2019-20 SEASONAL INFLUENZA VACCINE GUIDANCE FOR ACTIVE AND RESERVE COMPONENTS
Date Signed: 8/21/2019 | MARADMINS Number: 454/19
MARADMINS : 454/19
R 211803Z AUG 19
MARADMIN 454/19
MSGID/GENADMIN/CMC WASHINGTON DC DMCS//
SUBJ/2019-20 SEASONAL INFLUENZA VACCINE GUIDANCE FOR ACTIVE AND RESERVE COMPONENTS//
REF/A/DOC/BUMED WASHINGTON DC/20131007//
REF/B/MSG/CMC WASHINGTON DC PP0/20101105//
REF/C/DOC/CNO WASHINGTON DC/20161122//
REF/D/DOC/32 CFR PART 199.21/20161201//
NARR/REF A IS BUMEDINST 6230.15B, IMMUNIZATIONS AND CHEMOPROPHYLAXIS. REF B IS MARADMIN 631/10, REQUIREMENT TO TRACK AND IMPROVE INDIVIDUAL MEDICAL READINESS FOR ACTIVE AND RESERVE COMPONENTS. REF C IS OPNAVINST 3710.7V, NAVAL AIR TRAINING AND OPERATING PROCEDURES STANDARDIZATION GENERAL FLIGHT AND OPERATING INSTRUCTIONS. REF D IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS)/TRICARE: TRICARE PHARMACY BENEFITS PROGRAM//
POC/BROOM, KIMBERLY/CDR/HQMC/HS/TEL: 703-604-4602/EMAIL: KIMBERLY.BROOM@USMC.MIL, DIRECTOR OF PUBLIC HEALTH//
POC/CHEEVER, TYBER/HMC/HQMC/PPO/TEL: 703-571-1041/EMAIL: TYBER.CHEEVER@USMC.MIL, MRRS COORDINATOR//
GENTEXT/REMARKS/1.  Purpose.  Provide guidance to Marine Corps active and reserve components to implement the 2019-2020 mandatory Seasonal Influenza Vaccination Program.  The Department of Navy goal is 90 percent of personnel vaccinated no later than Sunday, 15 December 2019.
2.  Background.  Seasonal influenza is a highly contagious disease that has the potential to severely reduce mission readiness.  A timely comprehensive vaccination program must be enforced by leadership throughout the Marine Corps to mitigate mission risk.  Maximum and early influenza vaccination compliance reduces severity of the disease in Marines and Sailors who become exposed to the virus and strengthens the ability of the force to limit spread of the disease.
3.  Influenza Vaccine Shipping.  All commands will coordinate with their supporting Military Treatment Facility (if applicable) and verify their correct shipping address and point of contact information in the Vaccine Information and Logistics System (VIALS) to ensure prompt delivery and receipt.  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.  Shipments are expected to begin arriving in September 2019.
4.  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.  Segregate the vaccine in the refrigerator with a sign saying “DO NOT USE,” return temperature monitor to DLA-TSM, and await disposition.
5.  Execution.
     a.  Per REFs A and B, Marine Corps active and reserve component personnel shall receive the seasonal influenza vaccine annually, unless medically exempt.
     b.  Marine Corps active and reserve component commands shall monitor influenza vaccination compliance closely in the Medical Readiness Reporting System (MRRS) and coordinate with supporting medical commands to ensure a 90 percent seasonal influenza vaccination compliance rate is achieved no later than 15 December 2019.
     c.  Per REF B, MRRS will be used to enter vaccination status and monitor compliance.  Delinquent personnel will be identified by the command and directed to receive the vaccine at the earliest opportunity. 
     d.  Exemptions will be entered in MRRS only when an individual has a valid documented exemption for the influenza vaccine.  Do not use exemption codes “Medical, immune (MI),” “Medical, assumed (MA),” Medical, declined (MD),” “Not required (NR),” “Medical, permanent (MP)”, or “Medical, reactive (MR)” to defer seasonal influenza vaccinations for military personnel.  Due to the variety of influenza vaccines available each year and scientific evidence providing options for those individuals previously identified as having a contraindication to influenza vaccine, the risk(slash)benefit of influenza vaccine should be reviewed on an annual basis by a treating physician.  The Medical, Temporary (MT) exemption code should have an expiration date of no later than June 30, 2020.
     e.  Notify the Headquarters Marine Corps (HQMC) Health Services point of contact (POC) via the chain of command if 90 percent compliance is not expected to be achieved by 15 December 2019 to coordinate mitigation strategies with supporting organizations.  Based on previous experiences, major commands should attain at least 75 percent compliance in their roll-up reports by 1 November 2019 to be on track to achieve the 90 percent compliance by 15 December 2019.
6.  Vaccine Administration.  The Centers for Disease Control (CDC) vaccine information sheets will be reviewed by each Marine and Sailor prior to vaccination.  The injectable vaccine will be available for the 2019-20 influenza season.  The inactivated vaccine (injectable) requires a 12-hour grounding period for all personnel in an active flying status.  Intranasal vaccine (FluMist) will not be available.
7.  Adverse Reactions.  In the event of an adverse reaction, personnel should report to medical and a vaccine adverse event report should be submitted.  Instructions can be found at the vaers.hhs.gov website which is also referenced within the MRRS immunization reaction section.
8.  Action.
     a.  Vaccinations will be documented in the members health record and recorded in MRRS within 24 hours of administration.
     b.  REF D allows Tricare Prime enrolled members, which includes all active duty service members, to use Tricare authorized pharmacies to receive the seasonal influenza vaccine as part of their pharmacy benefit.  There should be no cost for active duty personnel or other Tricare Prime beneficiaries.  Personnel using this option must provide their MRRS representative and medical facility documentation of the manufacturer, lot number, amount and location given (right arm, left arm), and date of administration of the vaccine within one business day for inclusion in MRRS and their medical record.  Commands must ensure that documentation of influenza vaccine administration is coded to accurately reflect the type of vaccine given.
     c.  MRRS provides drill down capability to track compliance from the major subordinate command level to the individual Marine and Sailor level.  If a command does not have access to MRRS, contact the local MRRS security officer or the HQMC Plans, Policy, and Operations POC listed in this message for further assistance.
9.  This MARADMIN is applicable to the Marine Corps total force.
10.  This MARADMIN is cancelled 1 August 2020.
11.  Release authorized by Lieutenant General John J. Broadmeadow, Director, Marine Corps Staff.//