UNCLASSIFIED//

ROUTINE

R 042044Z MAY 21 MID200000824135U

FM CNO WASHINGTON DC

TO NAVADMIN

INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC

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NAVADMIN 088/21

MSGID/GENADMIN/CNO WASHINGTON DC/CNO/MAY//

SUBJ/SARS-COV-2 VACCINATION AND REPORTING POLICY UPDATE//

REF/A/DOC/DHA/DHA-IPM/13DEC2020//
REF/B/DOC/32 CFR PART 199.21/1DEC2016//
REF/C/MSG/OPNAV/161751ZDEC2020//
REF/D/MSG/OPNAV/311611ZMAR2021//
REF/E/DOC/OPNAV/22DEC2009//

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 
327/20.
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.

RMKS/

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/ 
hcp/acip-recs/vacc-specific/covid-19.html.

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 
administered.

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://mill_mrrs@navy.mil
(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) 
(https://www.med.navy.
mil/sites/nmotc/nami/arwg/Pages/AeromedicalReferenceandWaiverGuide.aspx).  
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 
guidance.
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.//

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