UNCLASSIFIED//

ROUTINE

R 181847Z OCT 18

FM CNO WASHINGTON DC

TO NAVADMIN

INFO CNO WASHINGTON DC

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NAVADMIN 255/18

PASS TO OFFICE CODES:
INFO CNO WASHINGTON DC//DNS//

MSGID/GENADMIN/CNO WASHINGTON DC/DNS/OCT//

SUBJ/2018-2019 NAVY INFLUENZA VACCINATION AND REPORTING POLICY//

REF/A/DOC/DOD/9JUN2014//

REF/B/MEMO/DHA/27JUL2018//

REF/C/MEMO/OASD(HA)/4APR2008//

REF/D/DOC/32 CFR PART 199.21/1DEC2016//

NARR/REF A IS THE DODI 6025.19 INDIVIDUAL MEDICAL READINESS ADDRESSING 
RESPONSIBILITIES AND PROCEDURES FOR MONITORING AND ON INDIVIDUAL MEDICAL 
READINESS.  REF B IS THE DEFENSE HEALTH AGENCY
2018-2019 SEASONAL INFLUENZA VACCINATION PROGRAM GUIDANCE.  REF C IS THE 
ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS MEMO MANDATING DEPARTMENT 
OF DEFENSE (DOD) CIVILIAN HEALTH CARE PERSONNEL INFLUENZA IMMUNIZATIONS.  REF 
D IS 32 CFR PART 199.21, CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED 
SERVICES (CHAMPUS)
/TRICARE:  TRICARE PHARMACY BENEFITS PROGRAM.// POC/CDR CAROLYN REIMANN/FALLS 
CHURCH VA/(703) 681-9120/EMAIL:
carolyn.a.reimann.mil@mail.mil//

RMKS/1.  Influenza or "flu" has the potential to adversely impact Navy force 
readiness and mission execution.  The Centers for Disease Control and 
Prevention estimates influenza has resulted in between approximately 9.2 
million and 35.6 million illnesses; between 140
,000 and 710,000 hospitalizations; and between 12,000 and 56,000 deaths 
annually.

2.  Influenza Vaccination and Reporting
    a.  Influenza Disease 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, teleworking, and sick leave) are 
effective methods to reduce the risk of spreading influenza.
    b.  Influenza Vaccine.  The 2018-2019 Department of Defense (DoD) 
influenza season vaccine supply will be comprised of injectable vaccines.
Intranasal vaccine will not be provided through the central ordering process, 
but it will be available by special request.
    c.  Influenza Vaccine Priority.  U.S. Navy ships and fleet assets have 
been identified by the DoD as a vaccine priority group for the 2018-2019 
influenza season.
    d.  Influenza Vaccine Ordering.  The Vaccine Information and Logistics 
System (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.  Navy influenza vaccine is centrally funded.  The VIALS Web site is 
common access card enabled:  
https://gov_only.nmlc.med.navy.mil/int_code03/vials/.
    e.  Influenza Vaccine Shipping.  All commands will verify their correct 
shipping address and point of contact information in VIALS to ensure prompt 
delivery.  To ensure receipt is available on the receiving end, the shipping 
schedule is Monday and Friday to Outside the Contiguous United States 
locations and Monday through Wednesday to Contiguous United States locations.  
The Defense Logistics Agency Troop Support Medical (DLA-TSM) does not ship on 
holidays or weekends and will only ship on Thursdays on a case-by-case basis.
    f.  Influenza Vaccine Integrity
        (1) Temperature Monitors.  All Influenza vaccine shipments include 
temperature monitors.
All monitors must be returned to the DLA-TSM cold chain office after receipt 
per the included instructions and shipping materials.
            (a) No Alarm Status.  The vaccine is ready for immediate use.
            (b) Alarmed Status.  Do not administer vaccine.  Suspend use of 
the vaccine and place in a refrigerator.  Return the temperature monitor, 
along with the completed instruction sheet, to DLA-TSM for vaccine 
disposition.
    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.  Process improvements are 
made to delivery and reporting procedures based on lessons learned.
    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 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 influenzavaccination.  Commands must 
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 healthcare personnel 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 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.
    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) 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 and e-mail:  mrrspo@navy.mil 
(800)537-4617 / (504) 697-7070 / DSN:  647-7070.
Ship-based commands may utilize Navy Medicine Online (NMO) or Shipboard Non-
Tactical Automated Data Processing 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, 
whether injectable or nasal.
        (3) Afloat units will enter influenza immunizations into the 
Shipboard Automated Medical System/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 to their command no later 
than the next duty or drill day to ensure compliance is appropriately 
recorded in their electronic health records and MRRS.
        (5) Vaccination Timeline
            (a) Active duty units have 72 hours (three business working days) 
following receipt of the vaccine to document, administer, 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, shipment dates 
must be coordinated 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.i, 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.
    j.  Navy Goals and Performance Standards
        (1) To ensure force medical readiness before peak influenza season, 
all Navy operational units and MTFs will administer the 2018-2019 influenza 
vaccination to exceed the 90 percent vaccination goal by 15 December 2018 for 
Active and Reserve Components.  Complete vaccine access will be provided for 
all 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 goals 
will be monitored:
            (a) Navy VIALS reports 100 percent of shipped vaccine received 
onboard by fleet and Navy units by 1 December 2018.
            (b) MRRS reports 90 percent of Active and Reserve Component 
vaccinated by 15 December 2018.  Commands will coordinate with the servicing 
MTF to align command-wide vaccinations with Navy vaccination goals.  Medical 
personnel at servicing MTFs will promptly report vaccinations in MRRS.

3.  Released by Mrs. Steffanie B. Easter, Director, Navy Staff.//

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