R 171240Z OCT 23 MID120000544408U
FM CNO WASHINGTON DC
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MSGID/GENADMIN/CNO WASHINGTON DC//
SUBJ/2023-2024 NAVY INFLUENZA VACCINATION AND REPORTING POLICY//
REF/G/DOC/OFR/32 CFR PART 199.21/01DEC2016//
NARR/REF A IS THE BUREAU OF MEDICINE AND SURGERY INSTRUCTION (BUMEDINST)
6230.15B IMMUNIZATIONS AND CHEMOPROPHYLAXIS FOR THE PREVENTION OF INFECTIOUS
REF B IS A WEEKLY CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) MORBIDITY
AND MORTALITY WEEKLY REPORT (MMWR) PREVENTION AND CONTROL OF SEASONAL
INFLUENZA WITH VACCINES, RECOMMENDATIONS FOR 2023-2024 INFLUENZA SEASON.
REF C IS THE DEFENSE HEALTH AGENCY PROCEDURAL INSTRUCTION (DHA-PI) 6025.34
GUIDANCE FOR THE DOD INFLUENZA VACCINATION PROGRAM (IVP).
REF D IS THE MEDICAL MATERIAL QUALITY CONTROL MESSAGE 2024-2025 INFLUENZA
VIRUS VACCINE CALL FOR REQUIREMENTS.
REF E IS THE DEPARTMENT OF DEFENSE INSTRUCTION (DODI) 6205.02 DEPARTMENT OF
DEFENSE (DOD) IMMUNIZATION PROGRAM, ADDRESSING RESPONSIBILITIES AND
PROCEDURES FOR ESTABLISHING A UNIFORM DOD IMMUNIZATION PROGRAM.
REF F IS DODI 6025.19 INDIVIDUAL MEDICAL READINESS PROGRAM, ADDRESSING
RESPONSIBILITIES AND PROCEDURES FOR MONITORING AND MAINTAINING INDIVIDUAL
REF G IS THE OFFICE OF THE FEDERAL REGISTER TITLE 32 OF THE CODE OF FEDERAL
REGULATIONS PART 199.21 (32 CFR PART 199.21), CIVILIAN HEALTH AND MEDICAL
PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS) TRICARE PHARMACY BENEFITS
POC/LCDR HELEN BARNHART/BUMED FALLS CHURCH VA/(703) 681-9474/EMAIL:
RMKS/1. Per references (a) through (g), this message outlines the 2023-2024
Navy influenza vaccination and reporting policy. Influenza is a contagious
acute febrile respiratory viral infection, which can cause mild to severe
illness, possibly resulting in hospitalization or death. Influenza has the
potential for widespread transmission through person-to-person contact and
can cause epidemics within military populations, especially under conditions
of crowding such as initial entry training or aboard ships, per reference
(a). Influenza has the potential to adversely impact Navy force readiness and
2. Influenza Vaccination and Reporting.
a. Influenza Disease Prevention. Vaccination is the most effective
measure to reduce risk of influenza by enhancing force immunity. Maintaining
a clean work environment, optimizing good hygiene practices such as
cough/sneeze and hand hygiene, mask wearing immediately after symptom onset,
and managing workforce exposure (e.g., social distancing, teleworking, and
taking appropriate sick leave) are additional methods to further reduce the
spread of influenza that should be implemented as mission allows. Detailed
respiratory disease prevention and control recommendations may be found in
b. Influenza Vaccine. Two influenza vaccines, Northern Hemisphere (NH)
and Southern Hemisphere (SH), are available based on service member location
and timing requirements as described in references (b) and (c). The 2023-
2024 DoD influenza season vaccine supply will consist of quadrivalent
injectable vaccines. Intranasal vaccine will not be provided through the
central ordering process but will be available through direct consultation
with the Defense Logistics Agency (DLA) if necessary.
c. Influenza Vaccine Priority. U.S. Navy ships, operational assets, and
training commands have been identified by the DoD and Department of the Navy
(DoN) as vaccine priority groups for the 2023-2024 influenza season.
d. Influenza Vaccine Ordering and Distribution.
(1) Operational Forces Support Division (OFSD), Naval Medical
Readiness Logistics Command Detachment (NMRLC-Det), Fort Detrick is
responsible for ordering and distributing influenza vaccine for all Navy and
Marine Corps activities per reference (c). Additional quantities required
must be coordinated with the Vaccine Information and Logistics System (VIALS)
helpdesk at: email@example.com.
(2) VIALS is the online requisition system for seasonal influenza
vaccine. VIALS tracks requisitioned vaccine electronically via Military
Standard Requisitioning and Issuing Procedure (MILSTRIP) from requisition
to receipt. The VIALS Web site is common access card enabled and can be
found at https://gov_only.med.ds.osd.mil/int_code03/vials/.
(3) All Defense Health Agency (DHA) Military Treatment Facilities
(MTFs) will submit the influenza requirements for their MTFs and the Branch
Health Clinics that they support into the U.S. Army Medical Materiel Agency
ordering portal, per reference (d).
(4) All Fleet, United States Marine Corps Reserve units, and Navy
Reserve commands will continue to submit their requirements in VIALS, per
e. 2024-2025 Influenza Vaccine Requirements. Reference (d) has
established the suspense date for the call for 2024-2025 influenza virus
vaccine requirements as 22 September 2023.
f. Influenza Vaccine Shipping. All commands will verify their correct
shipping address and two (2) points of contact information in VIALS to ensure
prompt delivery. Navy Fleet afloat will validate their shipping locations,
timeframes, and contact information.
g. Influenza Vaccine Integrity. All Influenza vaccine shipments include
temperature monitors. All monitors must be returned to the Defense Logistics
Agency-Troop Support Medical (DLA-TSM) cold chain office after receipt,
regardless of alarm status, per the included instructions and shipping
(1) No Alarm Status. The vaccine is ready for immediate use.
(2) Alarmed Status. Do not administer vaccine. Segregate the
vaccine in the refrigerator with a sign saying "DO NOT USE", return
temperature monitor to DLA-TSM, and await disposition.
h. Influenza Vaccine Exercise. Influenza vaccination campaigns may be
used to exercise and evaluate mass vaccination scenarios in coordination with
Emergency Management personnel. These coordinated mass vaccination campaign
exercises provide vaccinations rapidly and efficiently to protect the maximum
number of susceptible persons. Process improvements are made to delivery and
reporting procedures based on lessons learned.
i. Vaccine Delivery. Due to vaccine demand and manufacturer
requirements, complete vaccine delivery may be incremental throughout the
season. Incremental deliveries may test the ability to conduct rapid and
complete mass vaccination exercises.
j. Influenza Vaccination Compliance.
(1) Navy Military Personnel. Seasonal influenza vaccination is mandatory for
all DoD uniformed personnel who are not medically or administratively exempt,
per references (a), (c), (e), and (f). Any refusal to receive the influenza
vaccine, if a request for exemption has been denied, will constitute a
failure to obey a lawful order and may be punishable under the Uniform Code
of Military Justice and/or result in administrative action. Prior to
receiving the influenza vaccine, Navy Active and Reserve Component personnel
will have access to healthcare providers to address questions or concerns
with influenza vaccination. Commands must consult with the servicing Staff
Judge Advocate General for additional guidance on influenza vaccination non-
(2) Navy Civilian Personnel. Influenza vaccination is required for
all civilian healthcare personnel as per references (c) and (e) and is
strongly encouraged for all other Navy civilian employees.
(3) TRICARE Beneficiaries. Reference (g) authorizes retail network
pharmacies to administer the seasonal influenza vaccine. TRICARE
beneficiaries may receive influenza vaccinations with no co-pay at authorized
retail network pharmacies. Beneficiaries are encouraged to contact the
pharmacy regarding age restrictions as some pharmacies do not administer the
influenza vaccine to individuals younger than 18 years of age.
k. 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) Shore-based commands will 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). Point of contact: MRRS Program Office at e-mail:
firstname.lastname@example.org. Ship-based commands may utilize Navy Medicine Online
(NMO) or Shipboard Non-Tactical ADP Program (SNAP) Automated Medical System
(SAMS) to populate MRRS.
(2) Commands must ensure that documentation of influenza vaccine
administration is coded to accurately reflect the type of vaccine given.
(3) Afloat units will enter influenza immunizations into the SAMS /
Theater Medical Information Program for subsequent transfer to MRRS.
(4) All personnel who receive the vaccination from a retail network
pharmacy must provide documentation of vaccination no later than the next
duty or drill day to ensure compliance is appropriately recorded in their
electronic health records and MRRS. The following information will need to be
provided, at a minimum: date vaccine was administered, vaccine name or code,
manufacturer, expiration date, and lot number.
(5) Vaccination Timeline..
(a) Due to the risk of infection transmission within the unit and
impact on operations, it is imperative that the vaccine be given with as
minimal delay as possible. Active duty units have 72 hours (three business
working days) following receipt of the vaccine to document, begin
administering, and report vaccination. The 72-hour requirement begins
immediately only if the temperature monitor is in "no alarm" status upon
receipt; if in "alarmed" status the timed requirement begins once / if the
vaccine is cleared for use by DLA-TSM. If the 72-hour requirement cannot be
met, unit situation reports will be submitted to the respective Immediate
Superior in Command and Type Commanders. Situation reports are not required
if the temperature monitor is in alarmed status and the unit is awaiting
disposition from DLA-TSM.
(b) As Reserve Component Command schedules vary, NMRLC-Det and
DLA-TSM will coordinate to make every effort for the vaccine to arrive the
week of a drill weekend. Units have one drill weekend following receipt of
the vaccine to document, administer, and report vaccination if the
temperature monitor is in a "no alarm" status. If in "alarmed" status, the
timed requirement begins once / if the vaccine is cleared for use by DLA-TSM.
(6) Per paragraph 2.k, uniformed member compliance must be tracked in
MRRS. If desired, installations and MTFs may also use the Navy Family
Accountability and Assessment System (NFAAS) to conduct a Pandemic Influenza
response exercise in conjunction with the seasonal influenza vaccine program.
l. Navy Goals and Performance Standards.
(1) To ensure force medical readiness before peak influenza season,
all Navy operational units and Navy Medicine Readiness and Training Commands
/ Units will administer the 2023-2024 influenza vaccination to all eligible
Active and Reserve Component members (those without an approved medical or
administrative exemption) by 31 December 2023. Complete vaccine access will
be provided for all Navy family members (includes dependents, other
beneficiaries, and DoN civilians). Active coordination between command
leadership, public affairs officers, and medical personnel is necessary to
(2) Influenza Vaccination Performance Standards. The following goals
will be monitored:
(a) Navy VIALS reports 100 percent of shipped vaccine received
onboard by fleet and Navy units by 1 December 2023.
(b) MRRS reports 100 percent of required Active and Reserve
Component personnel receive the vaccine by 31 December 2023. Commands will
coordinate with the servicing MTF to align command-wide vaccination exercises
with Navy vaccination goals. Medical personnel at servicing MTFs will
promptly report vaccinations in MRRS.
m. DHA-Immunization Healthcare Division (DHA-IHD).
(1) The DHA-IHD provides an electronic resource center for vaccine
preventable diseases at https://www.health.mil/Military-Health-Topics/Health-
Readiness/Immunization-Healthcare. It contains guidance
(in the form of documents and templates) on vaccination storage and handling
(to include cold chain management tools), vaccine administration (to include
standing orders, vaccine product guides, and Vaccine Information Sheets
[VISs]), and adverse event reporting.
(2) The DHA-IHD 2023-2024 Seasonal Influenza Resource Center for
Care Personnel can be found at https://www.health.mil/Military-Health-
(3) The DHA-IHD Immunization Healthcare Support Center can be reached
at: 1-877-GET-VACC (1-877-438-8222);
or via email at: email@example.com.
The Support Center can provide clinical consultation, to include assistance
with questions regarding vaccine screening and potential vaccine-related
3. Released by Mr. Andrew S. Haeuptle, Director, Navy Staff.//