2013-2014 NAVY INFLUENZA VACCINATION AND REPORTING POLICY

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NAVADMIN 194/13

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SUBJ/2013-2014 NAVY INFLUENZA VACCINATION AND REPORTING POLICY//



REF/A/DOC/ASD(HA)/21JUN2013//
REF/B/DOC/CNO/18SEP2009//
REF/C/DOC/CNO/22JUL2005// 
REF/D/MEMO/ASD(HA)/04APR2008//
REF/E/DOC/32 CFR PART 199/10DEC2009//
NARR/REF A IS ASSISTANT SECRETARY OF DEFENSE (HEALTH AFFAIRS)
(ASD(HA)) GUIDANCE FOR THE USE OF INFLUENZA VACCINE FOR THE
2013-2014 INFLUENZA SEASON. REF B IS OPNAVINST 3500.41,
PANDEMIC INFLUENZA (PI) POLICY. REF C IS OPNAVINST 3440.17,
NAVY INSTALLATION EMERGENCY MANAGEMENT PROGRAM. REF D IS
ASSSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS MEMO,
MANDATING DEPARTMENT OF DEFENSE (DOD) CIVILIAN HEALTHCARE
WORKER INFLUENZA IMMUNIZATIONS. REF E IS 32 CFR PART 199.21,
CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES
(CHAMPUS)/TRICARE: INCLUSION OF RETAIL NETWORK PHARMACIES AS
AUTHORIZED TRICARE PROVIDERS FOR THE ADMINISTRATION OF
TRICARE COVERED VACCINES.//
POC/LCDR PATRICIA SKINNER/LOC: WASH DC/(703)571-2952/EMAIL:
PATRICIA.SKINNER(AT)NAVY.MIL//

Rmks/1. Influenza or "flu" has the potential to adversely
impact Navy force readiness and mission execution. Influenza
results in more than 25 million reported cases, 150,000
hospitalizations for serious complications and approximately
24,000 deaths each year in the United States.

2. The following influenza vaccination and reporting policy
is promulgated: 
A. Influenza 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,
tele-working, sick leave, etc.) are effective methods to
reduce the risk of spreading influenza.
B. Influenza Vaccine. Both injectable and intranasal
vaccines will be available for the 2013-2014 influenza seasons.
C. Influenza Vaccine Priority. Defense Logistics Agency (DLA)
acknowledges that Navy ships are part of vaccine priority
one for the 2013-2014 influenza seasons.
D. Influenza Vaccine Requisitions. The Navy on-line Vaccine
Information and Logistics System (VIALS) is the requisition
system tool for seasonal and emerging influenza vaccines.
VIALS is used to individually track requisitioned vaccines
via milstrip and simplifies vaccine requisitions to enable
electronic tracking of vaccine orders from requisition to
receipt. The VIALS web site is common access card (CAC)
enabled. Please visit:
https://gov_only.nmlc.med.navy.mil/int_code03/vials/.
E. Influenza Vaccine Ordering. Navy influenza vaccine is
batch-ordered by Naval Medical Logistics Command (NMLC)
from the DLA using command requirements in Navy VIALS. Navy
influenza vaccine is centrally funded vice individual Navy
command funded.
F. Influenza Vaccine Exercise.
(1) Previous influenza seasons have been used to exercise
and evaluate mass vaccination scenarios during a pandemic
event. These coordinated mass vaccination campaigns provided
rapid and efficient vaccinations to protect the maximum
number of susceptible persons. Based on lessons learned,
process improvements have been made to delivery and reporting
procedures.
(2) PI exercises will be conducted per OPNAVINST 3500.41
Pandemic Influenza Policy. Per Ref B, section 5(c), Navy
commands will exercise plans biennially in coordination with
appropriate higher headquarters/Combatant Commander. The Navy
Lessons Learned System (NLLS) will be utilized to capture all
PI exercise feedback. 
G. 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 Refs 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 (UCMJ) and/or result in
administrative action. Prior to receiving the influenza vaccine,
Navy Active/Reserve Component personnel shall have access to
healthcare providers to discuss objections or concerns with
influenza vaccination. Commands should consult with the servicing
staff judge advocate for additional guidance on influenza
vaccination non-compliance.
(2) Navy civilian personnel. Mandatory influenza vaccination is a
condition of employment for all civilian health care workers
providing direct patient care in DoD medical treatment facilities
(MTF) per Ref D. 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) Any Tricare beneficiary (dependents). Ref E authorizes retail
network pharmacies to administer the seasonal influenza vaccine.
Tricare beneficiaries may receive influenza vaccination with no
co-pay at a retail network pharmacy offering vaccines. Beneficiaries
are encouraged to contact the pharmacy regarding age restrictions as
some pharmacies do not administer the flu vaccine to individuals
less than 18 years of age. 
H. 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) Commands will request unit code identification based access to
MRRS by submitting a system access authorization form available at:
https://mrrs.sscno.nmci.navy.mil/mrrs/secure/welcome.m (note:
MRRS web address is case sensitive). POC/MRRS program office/email:
mrrspo(at)navy.mil/(901) 874-4682/DSN: 882-4682.
(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 (SAMS)/Theater Medical Information Program
(TMIP) for subsequent transfer to MRRS. 
(4) All personnel who receive the vaccination from a retail network
pharmacy must provide documentation of vaccination to the command no
later than the next business day to ensure compliance is appropriately
recorded in MRRS.
I. Navy Goals and Performance Standards.
(1) All Navy operational units and MTFs will administer the 2013-2014
flu vaccination to meet 90 percent vaccination by 16 Decemeber 2013 
for Active and Reserve Component, and 100 percent vaccine access total for 
Navy family (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 metrics
will be monitored:
- Navy VIALS reports 100 percent of shipped vaccine delivered to Fleet
and Navy units by 1 December 2013.
- MRRS reports 90 percent of Active and Reserve Component vaccinated by 16 
December 2013.
(3) All units that receive flu vaccine shipments have 72 hours
(three working days) to document, administer, and report vaccination
from time of adequate vaccine receipt. Navy Reserve Component units
have one drill weekend to document, administer, and report vaccination
from time of vaccine receipt. The clock begins when the vaccine is
approved for administration. Unit situation reports are required if
vaccine shipments are delayed. If shipments arrive with temperature
sensors in an alarmed status, suspend vaccine (per cold chain protocol)
in your reefer. Return the sensor along with the appropriate paperwork
to DLA for approval or disapproval to use the vaccine. Commands will
coordinate with the servicing MTF to align command-wide vaccinations
with Navy vaccination goals. Medical personnel at servicing MTFs will
expeditiously report vaccinations in MRRS.

3. Released by Vice Admiral R. W. Hunt, Director, Navy Staff.//
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