doi:https://doi.org/10.1001/archneur.64.3.458-a
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