SARS-COV-2 VACCINATION AND REPORTING POLICY UPDATE:
R 042044Z MAY 21 MID200000824135U
FM CNO WASHINGTON DC
INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC
MSGID/GENADMIN/CNO WASHINGTON DC/CNO/MAY//
SUBJ/SARS-COV-2 VACCINATION AND REPORTING POLICY UPDATE//
REF/B/DOC/32 CFR PART 199.21/1DEC2016//
NARR/REF A IS THE DEFENSE HEALTH AGENCY INTERIM PROCEDURES MEMORANDUM 20-004
DEPARTMENT OF DEFENSE (DOD) CORONAVIRUS DISEASE 2019 (COVID-19) VACCINATION
PROGRAM IMPLEMENTATION PROGRAM.
REF B IS 32 CFR PART 199.21, CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE
UNIFORMED SERVICES (CHAMPUS)/TRICARE: TRICARE PHARMACY BENEFITS PROGRAM.
REF C IS THE SARS-COV-2 VACCINATION AND REPORTING POLICY, VERSION 1, NAVADMIN
REF D IS THE SARS-COV-2 VACCINATION AND REPORTING POLICY, VERSION 1 (UPDATE
1), NAVADMIN 070/21.
REF E IS OPNAVINST 3100.6 SERIES GUIDANCE, POLICY, AND INSTRUCTIONS FOR
SPECIAL INCIDENT REPORTING.
1. References (c) and (d) are cancelled. The SARS-CoV-2 virus and the
disease it causes, COVID-19, have disrupted Navy mission execution. The most
effective strategy for maintaining mission capability is to vaccinate the
force. This NAVADMIN lays out policy guidance for vaccination efforts and
subsequent reporting requirements.
2. Specific Policy Guidance.
2.a. Coordination. Military Treatment Facilities (MTFs) will coordinate
ordering and administration of vaccines with their supported local units and
other eligible populations.
2.b. Emergency Use Authorization (EUA). While authorized under a Food and
Drug Administration (FDA) EUA or Expanded Availability (EA), the vaccination
is voluntary for service members.
2.c. Recipient Awareness. While under EUA/EA, MTFs will make vaccine
recipients aware the FDA has authorized emergency use of the vaccine and
ensure recipients understand the known benefits and potential risks, as well
as the extent to which such benefits and risks are unknown. If the
prospective recipient expresses concern about receiving the vaccine, the MTF
will inform recipients of available alternatives and risks.
While under EUA/EA, members receiving the vaccine will sign a consent form.
2.d. Other COVID-19 Mitigation Measures. Vaccinated personnel shall comply
with Centers for Disease Control and Prevention (CDC) and higher headquarters
COVID-19 mitigation guidance.
3. Operational Guidance.
3.a. COVID-19 Vaccine Incident Reporting. Report COVID-19 vaccine-related
events in accordance with standard reporting procedures identified in
reference (e). Specifically, COVID-19 related events that would not normally
trigger an incident report (i.e. lost vaccination doses, vaccinated
individual subsequently diagnosed with COVID-19, adverse reaction to
vaccine), are no longer reportable unless the incident falls into an existing
category within reference (e).
3.b. Timing. Two dose series SARS-CoV-2 vaccines are separated by 21
(Pfizer) or 28 days (Moderna). Commanders must ensure second dose timing is
planned to support operational commitments prior to initiating the sequence.
If operational limitations require, second doses may be administered within
-4 to +14 days of the targeted second dose day. Individuals should not be
deployed while awaiting a second dose if the vaccine, by the same
manufacturer, is not available at the destination.
3.c. Reserve Component (RC) Forces. Navy Operational Support Centers
(NOSCs)/Navy Reserve Activities (NRAs) will coordinate with the nearest MTF
to vaccinate Navy Reserve Members. Where an MTF is not available, members
should receive their vaccination from a civilian or local vaccination
program. RC members will provide vaccination documentation received from
civilian or local vaccination programs to NOSC medical staff for
documentation in the Medical Readiness Reporting System (MRRS). NOSC plans
for vaccinating Reservists must account for the applicable delay between
doses stipulated by the vaccine manufacturer.
3.d. Navy Civilian Personnel. COVID-19 vaccinations are available for all
Navy civilian employees.
3.e. TRICARE Beneficiaries. COVID-19 vaccinations are available for all
eligible TRICARE beneficiaries. MTFs will follow current CDC guidance for
vaccinating younger dependents.
3.f. Vaccination on the Economy. Reference (b) authorizes retail network
pharmacies to administer vaccines. TRICARE beneficiaries may receive
COVID-19 vaccinations with no co-pay at DoD MTFs and authorized retail
network pharmacies as per reference (a).
4. Medical Guidance.
4.a. Fully or partially vaccinated individuals who experience COVID-19
symptoms outside the expected side effects should be treated and isolated in
accordance with CDC guidance and clinical practice guidelines.
4.b. Side Effects. Medical personnel shall explain known potential side
effects of the vaccine to the patient prior to administering the vaccine.
4.c. Choice. If available, MTFs should be prepared to offer an alternate EUA
approved COVID-19 vaccine to persons who are hesitant to receive a particular
vaccine from one manufacturer or another.
4.d. Co-Administration Guidance. Administration of COVID-19 vaccines with
other vaccines must be done in accordance with the current Advisory Council
on Immunization Practices (ACIP) guidelines: https://www.cdc.gov/vaccines/
4.e. Personnel Administering Vaccines. Only trained and qualified medical
personnel, working within their scope of practice, will administer the COVID-
19 vaccine per reference (a). COVID-19 vaccination staff will complete the
CDC and manufacturer educations modules: CDC COVID-19 Vaccine Training:
General Overview of Immunization Best Practices for Healthcare Professionals
(https://www2.cdc.gov/vaccines/ed/covid19/SHVA/index.asp) and the online
training module provided by each manufacturer for the products that will be
4.f. Documenting COVID-19 Vaccination. MRRS will be the system of record for
individual vaccination status. All COVID-19 vaccinations, exemptions, or
deferrals shall also be documented in MRRS. Documentation may occur through
the Electronic Health Record (EHR). Shore-based commands or representatives
may request access to MRRS based on their unit identification code by
submitting a system access authorization request available at:
https://mrrs.dc3n.navy.mil/mrrs (note: MRRS Web address is case sensitive).
MRRS program office contact information: https://firstname.lastname@example.org
(800) 537-4617 / (504) 697-7070/ DSN: (312) 647-7070. Ship-based commands
may use Navy Medicine Online (NMO) or Shipboard Non-Tactical Automated Data
Processing Automated Medical System (SAMS) to populate MRRS.
4.f.1. All personnel who receive the vaccination from a retail network
pharmacy must provide documentation of vaccination no later than the next
work day (or next drill day for Reserve personnel) to ensure vaccination is
recorded in MRRS and the Electronic Health Record (EHR).
4.g. Duty in a Flight Status. The NATOPS Manual (CNAF M-3710.7) requires a
12-hour grounding period following immunizations unless otherwise specified
in the current Aeromedical Reference and Waiver Guide (ARWG)
The ARWG now covers nucleic acid and live non-replicating viral vector SARS-
CoV-2 vaccines with a recommended self-limited grounding period of 48-hours
after any dose in the series to assess for onset of reactions and side
effects such as fatigue, headache, myalgia, nausea, and fever. The
development or presence of any systemic side effect during these 48-hours
requires extending the self-limited grounding for a total of 72-hours,
regardless of when effects resolve, to allow for full recovery. If systemic
side effects persist for greater than 72-hours, any personnel in a flight
duty status should see their Aerospace Medicine provider for evaluation. The
presence and severity of symptoms may require the grounding of some personnel
for greater than 72-hours.
4.h. Dive Status, Undersea, and Special Operations. Nucleic acid and live
non-replicating viral vector SARS-CoV-2 vaccines are covered by this
High-risk activities or operations should be limited for 48-hours after any
dose in the series to assess onset of reactions and systemic side effects to
include, but not limited to fatigue, headache, myalgia, nausea, and fever.
The development or presence of any systemic side effects during these 48-
hours requires extending the limitation of high risk activities and duties
for a total of 72-hours, regardless of when symptoms resolve, to allow for
full recovery. If systemic side effects persist for greater than 72-hours,
personnel should seek evaluation by an Undersea Medical Officer or
appropriate medical authority.
5. Released by VADM P. G. Sawyer, Deputy Chief of Naval Operations for
Operations, Plans and Strategy, OPNAV N3/N5.//