R 252100Z SEP 23
MARADMIN 489/23
MSGID/GENADMIN/CMC WASHINGTON DC DMCS//
SUBJ/2023-24 INFLUENZA VACCINE GUIDANCE FOR ACTIVE AND RESERVE COMPONENTS//
REF/A/DOC/USD P&R WASHINGTON DC/23JUL19//
REF/B/DOC/BUMED WASHINGTON DC/07OCT13//
REF/C/DOC/DHA WASHINGTON DC/21AUG20//
REF/D/GENADMIN/CMC WASHINGTON DC PP0/051110ZNOV10//
REF/E/DOC/CNO WASHINGTON DC/22NOV16//
REF/F/DOC/32 CFR PART 199.21/01DEC16//
REF/G/DOC/CDC/MMWR RECOMMENDATIONS AND REPORTS NO. 2/25AUG2023//
NARR/REF A IS DODINST 6205.02, DOD IMMUNIZATION PROGRAM. REF B IS BUMEDINST 6230.15B, IMMUNIZATIONS AND CHEMOPROPHYLAXIS FOR THE PREVENTION OF INFECTIOUS DISEASES. REF C IS DEFENSE HEALTH AGENCY (DHA) PROCEDURAL INSTRUCTION 6025.34, GUIDANCE FOR THE DOD INFLUENZA VACCINATION PROGRAM. REF D IS MARADMIN 631/10, REQUIREMENT TO TRACK AND IMPROVE INDIVIDUAL MEDICAL READINESS FOR ACTIVE AND RESERVE COMPONENTS. REF E IS OPNAVINST 3710.7V, NAVAL AIR TRAINING AND OPERATING PROCEDURES STANDARDIZATION GENERAL FLIGHT AND OPERATING INSTRUCTIONS. REF F IS THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES (CHAMPUS)/TRICARE: TRICARE PHARMACY BENEFITS PROGRAM. REF G IS THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) RECOMMENDATIONS FOR 2023-2024 INFLUENZA SEASON.//
POC/DRISCOLL, SEAN/CDR/HQMC/HS/DIRECTOR OF PUBLIC HEALTH/TEL: 703-604-4602/ EMAIL: SEAN.DRISCOLL@USMC.MIL//
POC/BALISI, FRANCISPAUL/HM1/HQMC/HS/MRRS COORDINATOR/TEL: 703-604-4602/ EMAIL: FRANCISPAUL.BALISI@USMC.MIL//
GENTEXT/REMARKS/1.  Purpose.  Provide guidance to Marine Corps active and reserve components to implement the 2023-2024 Northern and Southern Hemisphere Influenza Vaccination Program.
2.  Background.  Seasonal Influenza is a highly contagious disease that has the potential to significantly impact force health and mission readiness.  A timely comprehensive vaccination program must be enforced by Marine Corps leadership in order to mitigate risk to force and risk to mission.  Maximum vaccination of the force reduces transmission of disease, and reduces severity of disease in personnel who become infected.
3.  Execution.
3.a.  Per refs (a), (b), and (c), all Marine Corps active and reserve component personnel shall receive the 2023-2024 seasonal Influenza vaccine(s) unless medically or administratively exempt.  The Marine Corps active component shall ensure 100 percent of personnel are compliant with DoD policy (vaccinated or approved medical or administrative exemption) no later than 15 Dec 23.  The Marine Corps reserve component shall vaccinate at least 90 percent of required personnel no later than the DoD goal of 15 Jan 24.
3.b.  Per encl (3) of ref (c), Marine Corps personnel shall receive the seasonal NH Influenza vaccine if they will be assigned, permanently or temporarily, more than 14 days in the NH Influenza zone between 1 Oct 23 and 30 Mar 24.  Marine Corps personnel shall receive the seasonal Southern Hemisphere (SH) Influenza vaccine if they will be assigned more than 14 days in the SH Influenza zone between 1 Apr 23 and 30 Sep 23 (see ref (c), appendix (5), for a list of applicable countries).  If personnel require vaccination with both hemisphere vaccines, administration should be separated by a minimum of 30 days.
3.c.  Operational forces and training commands are prioritized for receipt of Influenza vaccine by the Department of the Navy.  Marine Corps component commanders and surgeons shall coordinate with supporting Military Treatment Facilities (MTFs) to ensure operational forces and training commands receive priority administration from Influenza vaccine shipments.  Commanders should prioritize vaccination of deploying forces, recruits and instructors at recruit depots, and healthcare providers assigned to Marine Corps units.
3.d.  Commanders should advise Marine Corps civilian employees that the Influenza vaccine is also available to them at retail pharmacies, without cost or copay, as a benefit of the Federal Employee Health Benefits program.  See paragraph 6.a for additional information.
3.e.  Marine Corps active and reserve component commands shall monitor Influenza vaccination compliance via the Medical Readiness Reporting System (MRRS), and coordinate with supporting MTFs to ensure seasonal Influenza vaccination compliance no later than the deadlines in paragraph 3.a.
3.f.  Marine Corps components will document administration of Influenza vaccine for all personnel in the Electronic Health Record (either Armed Forces Health Longitudinal Technology Application or Military Health System GENESIS) preferentially, but may document vaccination directly in MRRS if the units do not have ready access to the Electronic Health Record.  Vaccination shall be documented within one (1) business day of administration to ensure timely and accurate daily monitoring of Force compliance with this MARADMIN.
3.g.  Personnel who receive Influenza vaccination from non-military facilities (e.g., civilian pharmacies) shall provide verification and details to their supporting MTF or command MRRS representative no later than 1600 on the next regular duty day (see paragraph 6.a).
3.h.  If a command does not have authorized personnel with access to MRRS, contact the local MRRS security officer or the Headquarters Marine Corps Health Services MRRS POC listed in this message for further assistance.
3.i.  Medical exemptions will be entered in MRRS only when an individual has a valid exemption for the Influenza vaccine, as determined by a licensed healthcare provider.  See refs (b) and (c) for details regarding exemptions and required evaluation of those reporting a history of allergic reaction to the Influenza vaccine.
3.j.  Administrative exemptions are a non-medical command determination, and will be entered in MRRS in accordance with ref (b). Units are advised to refrain from temporary exemptions due to TAD status in order to avoid erroneous exemptions and ensure compliance with ref (a).
4.  Vaccine Handling and Administration.
4.a.  Commanders shall ensure that all medical personnel assigned to Marine Corps units who handle and/or administer Influenza vaccine receive appropriate annual training, and that competencies are documented.  Commanders shall also establish procedures for proper handling and storage of Influenza immunization stock IAW ref (c) and regional policy and practices of the supporting MTF.
4.b.  Only appropriately trained and qualified personnel, working under signed orders of an appropriately privileged healthcare provider, will administer the Influenza vaccine.
4.c.  All personnel handling and/or administering Influenza vaccine shall receive training in cold-chain management, and have a signed competency form verifying competency in all aspects of the Influenza vaccine products being utilized.  Training can be accessed via Joint Knowledge Online (DHA-US070), and additional comprehensive resources are available at www.health.mil/vaccines.
4.d.  Influenza vaccines shall be stored and transported, at all times, with appropriate temperature monitoring.
4.e.  Any time that a temperature compromise is known or suspected, immediately place that vaccine in a proper storage container at the proper temperature, and clearly label “DO NOT USE”.  Do not discard the vaccine unless directed by Defense Logistics Agency-Troop Support Medical (DLA-TSM).  Notify the supporting MTF, NMRLC vaccine service representative at usn.detrick.nmrlc-detftdmd.list.vialhelp@mail.mil, and the appropriate DHA Immunization Healthcare Specialist.  Complete a DHA Form 177, Potentially Compromised Temperature Sensitive Medical Provider Worksheet.  DLA-TSM will advise on disposition of the vaccine.
4.f.  Commands with excess Influenza vaccine that will not be used prior to expiration shall notify their supporting MTF, NMRLC vaccine service representative, and DHA Immunization Healthcare Specialist, who may direct redistribution.
4.g.  Prior to vaccination, all personnel being vaccinated shall be screened by medical personnel using DHA Form 116, and shall be provided the current Vaccine Information Statement (VIS) for the product being administered.
4.h.  Aircrew will require a period of grounding specific to the product being administered, per ref (e).
5.  Adverse Reactions.  Local swelling, injection site soreness, and headache are common Influenza vaccine side effects that resolve quickly.  These symptoms, along with fever, fatigue, and muscle aches may occur within 6-12 hours of vaccination, and may persist for 1-2 days.  More severe allergic reactions, while rare, shall be evaluated by medical personnel and reported through the Vaccine Adverse Event Reporting System (VAERS) at:  https:(slash)(slash)vaers.hhs.gov/reportevent.html.
6.  Additional Information.
6.a.  Per ref (f), TRICARE Prime beneficiaries, including all active duty service members, may utilize TRICARE-authorized pharmacies to receive the seasonal Influenza vaccine at no cost.  Participating pharmacies may be found at:  https:(slash)(slash)militaryrx.express-scripts.com/find-pharmacy.  Personnel utilizing this option shall provide their supporting MTF and/or MRRS representative documentation of the manufacturer, lot number, amount and location given (right arm, left arm), and date of administration.  Command medical personnel and/or MRRS representatives must ensure that documentation of Influenza vaccine administration is coded to accurately reflect the type of vaccine given.
6.b.  The DHA’s Influenza vaccine resource center can be found at www.health.mil/vaccines, and contains guidance documents and templates to include standing orders, vaccine product guides and VISs, and cold chain management tools.
6.c.  The Defense Health Agency-Immunization Healthcare Division (DHA-IHD) Immunization Healthcare Support Center can be reached at:  1-877-GET-VACC (1-877-438-8222); or via email at:  DoDvaccines@mail.mil.  The Support Center can provide clinical consultation, to include assistance with questions regarding vaccine screening and potential vaccine-related adverse events.
7.  This MARADMIN is applicable to the Marine Corps Total Force.
8.  This MARADMIN is cancelled 1 Aug 24.
9.  Release authorized by Lieutenant General Gregg P. Olson, Director, Marine Corps Staff.//