UNCLASSIFIED

ROUTINE

R 191759Z AUG 16

FM CNO WASHINGTON DC

TO NAVADMIN

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NAVADMIN 183/16

SUBJ/2016-2017 NAVY INFLUENZA VACCINATION AND REPORTING POLICY//

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

REF/A/INST/DOD/09JUN2014//

REF/B/MEMO/OASD (HA)/04APR2008//

REF/C/DOC/32 CFR PART 199/10DEC2009//

NARR/REF A IS THE DODI 6025.19 INDIVIDUAL MEDICAL READINESS ADDRESSING 
RESPONSIBILITIES AND PROCEDURES FOR MONITORING AND ON INDIVIDUAL MEDICAL 
READINESS (IMR).  REF B IS THE ASSISTANT SECRETARY OF DEFENSE FOR HEALTH 
AFFAIRS MEMO MANDATING DEPARTMENT OF DEFENSE (DOD) CIVILIAN HEALTHCARE WORKER 
INFLUENZA IMMUNIZATIONS.
REF C 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/HMCM DIANNE SEYMOUR/LOC:  WASH DC/(703) 614-9299/
EMAIL: dianne.seymour@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 death 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.  Injectable vaccine will be available for the 
2016-2017 influenza season.
    c.  Influenza Vaccine Priority.  U.S. Navy ships and fleet assets have 
been identified by the Defense Logistics Agency (DLA) as a vaccine priority 
group for the 2016-2017 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 website 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 VIALS.  Navy influenza vaccine is centrally funded.
    f.  Influenza Vaccine Shipping.  Vaccine shipping schedule is 
Monday/Friday to Outside the Contiguous United States (OCONUS) locations and 
Monday/Tuesday/Wednesday to Contiguous United States
(CONUS) locations to ensure receipt on the receiving end.  DLA Troop Support 
Medical (DLA-TSM) does not ship on holidays or weekends, over holidays, and 
will only ship on Thursdays on a case-by-case basis.
    g.  Influenza Vaccine Integrity:
        (1) Active Duty 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 envelopes.
            (a) No Alarm Status.  Units have 72 hours (three business working 
days) from the time of receipt of vaccine 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 of vaccine 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.
    h.  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.
    i.  Influenza Vaccination Compliance.
        (1) Navy Military Personnel.  The seasonal influenza vaccination is 
mandatory for all Department of Defense (DoD) uniformed personnel who are not 
medically or administratively exempt per reference (a).  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 (b).  
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 (c) 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.
    j.  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 access to MRRS based on their unit 
identification code (UIC) by submitting a system access authorization request 
available at:
https://mrrs.sscno.nmci.navy.mil/mrrs/secure/welcome.m (note:  MRRS web 
address is case sensitive).  Point Of Contact/MRRS program
Office/email:  mrrspo@navy.mil/(800) 537-4617/(504) 697-7070/
DSN: 647-7070.
        (2) Commands must ensure that documentation of influenza vaccine 
administration is coded to accurately reflect the injectable type of vaccine 
given.
        (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 the next duty or drill day to ensure compliance is appropriately 
recorded in MRRS.
        (5) Units have 72 hours (three business working days) from the time 
of receipt of vaccine to document, administer, and report vaccination.  If 
the 72 hour requirement cannot be met, unit situation reports (SITREP) will 
be submitted to the respective Immediate Superior in Command (ISIC) and Type 
Commanders.  SITREPs are not required if the temperature monitor is in 
alarmed status and the unit is merely awaiting disposition from DLA-TSM.
    k.  Navy Goals and Performance Standards.
        (1) All Navy operational units and MTFs will administer the
2016-2017 flu vaccination to meet 90 percent vaccination by
15 December 2016 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 2016.
            (b) MRRS reports 90 percent of active and reserve component 
vaccinated by 15 December 2016.  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 R. L. Thomas, Director, Navy Staff//

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