UNCLASSIFIED// ROUTINE R 181847Z OCT 18 FM CNO WASHINGTON DC TO NAVADMIN INFO CNO WASHINGTON DC BT UNCLAS 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(AT)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(AT)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.// BT #0001 NNNN UNCLASSIFIED//