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MSGID/GENADMIN/CNO WASHINGTON DC/DNS/AUG//

SUBJ/2014-2015 NAVY INFLUENZA VACCINATION AND REPORTING POLICY//

REF/A/INST/DOD/02OCT2013//
REF/B/MEMO/OASD/09JUL2014//
REF/C/MEMO/OASD (HA)/04APR2008//
REF/D/DOC/32 CFR PART 199/10DEC2009//
NARR/REF A IS DODI 6025.19 INDIVIDUAL MEDICAL READINESS ADDRESSING 
RESPONSIBILITIES AND PROCEDURES FOR MONITORING AND ON INDIVIDUAL MEDICAL 
READINESS (IMR).  REF B IS (OASD (HA)) GUIDANCE FOR THE USE OF INFLUENZA 
VACCINE FOR THE 2014-2015 INFLUENZA SEASON. REF C IS THE ASSISTANT SECRETARY 
OF DEFENSE FOR HEALTH AFFAIRS MEMO, MANDATING DEPARTMENT OF DEFENSE (DOD) 
CIVILIAN HEALTHCARE WORKER INFLUENZA IMMUNIZATIONS.  REF D IS 32 CFR PART 
199.21, CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES 
(CHAMPUS)/TRICARE: INCLUSION OF RETAIL NETWORK PHARMACIES AS AUTHORIZED 
TRICARE PROVIDERS FOR THE ADMINISTRATION OF TRICARE COVERED VACCINES.//
POC/LCDR PATRICIA SKINNER/LOC:  WASH DC/(703)571-2952/EMAIL:
patricia.skinner@navy.mil//

RMKS/1. Influenza or "flu" has the potential to adversely impact Navy force 
readiness and mission execution. Influenza results in more than 25 million 
reported cases, 150,000 hospitalizations for serious complications and 
approximately 24,000 deaths each year in the United States.

2.  The following influenza vaccination and reporting policy is promulgated:
    a.  Influenza Prevention. Vaccination is the primary method to reduce 
risk of influenza by enhancing force immunity. Maintaining a clean work 
environment, good hygiene practices, and managing workforce exposure (e.g., 
social distancing, tele-working, sick leave, etc.) are effective methods to 
reduce the risk of spreading influenza.
    b.  Influenza Vaccine. Both injectable and intranasal vaccines will be 
available for the 2014-2015 influenza seasons.
    c. Influenza Vaccine Priority. US Navy ships and fleet assets have been 
identified by the Defense Logistics Agency (DLA) as a vaccine priority group 
for the 2014-2015 Influenza Season.
    d.  Influenza Vaccine Requisitions. The Navy on-line Vaccine Information 
and Logistics System (VIALS) is the requisition system tool for seasonal 
influenza vaccines. VIALS is used to individually track requisitioned 
vaccines via Military Standard Requisitioning and Issuing Procedures and 
simplify vaccine requisitions to enable electronic tracking of vaccine orders 
from requisition to receipt. The VIALS web site is common access card (CAC) 
enabled. Please visit: https://gov_only.nmlc.med.navy.mil/int_code03/vials/.
    e.  Influenza Vaccine Ordering. Navy influenza vaccine is batch-ordered 
by Naval Medical Logistics Command (NMLC) from the DLA using command 
requirements in Navy VIALS. Navy influenza vaccine is centrally funded vice 
individual Navy command funded.
    f.  Influenza Vaccine Integrity:
        (1) Active Duty Commands. All shipments will arrive with temperature 
monitors. Monitors must be returned to the Defense Logistics Agency Troop 
Support Medical (DLA-TSM) Cold Chain office, regardless of alarm status. 
Temperature monitors must be shipped in accordance with the provided 
instructions and shipping envelopes.
            (a) No Alarm status. Units have 72 hours (three business working 
days) from the time of receipt to document, administer, and report 
vaccination. The 72 hour (three business working days) requirement begins 
immediately only if the temperature monitor is a No Alarm upon receipt.
            (b) Alarmed status. Do not administer vaccine and suspend the 
vaccine in your refrigerator, as instructed. Return the temperature monitor, 
along with the completed instruction sheet, to DLA-TSM for approval or 
disapproval to use the vaccine. The 72 hour requirement does not begin until 
the vaccine has been determined to be suitable for use by DLA-TSM.
        (2) Reserve Component commands. All shipments will arrive with 
temperature monitors. Monitors must be returned to the DLA-TSM Cold Chain 
office, regardless of alarm status. Temperature monitors must be shipped in 
accordance with the provided instructions and shipping envelope.
            (a) No Alarm status. Units have one drill weekend from the time 
of receipt to document, administer, and report vaccination. The one drill 
weekend requirement begins immediately only if the temperature monitor is a 
No Alarm upon receipt.
            (b) Alarmed status.  Do not administer vaccine and suspend the 
vaccine in your refrigerator, as instructed. Return the temperature monitor, 
along with the completed instruction sheet, to DLA-TSM for approval or 
disapproval to use the vaccine. Reserve units will have one drill weekend 
from the time the vaccine is determined to be suitable for use by DLA-TSM.
    g.  Influenza Vaccine Exercise. Previous influenza seasons have been used 
to exercise and evaluate mass vaccination scenarios. These coordinated mass 
vaccination campaigns provide rapid and efficient vaccinations to protect the 
maximum number of susceptible persons. Based on lessons learned, process 
improvements are made to delivery and reporting procedures.
    h.  Influenza Vaccination Compliance.
        (1) Navy military personnel. The seasonal influenza vaccination is 
mandatory for all DoD uniformed personnel who are not medically or 
administratively exempt per references (a) and (b). Any refusal to receive 
the influenza vaccine will constitute a failure to obey a lawful order and 
may be punishable under the Uniform Code of Military Justice (UCMJ) and/or 
result in administrative action. Prior to receiving the influenza vaccine, 
Navy Active/Reserve Component personnel shall have access to healthcare 
providers to discuss objections or concerns with influenza vaccination.  
Commands should consult with the servicing staff Judge Advocate General for 
additional guidance on influenza vaccination non-compliance.
        (2) Navy civilian personnel.  Mandatory influenza vaccination is a 
condition of employment for all civilian health care workers providing direct 
patient care in DoD medical treatment facilities (MTF), per reference (c). 
Influenza vaccination is mandatory for all civilians where it is written in 
their position description as a condition of employment. Other Navy civilian 
personnel are highly encouraged to receive influenza vaccinations.
        (3) Tricare beneficiaries.  reference (d) authorizes retail network 
pharmacies to administer the seasonal influenza vaccine. Tricare 
beneficiaries may receive influenza vaccination with no co-pay at a retail 
network pharmacy offering vaccines. Beneficiaries are encouraged to contact 
the pharmacy regarding age restrictions as some pharmacies do not administer 
the flu vaccine to individuals less than 18 years of age.
    i.  Influenza Vaccination Reporting. Active and Reserve Component Navy 
force vaccination administration compliance will be monitored via the Medical 
Readiness Reporting System (MRRS). Designated command personnel will access 
MRRS to track their personnel to ensure compliance.
        (1) Commands will request unit code identification based access to 
MRRS by submitting a system access authorization form available at:
https://mrrs.sscno.nmci.navy.mil/mrrs/secure/welcome.m (note:  MRRS web 
address is case sensitive). POC/MRRS program office/email:  
mrrspo@navy.mil/(901) 874-4682/DSN:  882-4682.
        (2) Commands must ensure that documentation of influenza vaccine 
administration is coded to accurately reflect the type of vaccine given 
whether injectable or nasal.
        (3) Afloat units will enter influenza immunizations into the 
Shipboard Automated Medical System (SAMS)/Theater Medical Information Program 
(TMIP) for subsequent transfer to MRRS.
        (4) All personnel who receive the vaccination from a retail network 
pharmacy must provide documentation of vaccination to the command no later 
than 24 hours (one business working day) to ensure compliance is 
appropriately recorded in MRRS.
        (5) Units have 72 hours (three business working days) from the time 
of receipt to document, administer, and report vaccination. If the 72 hour 
requirement cannot be met, unit situation reports will be submitted to the 
respective Immediate Superior in Command (ISIC) and Type Commanders. 
Situation reports are not required if the temperature monitor is in Alarmed 
status and the unit is merely awaiting disposition from DLA-TSM.
    j.  Navy Goals and Performance Standards.
        (1) All Navy operational units and MTFs will administer the 2014-2015 
flu vaccination to meet 90 percent vaccination by 15 December 2014 for Active 
and Reserve Component, and 100 percent vaccine access total for Navy family 
(includes dependents, other beneficiaries and Department of the Navy 
civilians). Active coordination between command leadership, public affairs 
officers, and medical personnel is necessary to achieve success.
        (2) Influenza vaccination performance standards. The following 
metrics will be monitored:
            (a) Navy VIALS reports 100 percent of shipped vaccine received on 
board by fleet and Navy units by 1 December 2014.
            (b) MRRS reports 90 percent of Active and Reserve Component 
vaccinated by 15 December 2014. Commands will coordinate with the servicing 
MTF to align command-wide vaccinations with Navy vaccination goals. Medical 
personnel at servicing MTFs will expeditiously report vaccinations in MRRS.

3. Released by Vice Admiral S. H. Swift, Director, Navy Staff.//

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