UNCLASSIFIED// ROUTINE R 311913Z AUG 21 MID200001090997U FM CNO WASHINGTON DC TO NAVADMIN INFO SECNAV WASHINGTON DC BT UNCLAS NAVADMIN 190/21 MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/AUG// SUBJ/2021-2022 NAVY MANDATORY COVID-19 VACCINATION AND REPORTING POLICY// REF/A/DOC/SECDEF/24AUG21// REF/B/ALNAV/SECNAV/302126ZAUG21// REF/C/DOC/BUMEDINST 6230.15B/7OCT13// REF/D/DOC/BUPERSINST 1730.11A/16MAR20// REF/E/DOC/MILPERSMAN 1730-020// REF/F/NAVADMIN/OPNAV/042044ZMAY21// REF/G/DOC/DHA/DHA-IPM/6MAY21// REF/H/DOC/ASD/3JUN2021// NARR/REF A IS THE SECRETARY OF DEFENSE MEMO MANDATING CORONAVIRUS DISEASE 2019 VACCINATION FOR DEPARTMENT OF DEFENSE SERVICE MEMBERS. REF B IS ALNAV 062/21, 2021-2022 DEPARTMENT OF NAVY MANDATORY COVID-19 VACCINATION POLICY. REF C IS BUMEDINST 6230.15B, IMMUNIZATIONS AND CHEMOPROPHYLAXIS FOR THE PREVENTION OF INFECTIOUS DISEASE. REF D IS BUPERSINST 1730.11A, STANDARDS AND PROCEDURES GOVERNING THE ACCOMMODATION OF RELIGIOUS PRACTICES. REF E IS MILPERSMAN 1730-020, IMMUNIZATION EXEMPTIONS FOR RELIGIOUS BELIEFS. REF F IS NAVADMIN 088/21, SARS-COV-2 VACCINATION AND REPORTING POLICY UPDATE. REF G IS DEFENSE HEALTH AGENCY INTERIM PROCEDURES MEMORANDUM 20-004, DEPARTMENT OF DEFENSE (DOD) CORONAVIRUS DISEASE 2019 (COVID-19) VACCINATION PROGRAM IMPLEMENTATION PROGRAM. REF H IS ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS MEMO, CO- ADMINISTRATION OF CORONAVIRUS DISEASE 2019 VACCINES WITH OTHER VACCINES. POC/BUMED COVID-19 CRISIS ACTION TEAM / (703) 681-1125/EMAIL: USN.NCR.BUMEDFCHVA.MBX.BUMED---2019-NCOV-RESPONSE-CELL(AT)MAIL.MIL / OPNAV COVID-19 CRISIS ACTION TEAM / (703) 571-2822 / EMAIL: OPNAV_COVID_CRISIS_RESPONSE_CELL(AT)NAVY.MIL. RMKS/1. Background. Disease modeling forecasts that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID- 19, will continue to spread throughout the remainder of 2021. Data and modeling also indicate that the available vaccines will continue to be effective against severe illness and mortality caused by COVID 19. Of note, all Navy COVID deaths have been individuals not immunized (one individual was partially vaccinated). In consideration of this persistent health and readiness threat to Navy service members, vaccination against COVID-19 is now mandatory per references (a) and (b). This NAVADMIN provides guidance regarding implementation within the Navy. 2. Policy. In accordance with references (a), (b), and this NAVADMIN, Navy service members will be fully vaccinated against COVID-19 through administration of vaccines that have received Food and Drug Administration (FDA) licensure or through the voluntary administration of vaccines under FDA Emergency Use Authorization (EUA) or World Health Organization (WHO) Emergency Use Listing. 2.a. Navy Service Members. Active duty service members, service members in the selected reserve, and service members in the Individual Ready Reserve are considered Navy service members for the purposes of this NAVADMIN. 2.b. Fully Vaccinated. Navy service members vaccinated per paragraph 2 or voluntarily immunized with a COVID-19 vaccine under FDA EUA or WHO Emergency Use Listing in accordance with applicable dose requirements prior to, or after, the establishment of this policy are considered fully vaccinated. Navy service members are considered fully vaccinated two weeks after completing the second dose of a two-dose COVID-19 vaccine or two weeks after receiving a single dose of a one-dose COVID-19 vaccine. Booster shots are still under evaluation and will be addressed via separate message. 2.c. Coordination. Military Treatment Facilities (MTFs) will coordinate ordering, distributing, and administering vaccines, along with their supported activities, units, and other eligible populations. 2.d. COVID-19 Disease Prevention. Vaccination has proven to be the most effective defense against serious illness caused by COVID-19. Maintaining a clean work environment, good hygiene practices including cough/sneeze etiquette, and managing workforce exposure (e.g., social distancing, teleworking, and sick leave) also continue to be effective tools in reducing the spread of COVID-19. 3. COVID-19 Vaccination Administering Requirements and Reporting 3.a. COVID-19 vaccination is mandatory for all DoD service members who are not medically or administratively exempt per references (c), (d), and (e). Navy service members who are not medically or administratively exempt shall be fully vaccinated against COVID-19 as defined in paragraph 2.b above. 3.b. Active duty Navy service members will be fully vaccinated within 90 days from the date of reference (b). Ready Reserve Navy service members will be fully vaccinated within 120 days from the date of reference (b). New accessions will be fully vaccinated as soon as practicable following service entry. 3.c. This NAVADMIN constitutes a lawful order. Refusal to be fully vaccinated against COVID-19, absent an approved exemption, will constitute a failure to obey a lawful order and is punishable under the Uniform Code of Military Justice and/or may result in administrative action. Adjudication will be in accordance with paragraph 3.e.(5) below. Prior to receiving the COVID-19 vaccine, Navy service members will have access to healthcare providers to address questions regarding the risks of COVID-19 and the benefits of COVID-19 vaccination. 3.d. Exemptions. The two types of exemptions from immunization are medical and administrative. Administrative exemptions include religious accommodations, per references (d) and (e), as well as others per reference (c). The process for obtaining exemptions for mandatory vaccinations is provided in reference (c) for medical and administrative exemptions and references (d) and (e) for religious accommodations. Specifically for the COVID-19 vaccination, in addition to the processes in reference (c), the authority to grant approval of a permanent medical exemption is the first Navy Medical Department Flag Officer in the medical providers chain of command. Medical Departments may send questions regarding the permanent medical exemption process to usn.ncr.bumedfchva.mbx.bumed--- 2019-ncov-response- cell(AT)mail.mil. 3.d.(1). A history of COVID-19 disease and/or positive serology does not exempt a Navy service member from receiving a COVID-19 vaccine. Those Navy service members who previously received a medical exemption from COVID-19 vaccine while the vaccines were authorized under an EUA will be reevaluated per paragraph 3.d above. 3.d.(2). Navy service members who are actively participating in COVID-19 clinical trials are exempt from mandatory vaccination against COVID-19 until the trial is complete. 3.e. Commanders, Commanding Officers, and Officers in Charge will: 3.e.(1). Identify Navy service members who are not vaccinated against COVID- 19 using Medical Readiness Reporting System (MRRS) detailed in paragraph 3.f below. 3.e.(2). Provide sufficient resources to local MTFs or vaccination locations to execute local vaccination plans. In coordination with local commanders, MTFs will develop plans to administer vaccinations. 3.e.(3). In coordination with supporting cognizant medical authority, direct that unvaccinated Navy service members will initiate vaccination with an FDA- licensed vaccine or, optionally and alternatively, with a vaccine approved for emergency use, on a timeline that achieves full vaccination per paragraph 3.b above. This direction will include information and guidance regarding vaccine availability and administering locations. 3.e.(4). For Navy service members without a pending exemption request or whose exemption request was denied, provide counseling regarding refusal to take the COVID-19 vaccine. This counseling will include access to a healthcare professional to answer questions regarding the risks of COVID-19 and the benefits of COVID-19 vaccinations. Commands will then issue a uniform NAVPERS 1070/613 (Page 13) ordering initiation of the COVID-19 vaccine series, to be completed within the time requirements of paragraph 3.b above. An example NAVPERS 1070/613 can be found at: https://portal.secnav.navy.mil/cop/crc/COVID/Documentationand PDFTraining/Forms/Allitems.aspx. 3.e.(5). For Navy service members who remain unvaccinated, and who have or are expected to exceed the time requirements of paragraph 3.b, their ultimate disposition will be determined by the designated COVID Consolidated Disposition Authority (CCDA). The CCDA will serve as the central authority for adjudication and will have at his or her disposal the full range of administrative and disciplinary actions. Until further notice, authority is withheld for initiating non- judicial punishment, courts-martial, or administrative separation in cases of Navy Service Members refusing the vaccine. The assigned CCDA and specific required reporting procedures and information will be promulgated via separate message. 3.f. COVID-19 Vaccination Reporting 3.f.(1). Navy service member vaccination administration compliance will be monitored via MRRS. Designated command personnel will access MRRS to track personnel to ensure compliance. 3.f.(2). Vaccine administrators must report vaccine administration errors, serious adverse vaccine reactions or clinically significant adverse events in the Vaccine Adverse Event Reporting System: https://vaers.hhs.gov/resources/infoproviders.html. 3.f.(3). Vaccine administrators must ensure that documentation of COVID-19 vaccine administration is coded to accurately reflect the type of vaccine provided. 3.f.(4). COVID-19 immunization documentation will be completed within an approved electronic health record (EHR). Afloat units will enter COVID-19 immunizations into the Shipboard Automated Medical System/Theater Medical Information Program for subsequent transfer to MRRS. Garrison units will enter COVID-19 immunizations into AHLTA/MHS GENESIS for subsequent transfer to MRRS. When an approved EHR is not available, readiness documentation may be entered directly in MRRS, but must also be entered into EHR once available. 3.f.(5). Navy service members who receive the vaccine from a retail network pharmacy or other non-DoD vaccine administrator must provide documentation of COVID-19 vaccination to their respective command no later than the next duty day for Active Component or within 7 days for Reserve Component for entry into EHR and/or MRRS. 3.f.(6). Shore-based commands will request access to MRRS based on unit identification code by submitting a system access authorization request available at: //mrrs.dc3n. navy.mil/mrrs (note: MRRS Web address is case sensitive). Point of contact: MRRS program office, mrrspo(AT)navy.mil / (800) 537-4617 / (504) 697-7070 / DSN: 647-7070. Ship-based commands may utilize Navy Medicine Online or Shipboard Non-Tactical Automated Data Processing Automated Medical System to populate MRRS. 4. COVID-19 Vaccination Administration 4.a. Vaccine administrators should follow the guidance provided in references (f) and (g). 4.b. Per reference (h), there is no harm (contraindication) for co- administration of the COVID-19 vaccination with other vaccines. 4.c. COVID-19 Vaccine Ordering. Naval Medical Logistics Command is responsible for coordinating distribution of COVID-19 vaccine for all Navy and Marine Corps activities: usn.detrick.navmedlogcomftdmd.list.vialhelp(AT)mail.mil. Navy COVID-19 vaccine is centrally funded. Navy activities will place their order for COVID-19 vaccine via USAMMA-DOC's secure web site: https://a01.usamma.amedd.army.mil/docvac/Account/Login. 4.d. COVID-19 Vaccine Integrity. If temperature limits are exceeded during shipment, upon receipt immunization sites must call DLA or USAMMA-DOC at 301- 619-4318/8002 or DSN: 343-4318/8002 and DLA DSCPColdchain(AT)dla.mil or paacoldchainteam(AT)@dla.mil. For temperature limits exceeded in storage please refer to the following website: https://www.health.mil/Military-Health-Topics/Health- Readiness/Immunization-Healthcare/Vaccine-Storage-and- Handling/Potential-Vaccine-Compromise-Reporting. 4.e. Vaccination and Reporting Timeline 4.e.(1). Due to the risk of rapid infection transmission within units and potential impact on operations, vaccines should be given as quickly as possible. MTFs should be prepared to begin administration of vaccine within 24 hours of receipt. If directly receiving the vaccine, active duty operational units have 72 hours (three working days) following receipt of the vaccine to begin documentation, administration, and vaccination reporting. 4.e.(2). As schedules vary for Navy service members in the Selected Reserve or Individual Ready Reserve, NMLC will coordinate with DLA and the ordering Reserve Command for the vaccine to arrive the week of a drill weekend. Units have 30 days following receipt of the vaccine to document, administer, and report vaccination. 4.e.(3). Installations and MTFs may use the Navy Family Accountability and Assessment System, similar to seasonal influenza efforts, conduct a Pandemic COVID-19 response exercises in conjunction with the COVID-19 vaccine program. 5. Points of contact: 5.a. OPNAV: CAPT Steven Tarr III, (703) 614-9250 / Email: steven.tarr3(AT)navy.mil. 5.b. BUMED: BUMED COVID-19 CRISIS ACTION TEAM / (703) 681-1125 / Email: USN.NCR.BUMEDFCHVA.MBX.BUMED--- 2019-NCOV-RESPONSE- CELL(AT)MAIL.MIL. 6. Released by VADM W. R. Merz, Deputy Chief of Naval Operations for Operations, Plans and Strategy, OPNAV N3/N5.// BT #0001 NNNN UNCLASSIFIED//