CLASSIFICATION: UNCLASSIFIED// ROUTINE R 171240Z OCT 23 MID120000544408U FM CNO WASHINGTON DC TO NAVADMIN INFO CNO WASHINGTON DC//DNS// BT UNCLAS NAVADMIN 250/23 PASS TO OFFICE CODES: FM CNO WASHINGTON DC//DNS// INFO CNO WASHINGTON DC//DNS// MSGID/GENADMIN/CNO WASHINGTON DC// SUBJ/2023-2024 NAVY INFLUENZA VACCINATION AND REPORTING POLICY// REF/A/DOC/BUMEDINST 6230.15B/07OCT2013// REF/B/DOC/CDC/MMWR/25AUG2023// REF/C/DOC/DHA-PI 6025.34/21AUG2020// REF/D/DOC/MMQC-23-1251/22AUG2023// REF/E/DOC/DODI 6205.02/23JUL2019// REF/F/DOC/DODI 6025.19/13JUL2022// 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 DISEASES. 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 MEDICAL READINESS. 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 PROGRAM.// POC/LCDR HELEN BARNHART/BUMED FALLS CHURCH VA/(703) 681-9474/EMAIL: HELEN.M.BARNHART.MIL(AT)HEALTH.MIL// 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 mission execution. 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 reference (b). 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: usn.detrick.nmrlc-detftdmd.list.vialhelp(at)health.mil. (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 reference (d). 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 materials. (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- compliance. (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: mill_mrrs(at)navy.mil. 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 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 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 Health Care Personnel can be found at https://www.health.mil/Military-Health- Topics/Health-Readiness/Immunization-Healthcare/Vaccine-Preventable- Diseases/Influenza-Seasonal-Northern-Hemisphere/Influenza-Resource-Center. (3) The DHA-IHD Immunization Healthcare Support Center can be reached at: 1-877-GET-VACC (1-877-438-8222); or via email at: DoDvaccines(at)mail.mil. The Support Center can provide clinical consultation, to include assistance with questions regarding vaccine screening and potential vaccine-related adverse events. 3. Released by Mr. Andrew S. Haeuptle, Director, Navy Staff.// BT #0001 NNNN CLASSIFICATION: UNCLASSIFIED//