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1 1 (April 26, 2021)

handle is hein.crs/govedcg0001 and id is 1 raw text is: C o n r e s i n a R e e a c S e r c S April 26, 2021 Defense Health Primer: Military Vaccinations The Department of Defense (DOD) administers a variety of force health protection (FHP) measures to promote, protect, improve, conserve, and restore the health and well-being of servicemembers. These measures include health promotion and education programs, periodic health assessments, preventive therapies, medical countermeasures, and vaccinations. The U.S. military instituted its first vaccination program in 1777 when General George Washington directed the inoculation of the Continental Army to protect personnel from smallpox. Since then, DOD has implemented a variety of enduring or situational FHP measures to protect servicemembers from health threats. Certain vaccines are required for all servicemembers, while others may only be required for those deploying to particular locations. Other vaccines may be available based on public health recommendations or on a voluntary basis. Since at least the late 1990s, Congress has expressed interest in DOD vaccination policies, specifically those on compulsory vaccinations. Similar interest among certain Members of Congress has arisen as DOD administers the Coronavirus (COVID-19) vaccine to servicemembers on a voluntary-basis. This In Focus describes DOD's military vaccination policies and immunization program, and offers issues for congressional consideration. DOD Policies on Military Vaccinations DOD Instruction 6205.02 establishes the DOD Immunization Program. The policy generally directs combatant commands and the military departments to identify and define mandatory immunization requirements for servicemembers. The Joint Regulation on Immunization and Chemoprophylaxis for the Prevention of Infectious Diseases outlines specific vaccination requirements for servicemembers, as well as service- specific procedures for administering such requirements. In general, DOD vaccination requirements follow the recommendations of the U.S. Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). DOD vaccination requirements fall into one of three categories: * vaccinations during initial entry or basic training; * routine adult vaccinations; and * special risk-based, or occupation-specific vaccinations. Table 1 lists the mandatory vaccinations required for all servicemembers upon entering initial entry or basic training. In addition to these vaccinations, combatant commands establish further requirements for servicemembers, other DOD personnel, and certain family members, based on specific health threats in a geographic region. Table I. Mandatory Vaccinations for All Servicemembers Adenovirus Meningococcal Hepatitis A & B Poliovirus Influenza Tetanus-Diphtheria Measles/Mumps/Rubella Varicella Source: Joint Service Regulation on Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases, October 7, 2013, p. 29. DOD Immunization Program The Defense Health Agency (DHA) manages the DOD Immunization Program. Based on the military departments' and combatant commands' vaccination requirements, as well as CDC and ACIP recommendations, DHA coordinates the administration of vaccines to servicemembers and other DOD beneficiaries. Vaccinations are typically available in military treatment facilities, certain military-specific settings (e.g., basic training), or from participating TRICARE providers. DHA is also responsible for relevant medical documentation, patient safety surveillance, and coordination with the Defense Logistics Agency and commercial manufacturers to procure such vaccines. DOD health care providers typically document servicemember vaccinations and any related adverse health events in the electronic health record system (e.g., MHS Genesis), paper medical records, and the respective military departments' medical readiness information system. Opting Out of a Vaccination A servicemember may request to opt out of a mandatory vaccination. Upon request by a servicemember, DOD may authorize a temporary or permanent medical or administrative exemption to a required vaccine. DOD health care providers may authorize a medical exemption when a servicemember has an underlying health condition or known adverse reaction contraindicated with a certain vaccine. Unit commanders may authorize an administrative exemption for a servicemember who is within 180 days from separating or retiring from the military or within 30 days of departing a permanent assignment location. Pursuant to the Religious Freedom Restoration Act (42 U.S.C. §2000bb-1), administrative exemptions for religious reasons may also be granted. DOD policy requires that: * the unit commander seek input from medical, legal, and chaplain representatives; * the unit commander counsel the servicemember on potential adverse impact to deployability, assignment, or international travel; and ittps:/crsreports.cong ress.gov

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