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UNCLAS //N02300//
NAVADMIN 068/07
MSGID/GENADMIN/CNO WASHINGTON DC/DNS/FEB//
SUBJ/RESUMPTION OF MANDATORY ANTHRAX VACCINE IMMUNIZATION PROGRAM
(AVIP)//
REF/A/DOC/DEPSECDEF/YMD:20061012//
REF/B/DOC/USD (P AND R)/YMD:20061207//
REF/C/MSG/CNO (N09) WASHINGOTN DC/192219ZJAN2006//
REF/D/MSG/CNO WASHINGTON DC/201855ZMAY2005//
REF/E/MSG/CNO (N09) WASHINGTON DC/290118ZOCT2004//
REF/F/DOC/SECNAVINST 6230.4/YMD:19980428//
REF/G/DOC/BUMEDINST 6230.15A/YMD:20060929//
REF/H/DOC/USD (P AND R)/YMD:20020806// REF/I/DOC/ASD
(HA)/YMD:20020806//
NARR/REF A IS DEPUTY SECRETARY OF DEFENSE (DEPSECDEF) MEMO DIRECTING
RESUMPTION OF THE MANDATORY ANTHRAX VACCINE IMMUNIZATION PROGRAM
(AVIP) FOR DESIGNATED DOD PERSONNEL AND ELIGIBILITY FOR VOLUNTARY
CONTINUATION OF ANTHRAX VACCINATIONS. REF B IS UNDER SECRETARY OF
DEFENSE (PERSONNEL AND READINESS) (USD (P&R)) MEMO PROVIDING
IMPLEMENTATION GUIDANCE FOR RESUMING THE MANDATORY AVIP. REF C IS
NAVADMIN 034/06 DIRECTING CONTINUATION OF AVIP. REF D IS NAVADMIN
110/05 EMERGENCY USE AUTHORIZATION TO RESUME ANTHRAX VACCINATIONS.
REF E IS NAVADMIN 245/04 DIRECTING ANTHRAX VACCINE IMMUNIZATION PROGRAM
PAUSE. REF F IS SECNAVINST 6230.4, DEPARTMENT OF THE NAVY
(DON) ANTHRAX VACCINATION IMPLEMENTATION PROGRAM (AVIP). REF G IS BUMED
INSTRUCTION (BUMEDINST) 6230.15A IMMUNIZATION AND CHEMOPROPHYLAXIS. REF
H IS USD (P&R) POLICY MEMO ON ADMINISTRATIVE ISSUES RELATED TO THE AVIP.
REF I IS ASSISTANT SECRETARY OF DEFENSE (HEALTH AFFAIRS) (ASD(HA))
POLICY MEMO ON CLINICAL ISSUES RELATED TO ANTHRAX VACCINATION.//
POC/CATHLEEN DONOHUE/LCDR/CNO N931D5/LOC:WASHINGTON DC
/TEL:202-762-3437/TEL:DNS: 762-3437/EMAIL:CATHLEEN.DONOHUE@NAVY.MIL//
RMKS/1. POLICY. PER REF A, DEPSECDEF DIRECTED RESUMPTION OF THE DOD
MANDATORY AVIP FOR DESIGNATED PERSONNEL PLUS VOLUNTARY INITIAL
IMMUNIZATION AND CONTINUATION OF AVIP FOR OTHER INDIVIDUALS. REF B
PROVIDES DOD AVIP IMPLEMENTATION GUIDANCE AND POLICY.
A. THIS NAVADMIN CANCELS REFS C THROUGH E WHICH PROVIDED EXECUTION
GUIDANCE FOR THE NAVY_S AVIP DURING THE U.S. DISTRICT COURT OF THE
DISTRICT OF COLUMBIA INJUNCTION HALTING DOD_S MANDATORY AVIP.
B. NAVY AVIP GUIDANCE CONTAINED HEREIN WILL BE INCORPORATED INTO REF F,
CURRENTLY UNDER REVISION.
2. MANDATORY ANTHRAX IMMUNIZATIONS. ANTHRAX IMMUNIZATIONS ARE MANDATORY
FOR THE FOLLOWING PERSONNEL UNLESS EXEMPTED UNDER APPLICABLE MEDICAL
AND ADMINISTRATIVE EXEMPTION POLICIES (REFS H AND I):
A. UNIFORMED PERSONNEL, TO INCLUDE THOSE ASSIGNED TO U.S. EMBASSIES,
FORCES AFLOAT, AND CIVILIAN AND CONTRACT MARINERS UNDER COMMANDER,
MILITARY SEALIFT COMMAND (MSC), SERVING IN THE CENTRAL COMMAND
(CENTCOM) AREA OF RESPONSIBILITY (AOR) FOR 15 OR MORE CONSECUTIVE DAYS.
B. UNIFORMED PERSONNEL ASSIGNED TO THE KOREAN PENINSULA FOR 15 OR MORE
CONSECUTIVE DAYS.
C. U.S. PACIFIC COMMAND FORWARD DEPLOYED NAVAL FORCES AND III MARINE
EXPEDITIONARY FORCE ASSIGNED OR DESIGNATED AS EARLY DEPLOYERS (C-DAY TO
C+20) TO THE KOREAN PENINSULA.
D. EMERGENCY ESSENTIAL AND EQUIVALENT DOD CIVILIANS ASSIGNED TO THE
CENTCOM AOR OR TO THE KOREAN PENINSULA FOR 15 OR MORE CONSECUTIVE DAYS.
EQUIVALENT PERSONNEL ARE THOSE WHOSE DUTIES MEET THE REQUIREMENTS OF 10
U.S.C. 1580, BUT HAVE NOT BEEN DESIGNATED AS EMERGENCY ESSENTIAL. FOR
ADDITIONAL GUIDANCE, CONTACT LOCAL PERSONNEL ADVISORY CENTERS.
E. DOD CONTRACTOR PERSONNEL CARRYING OUT MISSION-ESSENTIAL SERVICES AND
ASSIGNED FOR 15 OR MORE CONSECUTIVE DAYS TO THE CENTCOM AOR OR KOREAN
PENINSULA. CONTRACTS MUST SPECIFY IMMUNIZATION AS A REQUIREMENT.
IMMUNIZATIONS WILL BE PROVIDED THROUGH THE MILITARY HEALTH SYSTEM.
F. PERSONNEL ASSIGNED TO SPECIAL UNITS; E.G., BIOWARFARE RELATED
MISSIONS, AND OTHER UNITS DESIGNATED BY ASD(HA) UPON RECOMMENDATION OF
THE CHAIRMAN OF THE JOINT CHIEFS OF STAFF, OR SERVICE SECRETARIES OR
THE COMMANDANT OF THE COAST GUARD, BASED ON CRITICAL MISSION
ASSIGNMENTS.
G. COMMANDS ISSUING ORDERS FOR PERMANENT CHANGE OF STATION (PCS),
TEMPORARY DUTY, OR RESERVE ORDERS LASTING MORE THAN 15 CONSECUTIVE DAYS
TO LOCATIONS COVERED BY THE MANDATORY PROGRAM, WILL INCLUDE IN THE
ORDERS THE REQUIREMENT TO START OR RESUME ANTHRAX VACCINATIONS AT THE
SOURCING COMMAND NOT EARLIER THAN 60 DAYS IN ADVANCE OF DEPLOYMENT WITH
THE GOAL OF ADMINISTERING THE FIRST THREE DOSES OF THE SIX-DOSE SERIES
PRIOR TO ARRIVAL IN THEATER.
3. VOLUNTARY ANTHRAX IMMUNIZATIONS. THE FOLLOWING PERSONNEL ARE
ELIGIBLE FOR VOLUNTARY VACCINATIONS (SUBJECT TO MEDICAL EXEMPTION)
BASED ON CURRENT LOCATION OR STATUS.
A. U.S. GOVERNMENT CIVILIAN EMPLOYEES AND U.S. CITIZEN CONTRACTOR
PERSONNEL WHEN ASSIGNED FOR 15 OR MORE CONSECUTIVE DAYS TO CENTCOM AOR
OR KOREA, OTHER THAN THOSE REQUIRING MANDATORY VACCINATIONS UNDER 2D
AND 2E. FOR CONTRACTORS, ELIGIBILITY FOR VOLUNTARY VACCINATIONS WILL BE
SPECIFIED IN THE CONTRACT.
B. ADULT FAMILY MEMBERS, 18-65 YEARS OF AGE, ACCOMPANYING DOD MILITARY
AND CIVILIAN PERSONNEL FOR 15 OR MORE CONSECUTIVE DAYS TO THE CENTCOM
AOR OR KOREA.
C. U.S. CITIZEN ADULT FAMILY MEMBERS, 18-65 YEARS OF AGE, ACCOMPANYING
U.S. CONTRACTOR PERSONNEL FOR 15 OR MORE CONSECUTIVE DAYS TO THE
CENTCOM AOR OR KOREA.
D. VACCINE MANUFACTURING AND RESEARCH PERSONNEL AND OTHERS AS
DESIGNATED BY ASD(HA). ASD(HA) WILL APPROVE REQUESTS ON A CASE-BY-CASE
BASIS.
E. ALL PERSONNEL WHO BEGIN OR BEGAN THE SIX-DOSE VACCINE SERIES DURING
OR AFTER 1998 WILL BE OFFERED COMPLETION OF THE VACCINE SERIES AND
ANNUAL BOOSTERS, ON A VOLUNTARY BASIS, AS LONG AS THEY REMAIN MEMBERS
OF THE ARMED FORCES OR MAINTAIN A CIVILIAN EMPLOYEE OR CONTRACTOR
STATUS COVERED BY THE PROGRAM. THIS GROUP INCLUDES PERSONNEL NO LONGER
SUBJECT TO MANDATORY VACCINATION.
4. REGISTRY AGREEMENTS AND MONTHLY REPORTING. THE FOLLOWING APPLIES TO
ACTIVE COMPONENT (AC) AND RESERVE COMPONENT (RC) COMMANDING OFFICERS
(CO) AND OFFICERS-IN-CHARGE (OIC) OF ACTIVITIES ADMINISTERING THE
ANTHRAX VACCINE; E.G., UNITS AFLOAT, NAVY MILITARY TREATMENT FACILITIES
(MTF), BRANCH HEALTH CLINICS (BHCL), NAVY MOBILIZATION PROCESSING SITES
(NMPS), AND NAVY OPERATIONAL SUPPORT CENTERS (NOSC).
A. COMPLETED REGISTRY AGREEMENTS AND CHECKLISTS MUST BE SUBMITTED TO
THE MILITARY VACCINE AGENCY PRIOR TO COMMENCING ANTHRAX IMMUNIZATIONS.
THESE DOCUMENTS ARE AVAILABLE AT WWW.ANTHRAX.MIL/AVIP2007.
(1) SUBMISSION OF A REGISTRY AGREEMENT AFFIRMS THAT THE SIGNATORY
UNDERSTANDS THE PROGRAM_S ADMINISTRATIVE, TRAINING AND REPORTING
REQUIREMENTS.
(2) ACTIVITIES WITH PREVIOUSLY APPROVED COMPLIANCE AGREEMENTS ARE NOT
REQUIRED TO SUBMIT A NEW REGISTRY AGREEMENT, PROVIDED THE SIGNATORY HAS
NOT CHANGED.
(3) LOGISTICS COMMANDS WILL NOT SHIP THE ANTHRAX VACCINE UNTIL THE
REGISTRY AGREEMENT IS RECEIVED BY MILVAX.
B. ADMINISTERING ACTIVITIES WILL SUBMIT MONTHLY REPORTS TO THE MILVAX
AGENCY BY THE FIFTH DAY OF THE FOLLOWING MONTH. ENSURE THAT EITHER THE
AC OR THE RC AVIP COORDINATOR, AS APPLICABLE, RECEIVES A COPY OF THE
REPORT. REPORT TEMPLATES ARE AVAILABLE AT WWW.ANTHRAX.MIL/AVIP2007.
(1) REPORTS WILL INCLUDE, IF TRUE, THE FOLLOWING SENTENCE: _NO ONE
COVERED BY THE VOLUNTARY POLICY RECEIVED THE ANTHRAX IMMUNIZATION
AGAINST HIS OR HER WILL, OR WITHOUT BEING INFORMED OF THEIR RIGHT TO
DECLINE VACCINATION, OR OTHERWISE IN VIOLATION OF THEIR RIGHT TO
DECLINE, AT THIS UNIT." IF THE STATEMENT ABOVE IS NOT TRUE, EXPLAIN
WHAT OCCURRED TO MAKE THE PROPOSED TEXT UNTRUE AND CORRECTIVE ACTION
TAKEN. BE SURE TO SPECIFY THE NUMBER OF PEOPLE VACCINATED WITHOUT AN
OPTION TO REFUSE AND BE PREPARED TO PROVIDE A LIST OF THEIR NAMES.
(2) THE NUMBER OF ANTHRAX VACCINE DOSES ADMINISTERED BY THE ACTIVTY OR
UNIT.
(3) ACTIVITY OR UNIT APPROVAL AUTHORITY SIGNATURE.
5. AVIP EDUCATION. COMMANDING OFFICERS (CO) AND OFFICERS-IN-CHARGE
(OIC) ARE RESPONSIBLE FOR EDUCATING THEIR PERSONNEL PRIOR TO RECEIVING
ANTHRAX IMMUNIZATIONS.
A. PERSONNEL WILL BE EDUCATED USING THE 12 OCTOBER 2006 VERSION OF THE
DOD AVIP TRIFOLD BROCHURE AND BRIEFS ARE AVAILABLE AT
WWW.ANTHRAX.MIL/AVIP2007. CO/OIC SHOULD CONSIDER DEVELOPING TEAMS OF
LOCAL HEALTHCARE PROVIDERS AND OTHER SUBJECT MATTER EXPERTS (E.G. JUDGE
ADVOCATE GENERAL, PUBLIC AFFAIRS OFFICER) TO ASSIST WITH DOD AVIP
BRIEFINGS. KEY POINTS TO EMPHASIZE ARE:
(1) YOUR HEALTH AND SAFETY ARE OUR NUMBER ONE CONCERN.
(2) THE ANTHRAX VACCINE IS SAFE AND EFFECTIVE.
(3) THE THREAT FROM ANTHRAX IS DEADLY AND REAL.
(4) VACCINATION OFFERS A LAYER OF PROTECTION IN ADDITION TO ANTIBIOTICS
AND OTHER MEASURES.
B. INFORM UNIFORM PERSONNEL REQUIRING MANDATORY ANTHRAX IMMUNIZATIONS
THAT UNLESS MEDICALLY OR ADMINISTRATIVELY EXEMPT, ANY REFUSAL TO BE
VACCINATED MAY CONSTITUTE A FAILURE TO OBEY A LAWFUL ORDER AND MAY BE
PUNISHABLE UNDER THE UNIFORM CODE OF MILITARY JUSTICE (UCMJ) AND/OR
ADMINISTRATIVE ACTION FOR FAILURE TO OBEY A LAWFUL ORDER (UCMJ, ARTICLE
92).
(1) ALL PERSONNEL SHALL HAVE ACCESS TO HEALTHCARE PROVIDERS TO DISCUSS
OBJECTIONS/CONCERNS WITH THE ANTHRAX VACCINE.
(2) REFUSALS BY CIVILIAN PERSONNEL SHOULD BE ADDRESSED WITH THE
CIVILIAN PERSONNEL OFFICE.
C. PROVIDE EACH INDIVIDUAL A COPY OF THE DOD TRIFOLD BROCHURE DATED
12 OCTOBER 2006 (OR LATER VERSION) BEFORE EACH ANTHRAX IMMUNIZATION.
ANTHRAX IMMUNIZATIONS WILL NOT BE ADMINISTERED UNTIL A DOD AVIP TRIFOLD
BROCHURE IS PROVIDED.
(1) ALL EARLIER VERSIONS OF THE DOD AVIP TRIFOLD BROCHURE WILL BE
COLLECTED AND DISCARDED OR RECYCLED. DO NOT RETAIN THEM FOR FUTURE USE.
BE SURE TO REMOVE OBSOLETE DOD AVIP TRIFOLD BROCHURES FROM PAMPHLET
RACKS IN WAITING ROOMS, ON BULLETIN BOARDS, INTRANETS, ETC.
(2) DOD AVIP TRIFOLD BROCHURES WILL BE SHIPPED TO REQUESTORS WHEN U.S.
ARMY MEDICAL MATERIEL AGENCY (USAMMA) RECEIVES VACCINE ORDERS (ONE FOR
EACH DOSE ORDERED). ADDITIONAL TRIFOLDS MAY BE ORDERED FOR EDUCATIONAL
PURPOSES BY SENDING AN E-MAIL TO USAMMADOC@DET.AMEDD.ARMY.MIL OR
VACCINES@AMEDD.ARMY.MIL. PLACE _TRIFOLD ORDER_ IN THE E-MAIL SUBJECT
LINE, STATE NUMBER OF DOD AVIP TRIFOLD BROCHURES NEEDED AND PROVIDE A
SHIPPING ADDRESS.
(3) DOD AVIP TRIFOLD BROCHURES CAN BE DOWNLOADED FROM THE MILVAX
WEBSITE LISTED IN PARA. 5A AND REPRODUCED IF NECESSARY.
D. COMMANDERS WILL SUPPLEMENT THE DOD AVIP TRIFOLD BROCHURE WHENEVER
POSSIBLE WITH A STANDARD DOD AVIP BRIEFING AVAILABLE ON THE MILVAX
WEBSITE CITED IN PARAGRAPH 5A.
6. ANTHRAX VACCINE ADMINISTRATION. THE FOLLOWING PROVIDES GUIDANCE FOR
HEALTHCARE PROVIDERS (E.G. PREVENTIVE MEDICINE AND PUBLIC HEALTH STAFF,
AMBULATORY CARE, ALLERGY-IMMUNOLOGY, FLIGHT MEDICINE, AND EMERGENCY
CARE) AND VACCINATORS.
A. HEALTHCARE PROVIDERS AND VACCINATORS WILL BE KNOWLEDGEABLE ON THE
FOLLOWING:
(1) DOD CLINICAL AND ADMINISTRATIVE POLICIES (REFS H AND I).
(2) BUMEDINST 6230.15A (REF G).
(3) THE DIFFERENT PERSONNEL CATEGORIES (MANDATORY AND VOLUNTARY) PER
PARAGRAPHS 2 AND 3.
(4) THE HEALTHCARE PROVIDERS BRIEF AT THE MILVAX WEBSITE
(WWW.ANTHRAX.MIL/AVIP2007).
(5) ANTHRAX VACCINE PRESCRIBING INFORMATION, AVAILABLE IN THE PACKAGE
INSERT WITH EVERY VACCINE VIAL OR AT WWW.ANTHRAX.MIL/AVIP2007.
(6) THE DOD AVIP TRIFOLD BROCHURE DATED 12 OCTOBER 2006 OR LATER.
(7) PROCEDURES FOR VACCINE ADVERSE EVENTS REPORTING SYSTEM (VAERS) AT
WWW.VAERS.ORG.
(8) DOSING SCHEDULE INFORMATION IN PARAGRAPH 6C.
(9) CONTRAINDICATIONS FOR ANTHRAX IMMUNIZATIONS AND INITIATING MEDICAL
EXEMPTION ASSESSMENTS PER REF I (E.G. PREVIOUS SERIOUS ALLERGIC
REACTIONS TO ANTHRAX IMMUNIZATIONS, PRESENCE OF CURRENT MODERATE OR
SEVERE ILLNESS, PREGNANCY, LATEX SENSITIVITY, IMMUNE-SUPPRESSIVE
CONDITIONS, GUILLAIN-BARRE SYNDROME, RECOVERY FROM ANTHRAX INFECTION IN
THE PAST).
(10) VACCINE INFORMATION SHEETS (VIS) ARE AVAILABLE AT WWW.ANTHRAX.MIL.
B. DOD POLICY IS TO DEFER ANTHRAX VACCINES DURING PREGNANCY PER REF H.
(1) ALL FEMALES OF CHILD-BEARING AGE SHALL BE ASKED ABOUT THE
POSSIBILITY OF PREGNANCY PRIOR TO RECEIVING ANTHRAX IMMUNIZATIONS.
THE CENTER FOR DISEASE CONTROL AND PREVENTION RECOMMENDS THE FOLLOWING
QUESTION BE USED ON ANY LOCALLY APPROVED SCREENING FORM _ARE YOU
PREGNANT OR IS THERE A CHANCE YOU COULD BECOME PREGNANT DURING THE NEXT
MONTH.?"
(2) IMMUNIZATION CLINICS AND PROVIDERS WILL DISPLAY A PROMINENT WRITTEN
SIGN DIRECTING WOMEN TO ALERT THE TECHNICIAN OR PROVIDER IF THEY THINK
THEY MIGHT BE PREGNANT.
(3) OFFER PREGNANCY TESTING BEFORE ANY IMMUNIZATION.
(4) IF WOMEN HAVE ANY QUESTIONS OR CONCERNS, THEY SHOULD CONSULT WITH
THEIR HEALTHCARE PROVIDER PRIOR TO RECEIVING IMMUNIZATIONS.
(5) PREGNANT WOMEN SHOULD ONLY BE VACCINATED AGAINST ANTHRAX IN UNUSUAL
CIRCUMSTANCES IF THE POTENTIAL BENEFITS OF VACCINATION OUTWEIGH THE
POTENTIAL RISKS TO THE FETUS.
C. DOD WILL ADMINISTER ANTHRAX IMMUNIZATIONS CONSISTENT WITH FDA
APPROVED DOSING SCHEDULE AND CURRENT STANDARDS OF MEDICAL PRACTICE.
(1) THE FDA-APPROVED DOSING SCHEDULE FOR ANTHRAX VACCINE IS 0, 2, AND 4
WEEKS, AND 6, 12, AND 18 MONTHS WITH ANNUAL BOOSTERS FOLLOWING
COMPLETION OF THE SIX SHOT SERIES.
(2) PERSONNEL RESUMING ANTHRAX IMMUNIZATIONS WILL CONTINUE THE DOSING
SCHEDULE WHERE THEY LEFT OFF. PER THE CENTERS FOR DISEASE CONTROL AND
PREVENTION_S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES
RECOMMENDATIONS, DO NOT REPEAT ANY DOSES IN THE SERIES RECEIVED
PREVIOUSLY OR RESTART THE SERIES.
D. COMMANDERS SHOULD DEVELOP ROUTINE PROCEDURES TO DETERMINE WHEN
PERSONNEL NEED SUBSEQUENT DOSES OF THE ANTHRAX VACCINE, UNLESS
MEDICALLY OR ADMINISTRATIVELY EXEMPT, AT THE FOLLOWING OPPORTUNITIES:
(1) DURING IN AND OUT PROCESSING TO A COMMAND, UNIT, OR TRAINING
SCHOOLS.
(2) WHEN SCREENING FOR INFLUENZA AND OTHER IMMUNIZATIONS.
(3) BASED ON ELECTRONIC TRACKING SYSTEMS (ETS) _IMMUNIZATIONS DUE_
REPORTS.
(4) DURING DEPLOYMENT READINESS PROCESSING.
(5) UPON REDEPLOYMENT.
(6) DURING BIRTH MONTH OR ANNUAL PREVENTIVE HEALTH ASSESSMENT (PHA)
MEDICAL RECORDS AUDITS.
(7) DURING OTHER ROUTINE AND PERIODIC ENCOUNTERS.
E. ALL IMMUNIZATION DATA WILL BE ENTERED IN THE MEMBER_S MEDICAL RECORD,
THE YELLOW SHOT CARD (PHS 731), AND DESIGNATED ETS THAT SUBMIT DATA TO
DEERS.
(1) CURRENTLY THOSE SYSTEMS ARE THE MEDICAL READINESS REPORTING SYSTEM
(MRRS), THE ARMED FORCES HEALTH LONGITUDINAL TRACKING APPLICATION
(AHLTA), AND THE SHIPBOARD NONTACTICAL ADP PROGRAM (SNAP) AUTOMATED
MEDICAL SYSTEM (SAMS).
(2) DOCUMENT ANY EXCEPTIONS (INCLUDING REFUSALS) USING CODES IN REFS H
AND I IN THE MEDICAL RECORD AND THE ETS.
F. CONTINUE TO EDUCATE PERSONNEL ABOUT THE SERVICES OFFERED BY THE
VACCINE HEALTHCARE SYSTEMS NETWORK (VHC).
(1) THE VHC IS A TEAM OF CLINICAL VACCINE EXPERTS WHO ASSIST MEMBERS
AND HEALTHCARE PROVIDERS WITH TREATMENT OF HEALTH PROBLEMS BEFORE AND
AFTER VACCINATIONS, ASSIST WITH MEDICAL EXEMPTIONS, AND TEACH MEMBERS
AND THEIR FAMILIES ABOUT VACCINES.
(2) THE NAVY REGIONAL VHC IS LOCATED AT NAVY MEDICAL CENTER PORTSMOUTH
VA, AND CAN BE CONTACTED AT 757-953-9150, DSN 377-9150.
(3) DOD HAS A CLINICAL CALL CENTER AVAILABLE 24 HOURS A DAY FOR ANY
QUESTIONS RELATED TO VACCINES, TOLL FREE AT 1-866-210-6469.
7. RESERVE COMPONENT (RC) PERSONNEL. IN ADDITION TO CRITERIA IN
PARAGRAPHS 2, 3, AND 4, RC PERSONNEL MUST MEET THE FOLLOWING CONDITIONS
IN ORDER TO RECEIVE ANTHRAX IMMUNIZATIONS.
A. RC PERSONNEL MUST BE IN A DUTY STATUS WHEN RECEIVING ANY DOD-
DIRECTED IMMUNIZATION.
B. AN ADVERSE REACTION TO A DOD-DIRECTED IMMUNIZATION IS A LINE OF DUTY
(LOD) CONDITION.
(1) RC PERSONNEL WHO INCUR OR AGGRAVATE ANY INJURY, ILLNESS, OR DISEASE
WHILE PERFORMING ACTIVE DUTY FOR LESS THAN 30 DAYS, OR ON INACTIVE DUTY
TRAINING ARE ENTITLED TO MEDICAL CARE APPROPRIATE FOR THE TREATMENT OF
THE INJURY, ILLNESS, OR DISEASE.
(2) WHEN RC PERSONNEL PRESENT FOR TREATMENT AT A MTF EXPRESSING BELIEF
THAT THE CONDITION FOR WHICH TREATMENT IS SOUGHT IS RELATED TO
RECEIVING A DOD-DIRECTED IMMUNIZATION DURING A PERIOD OF DUTY, THE
MEMBER MUST BE EXAMINED AND PROVIDED NECESSARY MEDICAL CARE. IT IS THE
RESPONSIBILITY OF THE TREATING FACILITY TO SUBMIT THE VAERS REPORT.
(3) WHEN TREATMENT HAS BEEN RENDERED OR THE INDIVIDUAL_S EMERGENT
CONDITION IS STABILIZED, A LINE OF DUTY (LOD) DETERMINATION WILL BE
MADE AS SOON AS POSSIBLE. FOR INJURIES, ILLNESSES, OR DISEASE UNRELATED
TO DUTY, RC MEMBERS SHOULD SEEK MEDICAL ATTENTION FROM THEIR PERSONAL
HEALTHCARE PROVIDER.
(4) RESERVE MEDICAL DEPARTMENT REPRESENTATIVES WILL ENSURE ACCURATE LOD
DATA IS ENTERED IN MRRS.
8. ANTHRAX VACCINE LOGISTICS. VACCINE DISTRIBUTION WILL BE LIMITED TO
SITES THAT HAVE SUBMITTED A REGISTRY AGREEMENT.
A. APPROVED SITES WILL DIRECTLY REQUISITION VACCINE USING U.S. ARMY
MEDICAL MATERIEL AGENCY (USAMMA) WEBSITE AT WWW.USAMMA.ARMY.MIL.
(1) INSTRUCTIONS ON ORDERING CAN BE FOUND AT
WWW.USAMMA.ARMY.MIL/VACCINES/ANTHRAX/ANTXHOME.HTM.
(2) NAVAL MEDICAL LOGISTICS COMMAND (NMLC) WILL LIAISON WITH USAMMA TO
COORDINATE THE DISTRIBUTION OF ANTHRAX VACCINE.
(3) VACCINE SHIPMENTS WILL ORIGINATE FROM THE MANUFACTURER.
(4) USAMMA DISTRIBUTION OPERATIONS CENTER (DOC) WILL NOTIFY EACH
RECEIVING ACTIVITY WITH THE SHIPMENT TRACKING NUMBER (AIR BILL NUMBER).
(5) DOD AVIP TRIFOLD BROCHURES WILL BE SHIPPED TO EACH REQUESTING UNIT
PRIOR TO VACCINE SHIPMENT.
B. REQUESTING ACTIVITIES MUST HAVE SUFFICIENT REFRIGERATION CAPACITY TO
PRESERVE VACCINE INTEGRITY, INCLUDING TEMPERATURE ALARMS AND BACK-UP
POWER CAPACITY.
(1) VACCINE MUST BE REFRIGERATED AND MAINTAINED AT TEMPERATURES BETWEEN
TWO AND EIGHT DEGREES CENTIGRADE (36 TO 46 DEGREES FAHRENHEIT).
(2) PERSONNEL MUST BE TRAINED IN COLD CHAIN MANAGEMENT PROCEDURES,
INCLUDING PROMPT REFRIGERATION OF VACCINE UPON RECEIPT.
(3) COLD CHAIN MANAGEMENT TRAINING CAN BE FOUND AT
WWW.USAMMA.ARMY.MIL/VACCINES/CCM/COLD_CHAIN_MANAGEMENT.CFM OR BY PHONE
301-619-4318 OR DSN 343-4318.
(4) THE USAMMA WEBSITE, WWW.USAMMA.ARMY.MIL, PROVIDES ADDITIONAL
GUIDANCE ON HANDLING, STORAGE, TRANSPORTATION, AND ADMINISTRATION OF
ANTHRAX VACCINE.
9. NAVY AVIP COORDINATORS ARE:
A. ACTIVE COMPONENT (AC): LCDR CATHLEEN DONOHUE, AVAILABLE AT NIPR
CATHLEEN.DONOHUE@NAVY.MIL; SIPR CATHLEEN.DONOHUE@NAVY.SMIL.MIL; OR COMM
202-762-3437, DSN 762-3437.
B. RESERVE COMPONENT (RC): HMCS SHELLEY DUNN, AVAILABLE AT NIPR
SHELLEY.DUNN@NAVY.MIL; OR COMM 703-614-4403, DSN 224-4403.
10. THE ANTHRAX VACCINE IMMUNIZATION PROGRAM REMAINS A COMMANDER_S
FORCE HEALTH PROTECTION RESPONSIBILITY. COMMANDERS WILL COMPLY WITH ALL
GUIDANCE TO PROPERLY IDENTIFY AND EDUCATE SERVICE MEMBERS AND DOD
CIVILIANS/CONTRACTORS TO BE VACCINATED, TRACK IMMUNIZATIONS, AND ENSURE
APPROPRIATE MEDICAL EVALUATION FOR ANY ADVERSE VACCINE REACTIONS.
11. RELEASED BY VADM M. P. FITZGERALD, DIRECTOR, NAVY STAFF.
BT
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