UNCLASSIFIED// ROUTINE R 042044Z MAY 21 MID200000824135U FM CNO WASHINGTON DC TO NAVADMIN INFO SECNAV WASHINGTON DC CNO WASHINGTON DC BT UNCLAS NAVADMIN 088/21 MSGID/GENADMIN/CNO WASHINGTON DC/CNO/MAY// SUBJ/SARS-COV-2 VACCINATION AND REPORTING POLICY UPDATE// REF/A/DOC/DHA/DHA-IPM/13DEC2020// REF/B/DOC/32 CFR PART 199.21/1DEC2016// REF/C/MSG/OPNAV/161751ZDEC2020// REF/D/MSG/OPNAV/311611ZMAR2021// REF/E/DOC/OPNAV/22DEC2009// NARR/REF A IS THE DEFENSE HEALTH AGENCY INTERIM PROCEDURES MEMORANDUM 20-004 DEPARTMENT OF DEFENSE (DOD) CORONAVIRUS DISEASE 2019 (COVID-19) VACCINATION PROGRAM IMPLEMENTATION PROGRAM. REF B IS 32 CFR PART 199.21, CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS)/TRICARE: TRICARE PHARMACY BENEFITS PROGRAM. REF C IS THE SARS-COV-2 VACCINATION AND REPORTING POLICY, VERSION 1, NAVADMIN 327/20. REF D IS THE SARS-COV-2 VACCINATION AND REPORTING POLICY, VERSION 1 (UPDATE 1), NAVADMIN 070/21. REF E IS OPNAVINST 3100.6 SERIES GUIDANCE, POLICY, AND INSTRUCTIONS FOR SPECIAL INCIDENT REPORTING. RMKS/ 1. References (c) and (d) are cancelled. The SARS-CoV-2 virus and the disease it causes, COVID-19, have disrupted Navy mission execution. The most effective strategy for maintaining mission capability is to vaccinate the force. This NAVADMIN lays out policy guidance for vaccination efforts and subsequent reporting requirements. 2. Specific Policy Guidance. 2.a. Coordination. Military Treatment Facilities (MTFs) will coordinate ordering and administration of vaccines with their supported local units and other eligible populations. 2.b. Emergency Use Authorization (EUA). While authorized under a Food and Drug Administration (FDA) EUA or Expanded Availability (EA), the vaccination is voluntary for service members. 2.c. Recipient Awareness. While under EUA/EA, MTFs will make vaccine recipients aware the FDA has authorized emergency use of the vaccine and ensure recipients understand the known benefits and potential risks, as well as the extent to which such benefits and risks are unknown. If the prospective recipient expresses concern about receiving the vaccine, the MTF will inform recipients of available alternatives and risks. While under EUA/EA, members receiving the vaccine will sign a consent form. 2.d. Other COVID-19 Mitigation Measures. Vaccinated personnel shall comply with Centers for Disease Control and Prevention (CDC) and higher headquarters COVID-19 mitigation guidance. 3. Operational Guidance. 3.a. COVID-19 Vaccine Incident Reporting. Report COVID-19 vaccine-related events in accordance with standard reporting procedures identified in reference (e). Specifically, COVID-19 related events that would not normally trigger an incident report (i.e. lost vaccination doses, vaccinated individual subsequently diagnosed with COVID-19, adverse reaction to vaccine), are no longer reportable unless the incident falls into an existing category within reference (e). 3.b. Timing. Two dose series SARS-CoV-2 vaccines are separated by 21 (Pfizer) or 28 days (Moderna). Commanders must ensure second dose timing is planned to support operational commitments prior to initiating the sequence. If operational limitations require, second doses may be administered within -4 to +14 days of the targeted second dose day. Individuals should not be deployed while awaiting a second dose if the vaccine, by the same manufacturer, is not available at the destination. 3.c. Reserve Component (RC) Forces. Navy Operational Support Centers (NOSCs)/Navy Reserve Activities (NRAs) will coordinate with the nearest MTF to vaccinate Navy Reserve Members. Where an MTF is not available, members should receive their vaccination from a civilian or local vaccination program. RC members will provide vaccination documentation received from civilian or local vaccination programs to NOSC medical staff for documentation in the Medical Readiness Reporting System (MRRS). NOSC plans for vaccinating Reservists must account for the applicable delay between doses stipulated by the vaccine manufacturer. 3.d. Navy Civilian Personnel. COVID-19 vaccinations are available for all Navy civilian employees. 3.e. TRICARE Beneficiaries. COVID-19 vaccinations are available for all eligible TRICARE beneficiaries. MTFs will follow current CDC guidance for vaccinating younger dependents. 3.f. Vaccination on the Economy. Reference (b) authorizes retail network pharmacies to administer vaccines. TRICARE beneficiaries may receive COVID-19 vaccinations with no co-pay at DoD MTFs and authorized retail network pharmacies as per reference (a). 4. Medical Guidance. 4.a. Fully or partially vaccinated individuals who experience COVID-19 symptoms outside the expected side effects should be treated and isolated in accordance with CDC guidance and clinical practice guidelines. 4.b. Side Effects. Medical personnel shall explain known potential side effects of the vaccine to the patient prior to administering the vaccine. 4.c. Choice. If available, MTFs should be prepared to offer an alternate EUA approved COVID-19 vaccine to persons who are hesitant to receive a particular vaccine from one manufacturer or another. 4.d. Co-Administration Guidance. Administration of COVID-19 vaccines with other vaccines must be done in accordance with the current Advisory Council on Immunization Practices (ACIP) guidelines: https://www.cdc.gov/vaccines/ hcp/acip-recs/vacc-specific/covid-19.html. 4.e. Personnel Administering Vaccines. Only trained and qualified medical personnel, working within their scope of practice, will administer the COVID- 19 vaccine per reference (a). COVID-19 vaccination staff will complete the CDC and manufacturer educations modules: CDC COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Professionals (https://www2.cdc.gov/vaccines/ed/covid19/SHVA/index.asp) and the online training module provided by each manufacturer for the products that will be administered. 4.f. Documenting COVID-19 Vaccination. MRRS will be the system of record for individual vaccination status. All COVID-19 vaccinations, exemptions, or deferrals shall also be documented in MRRS. Documentation may occur through the Electronic Health Record (EHR). Shore-based commands or representatives may 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). MRRS program office contact information: https://mill_mrrs(at)navy.mil (800) 537-4617 / (504) 697-7070/ DSN: (312) 647-7070. Ship-based commands may use Navy Medicine Online (NMO) or Shipboard Non-Tactical Automated Data Processing Automated Medical System (SAMS) to populate MRRS. 4.f.1. All personnel who receive the vaccination from a retail network pharmacy must provide documentation of vaccination no later than the next work day (or next drill day for Reserve personnel) to ensure vaccination is recorded in MRRS and the Electronic Health Record (EHR). 4.g. Duty in a Flight Status. The NATOPS Manual (CNAF M-3710.7) requires a 12-hour grounding period following immunizations unless otherwise specified in the current Aeromedical Reference and Waiver Guide (ARWG) (https://www.med.navy. mil/sites/nmotc/nami/arwg/Pages/AeromedicalReferenceandWaiverGuide.aspx). The ARWG now covers nucleic acid and live non-replicating viral vector SARS- CoV-2 vaccines with a recommended self-limited grounding period of 48-hours after any dose in the series to assess for onset of reactions and side effects such as fatigue, headache, myalgia, nausea, and fever. The development or presence of any systemic side effect during these 48-hours requires extending the self-limited grounding for a total of 72-hours, regardless of when effects resolve, to allow for full recovery. If systemic side effects persist for greater than 72-hours, any personnel in a flight duty status should see their Aerospace Medicine provider for evaluation. The presence and severity of symptoms may require the grounding of some personnel for greater than 72-hours. 4.h. Dive Status, Undersea, and Special Operations. Nucleic acid and live non-replicating viral vector SARS-CoV-2 vaccines are covered by this guidance. High-risk activities or operations should be limited for 48-hours after any dose in the series to assess onset of reactions and systemic side effects to include, but not limited to fatigue, headache, myalgia, nausea, and fever. The development or presence of any systemic side effects during these 48- hours requires extending the limitation of high risk activities and duties for a total of 72-hours, regardless of when symptoms resolve, to allow for full recovery. If systemic side effects persist for greater than 72-hours, personnel should seek evaluation by an Undersea Medical Officer or appropriate medical authority. 5. Released by VADM P. G. Sawyer, Deputy Chief of Naval Operations for Operations, Plans and Strategy, OPNAV N3/N5.// BT #0001 NNNN UNCLASSIFIED//