DoD policy states influenza immunizations are mandatory for all Active Duty, National Guard, and Reserve personnel. Influenza immunizations are mandatory for DoD civilian and contract health care personnel who provide direct patient care at military treatment facilities (MTFs).
Note: more information on DoD influenza policies can be found at www.vaccines.mil/Policies/Influenza_-_Seasonal.
The Office of the Assistant Secretary of Defense for Health Affairs (HA) Policy 08-005, dated 4 April 2008, mandates all civilian health care personnel who provide direct care to patients in medical treatment facilities must be immunized against seasonal influenza each year as a condition of employment. www.vaccines.mil/documents/1169HCPFluHAPolicy_08_005.pdf.
The primary goal is to vaccinate 100 percent of all Active Duty, National Guard, Reserve, and Health Care Providers whom provide direct patient care with a milestone goal of ≥ 90 percent by 16 December this year.
ACIP recommends the use of the seasonal influenza vaccinations for all people 6 months and older. Additionally, emphasis on providing routine annual vaccinations to certain groups at higher risk for influenza infection or complications should be a priority:
Vaccine shipments occur in early August. Your installation seasonal influenza vaccine program should begin immediately upon receipt of influenza vaccine to protect individuals at risk from developing influenza or its complications. All Services will follow Service-specific implementation guidelines. Influenza vaccinations should continue until supply is exhausted or the vaccine expiration is reached.
It is important to document immunizations properly into electronic immunization and paper-based systems. Vaccine, date of administration, lot number, manufacturer, Vaccine Information Statement version date, name of vaccine administrator and medical exemptions for military personnel must be documented in Service-specific immunization tracking systems.
All Services will monitor implementation using Service-specific electronic immunization tracking systems (Medical Protection System (MEDPROS), Aeromedical Services Information Management System (ASIMS), Medical Readiness Reporting System (MRRS), Shipboard Automated Medical System (SAMS), and the Defense Eligibility Enrollment Reporting System (DEERS). All Military Health System (MHS) beneficiary immunizations should be documented in the electronic health record.
DoD has arranged with the Defense Logistics Agency – Troop Support (DLA-TS) to contract for influenza vaccine from four different manufacturers. Three manufacturers will provide injectable trivalent inactivated influenza vaccine (IIV3), Sanofi-Pasteur (Fluzone®), CSL Biotherapies/Merck (Afluria®), and Novartis (Fluvirin® and Flucelvax®). MedImmune (FluMist®) produces the intranasal quadravalent live, attenuated influenza vaccine (LAIV4).
Note: More information regarding this year's influenza vaccines and the presentations available can be found at www.vaccines.mil/documents/1642_Influenza_Vaccines_for_Different_Age_Groups_-_2013-14.pdf
If you are having a medical emergency call 911. Contact your healthcare provider or the clinic at which you received your vaccination for appropriate follow-up.
You may also contact the the DoD 24/7 Vaccine Healthcare Centers Network at (877) 438-8222 or email via at https://askVHC.wramc.amedd.army.mil. Any clinically significant medical event that occurs after vaccination should be submitted to the Vaccine Adverse Event Reporting System (VAERS) at www.vaers.hhs.gov.
Influenza is a contagious respiratory illness caused by influenza types A or B viruses. Influenza viruses are easily spread by airborne respiratory droplets from person to person (often by sneezing or coughing).
Symptoms of infection include fever, muscle aches, headache, malaise (a general feeling of sickness), nonproductive cough, sore throat, and runny nose. The flu causes mild illness in most people, the majority of whom will not need medical care or antiviral drugs, and usually recover in less than two weeks. Some people, however, can suffer flu complications that result in being hospitalized. Sometimes influenza infection results in death.
Pneumonia, bronchitis, sinus infections and ear infections are examples of more severe flu-related complications. The flu also can make chronic health problems worse. For example, people with asthma may experience more frequent asthma attacks while they have the flu. The flu may also worsen congestive heart failure in people with this condition.
Children younger than 5 but especially children younger than 2 years of age, adult 65 years and older, pregnant women and individuals with various chronic medical conditions are at greatest risk for hospitalization and possibly death related to infection.
A full list of high-risk conditions can be found at: www.cdc.gov/flu/about/disease/high_risk.htm
Influenza viruses are constantly changing, so it is not unusual for new strains of influenza virus to emerge at any time of the year. This year's influenza vaccines were made using the following strains:
The B/Massachusetts and B/Brisbane strains are a change from last year's formulation.
Pregnant women are at high risk for influenza related complications and are a priority group for vaccination. The FDA has classified Fluzone and Afluria as "Pregnancy Category B", indicating that animal reproduction studies have not demonstrated a fetal risk, but there are no controlled studies in pregnant women.
The ACIP, the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Family Physicians recommends the use of injectable influenza vaccine for immunization of pregnant women because the benefit of protection outweighs the potential risk of any adverse event.
According to the ACIP and the American Academy of Pediatrics (AAP):
Children aged 6 months to 8 years who are receiving the influenza vaccine for the first time or whose previous vaccination status is unknown should receive two (2) doses of vaccine separated by at least four weeks.
Children aged 6 months through 8 years who have NOT received two (2) or more total doses of seasonal influenza vaccine since July 2010 should receive two (2) doses of vaccine separated by at least four weeks.
Children aged 6 months through 8 years who received two (2) or more total doses of seasonal influenza vaccine since July 2010 and all children 9 and older should receive one dose of seasonal influenza vaccine.
Yes. The live vaccine (FluMist®) may suppress a positive response to a tuberculin skin testing (TST or PPD) in a person who is infected with tuberculosis (TB), resulting in a false negative skin test. If a person needs TB skin testing and LAIV, you can correctly administer both in one of three ways
Fluzone®, Fluzone® Pediatric, Fluzone® High-Dose (HD), and Fluzone® Intradermal are inactivated injectable influenza virus vaccines manufactured by Sanofi-Pasteur. Presentations available this year include a multi-dose vial and a thimerosal-free single-dose syringe.
Fluzone and Fluzone Pediatric are licensed for persons aged 6 months and older, Fluzone HD is licensed for persons aged 65 years and older and Fluzone Intradermal is licensed for persons aged 18 through 64 years. DoD only contracted for Fluzone and Fluzone Pediatric this season.
ACIP recommends the use of injectable vaccines for immunization of persons described as eligible in manufacturer package inserts and for whom the live virus vaccine (FluMist®) is contraindicated.
The following populations should not be immunized with the Live Attenuated Intranasal Vaccine: