ROUTINE R 171959Z NOV 22 MID200080475819U FM CNO WASHINGTON DC TO NAVADMIN INFO CNO WASHINGTON DC BT UNCLAS NAVADMIN 258/22 PASS TO OFFICE CODES: FM CNO WASHINGTON DC//DNS// INFO CNO WASHINGTON DC//DNS// MSGID/GENADMIN/CNO WASHINGTON DC// SUBJ/2022-2023 NAVY INFLUENZA VACCINATION AND REPORTING POLICY// REF/A/DOC/DOD/13JUL2022// REF/B/MEMO/DHA/DHA-IPM/21AUG2020// REF/C/DOC/OFR/32 CFR PART 199.21/01DEC2016// REF/D/DOC/BUMED/07OCT2013// REF/E/CDC/MMWR/22JUL2022 REF/F/MMQC-22-1438/23AUG2022 NARR/REF A IS THE DEPARTMENT OF DEFENSE INSTRUCTION (DODI) 6025.19 INDIVIDUAL MEDICAL READINESS PROGRAM, ADDRESSING RESPONSIBILITIES AND PROCEDURES FOR MONITORING AND MAINTAINING INDIVIDUAL MEDICAL READINESS. REF B IS THE DEFENSE HEALTH AGENCY PROCEDURAL INSTRUCTION (DHA-PI) 6025.34 GUIDANCE FOR THE DOD INFLUENZA VACCINATION PROGRAM (IVP). REF C IS THE OFFICE OF THE FEDERAL REGISTRAR 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. REF D IS THE BUREAU OF MEDICINE AND SURGERY INSTRUCTION (BUMEDINST) 6230.15B IMMUNIZATIONS AND CHEMOPROPHYLAXIS FOR THE PREVENTION OF INFECTIOUS DISEASES. REF E IS A WEEKLY CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) MORBIDITY AND MORTALITY WEEKLY REPORT (MMWR) REPORT. REF F IS THE MEDICAL MATERIAL QUALITY CONTROL MESSAGE// POC/CDR PETER SEGUIN/BUMED FALLS CHURCH VA/(703) 681-9474/EMAIL: PETER.G.SEGUIN.MIL(AT)HEALTH.MIL// RMKS/1. Influenza (flu) is a contagious viral respiratory illness, which can cause mild to severe illness resulting in hospitalization or death. Flu has the potential to adversely impact Navy force readiness and mission execution. 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 including cough/sneeze hygiene, 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. Two influenza vaccines, Northern Hemisphere (NH) and Southern Hemisphere (SH), are available based on service member location and timing requirements as described in reference (b). The 2022-2023 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. 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 2022-2023 influenza season. d. Influenza Vaccine Ordering. All Defense Health Agency (DHA) Military Treatment Facilities (MTFs) will follow the MMQC-22-1438 guidance instructing them to 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. All Fleet, USMC units, and reserve commands will continue to submit their requirements in the Vaccine Information and Logistics System (VIALS). 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: https://gov_only.med.ds.osd.mil/int_code03/vials/. e. Operational Forces Support, Naval Medical Readiness Logistics Command (NMRLC), Detachment, Fort Detrick is responsible for ordering and distributing influenza vaccine for all Navy and Marine Corps activities. Additional quantities required must be coordinated with the VIALS helpdesk at: usn.detrick.navmedlogcomftdmd.list.vialhelp(AT)mail.mil. f. Influenza Vaccine Shipping. All commands will verify their correct shipping address and point of contact information in VIALS to ensure prompt delivery. g. Influenza Vaccine Integrity (1) Temperature Monitors. 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 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. 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. 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. Ensure masking, social distancing, group size limitations, and other appropriate precautions during any mass vaccination exercises, if undertaken, when appropriate. i. Vaccine Delivery. Due to vaccine demand and manufacturer limitations, complete vaccine delivery may be delayed. This delay will unintentionally test the ability to conduct rapid and complete mass vaccination exercises. j. 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), (b), and (d). 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 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 reference (b), and is strongly encouraged for all other Navy civilian employees. (3) TRICARE Beneficiaries. Reference (c) 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: //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. (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 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, 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 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.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. 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 2022-2023 influenza vaccination to exceed the 90 percent vaccination goal by 15 December 2022 for Active and Reserve Components. Complete vaccine access will be provided for all Navy family members (includes dependents, other beneficiaries, and DoN ivilians). 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 2022. (b) MRRS reports 90 percent of Active and Reserve Component vaccinated by 15 December 2022. 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. m. Vaccine administration and Coronavirus Disease 2019 (COVID -19) (1) There is no current contraindication for administration of the influenza vaccination during the COVID-19 pandemic and every effort should be made to deliver the vaccine as quickly as possible to eligible Service members. (2) Personnel who meet criteria to receive a COVID-19 booster dose are highly encouraged to do so as soon as they are available consistent with instructions from the CDC and from supporting MTFs. 3. Released by Mr. Andrew S. Haeuptle, Director, Navy Staff.// BT #0001 NNNN UNCLASSIFIED//