Resumption of Anthrax Vaccinations for DOD Personnel

1.  THIS MSG IS APPLICABLE TO SELECT ACTIVE
COMPONENT AND RESERVE COMPONENT MARINES, AS WELL
AS EMERGENCY-ESSENTIAL AND MISSION-ESSENTIAL 
CIVILIAN AND CONTRACTOR PERSONNEL.  REFS A-H 
REINTRODUCED AND EXPANDED THE ANTHRAX 
VACCINATION PROGRAM.  REFS I AND J DIRECTED
A TEMPORARY STOPPAGE OF AVIP.  REFS K AND L 
ANNOUNCED AVIP RESUMPTION.  THIS MARADMIN 
DIRECTS IMMEDIATE RESUMPTION OF ANTHRAX 
VACCINATIONS AND DIRECTS COMPONENT 
COMMANDER ANTHRAX REPORTING PER THE TIMELINE
IN PARAGRAPH 7.
2.  ON 22 DEC 03, THE U.S. DISTRICT COURT FOR
THE DISTRICT OF COLUMBIA ISSUED A PRELIMINARY
INJUNCTION AGAINST FURTHER ANTHRAX VACCINATIONS.
ON 30 DEC 03, THE FDA RULED THAT ANTHRAX VACCINE
ADSORBED (AVA, BIOTHRAX) IS SAFE AND EFFECTIVE
AGAINST ALL FORMS OF ANTHRAX, INCLUDING INHALATION ANTHRAX.
ON 7 JAN 04, THE U.S. DISTRICT COURT STAYED THE INJUNCTION.
OSD AND SECNAV HAVE THUS DIRECTED IMMEDIATE RESUMPTION OF
ANTHRAX VACCINATIONS.
3.  PER REF L, ALL USMC FORCES AND SUPPORT PERSONNEL
PREVIOUSLY AUTH TO RECEIVE ANTHRAX VACCINATIONS MAY
IMMEDIATELY RESUME THE SIX-SHOT SERIES AND ANNUAL
BOOSTER.  ALL USMC FORCES AND SUPPORT PERSONNEL
DEPLOYING TO THE IRAQI THEATER OF OPERATIONS
(ITO) OR ANY OF THE 15 COUNTRIES LISTED AS HIGHER
THREAT AREAS (HTAS), FOR 15 OR MORE CONSECUTIVE
DAYS, ARE REQUIRED TO RECEIVE ANTHRAX VACCINATIONS
PRIOR TO THEIR DEPLOYMENT DATE.  THREE OF THE SIX
ANTHRAX SHOTS, GIVEN DURING A 28-DAY SCHEDULE, 
CONSTITUTE THE MINIMUM ACCEPTABLE PROTECTION
LEVEL REQUIRED PRIOR TO DEPLOYMENT.  THE ITO 
INCLUDES THE COUNTRIES OF IRAQ, SAUDI ARABIA, 
QATAR, BAHRAIN, UNITED ARAB EMIRATES, JORDAN, 
AND KUWAIT.  ALL HTAS MAY BE VIEWED AT THE 
SIPR WEBSITE WWW.HQMC.USMC.SMIL.MIL/PLN/
VACCINATIONS/ANTHRAX/AVIP%20OVERVIEW.DOC
4.  ALL POLICY MEMOS, OSD GUIDANCE, AND CMC 
GUIDANCE MAY BE VIEWED AT WWW.VACCINES.ARMY.MIL OR
THE HQMC SIPR WEBSITE
WWW.HQMC.USMC.SMIL.MIL/PLN/PLN_HOME/HTM.
5.  CMC INTENT:  CONTINUE TO IMPLEMENT AUTHORIZED
ANTHRAX VACCINATIONS IOT PROTECT MARINE CORPS
PERSONNEL AND PRESERVE COMBAT EFFECTIVENESS IN
THE EVENT OF A BIOLOGICAL ATTACK.  WHILE THE THREAT
OF A BIOLOGICAL ATTACK CANNOT BE QUANTIFIED, THE
VACCINATION OF OUR FORCES REMAINS THE MOST 
EFFECTIVE COUNTERMEASURE.  COMPREHENSIVE UNIT 
EDUCATION IS THE CORNERSTONE OF A SAFE AND
SUCCESSFUL VACCINATION PROGRAM.  TO THE MAXIMUM
EXTENT POSSIBLE, ENSURE DEPLOYING PERSONNEL ARE
VACCINATED PRIOR TO DEPARTING CONUS.  IAW WITH REF
G, CMC HAS DELEGATED AUTHORITY TO THE DEPLOYING 
USMC COMPONENT COMMANDER TO GRANT WAIVER REQUESTS
IF CMC INTENT CANNOT BE MET.  
6.  EXECUTION:
A.  ANTHRAX VACCINATIONS ARE MANDATORY FOR PERSONNEL
DEPLOYING TO HTAS, EXCEPT AS PROVIDED UNDER APPLICABLE
MEDICAL AND ADMINISTRATIVE EXEMPTION POLICIES.  
INDIVIDUAL AUGMENTEES AND MARINES AT ENTRY LEVEL SCHOOLS,
SUCH AS THE SCHOOL OF INFANTRY (INFANTRY TRAINING 
BATTALION OR MARINE COMBAT TRAINING BATTALION), 
WITH FOLLOW-ON ORDERS TO A HTA-DEPLOYED OR DEPLOYING
UNIT ARE AUTH TO RECEIVE ANTHRAX VACCINATIONS.  
PER REF H, UNITS/PERSONNEL DEPLOYING TO AN HTA WILL NOT 
RECEIVE THEIR INITIAL ANTHRAX SHOT UNTIL WITHIN 45-DAYS
OF THEIR PROJECTED DEPLOYMENT DATE.  THE DEPLOYING 
FORCE COMMANDER WILL MAKE EVERY EFFORT TO ENSURE
THAT ALL FORCES RECEIVE THREE ANTHRAX VACCINATIONS
PRIOR TO ARRIVAL IN THEATER.  PERSONNEL WHO HAD 
ALREADY BEGUN THE ANTHRAX SERIES MAY IMMEDIATELY
RESUME RECEIVING THEIR NEXT SCHEDULED SHOT.  ONCE AN 
INDIVIDUAL STARTS THE ANTHRAX SERIES THEY WILL CONTINUE
TO RECEIVE ALL SIX SHOTS REGARDLESS OF THEIR DEPLOYMENT
STATUS. 
B.  COMMANDERS SHALL COORDINATE WITH MEDICAL TREATMENT
FACILITIES (MTF) FOR TRAINING, SCREENING QUESTIONNAIRES, 
VACCINE RECEIPT AND DISTRIBUTION DATES, AND INDIVIDUAL 
MEDICAL CONSULTATIONS.  COMMANDERS WILL ADDRESS 
VACCINATION REFUSALS AS THEY WOULD ADDRESS ANY REFUSAL
TO OBEY A LAWFUL ORDER, ENSURING THAT PERSONNEL HAVE 
RECEIVED APPROPRIATE EDUCATION AND ADMINISTRATIVE/MEDICAL
SCREENINGS.  
C.  MEDICAL PERSONNEL MUST CLEARLY UNDERSTAND THAT THEY
WILL BE OUR FRONT LINE FORCE IN RESPONDING TO QUESTIONS
AND CONCERNS.  THEY WILL FAMILIARIZE THEMSELVES WITH ALL
ANTHRAX WEBSITE RESOURCES, ESPECIALLY WWW.VACCINES.ARMY.MIL.
D.  FEMALES THAT MAY BE PREGNANT SHOULD UNDERGO PREGNANCY
SCREENING PRIOR TO ANTHRAX VACCINATION.  DOD POLICY IS TO 
DEFER ANTHRAX VACCINATION UNTIL AFTER PREGNANCY, PER REF C.
E.  IMMUNIZATION TRACKING VIA SHIPBOARD NON-TACTICAL ADP 
PROGRAM (SNAP) AUTOMATED MEDICAL SYSTEM (SAMS) AND DEERS IS
THE IMMUNIZATION TRACKING SYSTEM (ITS) MANDATED FOR ALL 
USMC COMMANDS.  IMMUNIZATION TRACKING IS VITAL FOR ALL 
ACTIVE AND RESERVE FORCES; COMMANDERS MUST ENFORCE SAMS/DEERS
COMPLIANCE.  ENSURE APPROPRIATE UNIT MEDICAL PERSONNEL ARE
TRAINED IN SAMS IMMUNIZATION TRACKING PROCEDURES AND HAVE
A CURRENT PASSWORD TO ACCESS THE DEERS IMMUNIZATION TRACKING
WEBSITE.  IMMEDIATELY FOLLOWING VACCINATION, MEDICAL 
PERSONNEL SHALL RECORD MEMBER DATA, UNIT DATA, VACCINE LOT 
NUMBER, AND VACCINATION SITE IN SAMS, IN MEMBER S HEALTH
RECORD AND ON YELLOW SHOT CARD (PHS 731).  INFORMATION FOR 
IMMUNIZATION TRACKING CAN BE OBTAINED VIA THE WEBSITE AT 
HTTPS://IMCENTER.MED.NAVY.MIL/ITS.  
F.  ALL ADVERSE EVENTS SHALL BE REPORTED TO THE VACCINE
ADVERSE EVENTS REPORTING SYSTEM (VAERS).  ADVERSE EVENTS
WILL BE MANAGED EXPEDITIOUSLY BY PRIVILEGED HEALTHCARE 
PROVIDERS APPLYING RECOMMENDATIONS, AS INDICATED, CONTAINED
IN DOD GUIDELINES FOR MANAGEMENT OF ADVERSE EVENTS AFTER
VACCINATION, AVAILABLE AT WWW.VACCINES.ARMY.MIL AND AT 
THE VACCINE HEALTHCARE CENTER WEBSITE, WWW.VHCINFO.ORG.  
G.  ANTHRAX VACCINE WILL BE ADMINISTERED ACCORDING TO 
FDA LABEL REQUIREMENTS, WITH FDA-LICENSED VACCINE.
H.  VACCINATION OF RESERVE COMPONENT (RC) PERSONNEL
WILL OCCUR TO THE GREATEST EXTENT POSSIBLE UPON ACTIVATION.
7.  COMPONENT COMMANDER VACCINATION REPORTING:
A.  THE OFFICE OF THE SECRETARY OF DEFENSE (HEALTH AFFAIRS) 
HAS AN ONGOING REQUIREMENT FOR THE REPORTING OF ANTHRAX 
VACCINATIONS WITHIN THE SERVICES.  THE FOL IS A REVISED
SCHEDULE FOR COMPONENT COMMANDER REPORTING AND SHOULD BE
INCLUDED WITH SMALLPOX REPORTING REQUIREMENTS LISTED 
IN REF M:
B.  BEGINNING ON 21 JANUARY 2004, COMPONENT COMMANDERS 
(INCLUDING MFR) WILL REPORT THEIR CURRENT ANTHRAX AND
SMALLPOX NUMBERS VIA NAVAL MESSAGE TO HQMC.    
C.  REPORTS ARE DUE TO THIS HEADQUARTERS ON THE FIRST 
AND THIRD WEDNESDAY OF EACH MONTH, NLT 1800Z.  NAVAL
MESSAGES SHALL BE ADDRESSED TO CMC WASHINGTON DC//PO//
WITH INFO COPY TO CMC WASHINGTON DC//PL/HS//.
D.  ALL COMPONENT COMMANDER REPORTS SHALL INCLUDE THE
FOL ANTHRAX INFO:
(1) CUMULATIVE NUMBER OF PERSONNEL ASSIGNED TO THAT
COMPONENT COMMAND WHO HAVE RECEIVED ANTHRAX 
VACCINATIONS SINCE REINTRODUCTION OF THE ANTHRAX
PROGRAM IN SEPTEMBER 2002.  THIS NUMBER SHOULD INCLUDE
PERSONNEL IN, OR SCHEDULED TO DEPLOY TO, AN HTA WHO
ARE AUTH TO RECEIVE ANTHRAX VACCINATIONS.  
(2) THE NUMBER OF PERSONNEL IN PAR 7.D.(1) WHO HAVE 
RECEIVED THREE OR MORE ANTHRAX VACCINATIONS SINCE 
REINTRODUCTION OF THE ANTHRAX PROGRAM IN SEPTEMBER 2002.
(3) THE NUMBER OF PERSONNEL IN PAR 7.D.(1) WHO HAVE 
COMPLETED THE ANTHRAX SIX-SHOT SERIES AND NOW RECEIVE
ANNUAL BOOSTERS.
(4) THE NUMBER OF PERSONNEL IN PAR 7.D.(1) WHO ARE 
MEDICALLY OR ADMINISTRATIVELY EXEMPT FROM RECEIVING
ANTHRAX VACCINATIONS.
(5) THE NUMBER OF PERSONNEL IN PAR 7.D.(1) WHO HAVE
REFUSED ANTHRAX VACCINATIONS SINCE REINTRODUCTION OF
THE ANTHRAX PROGRAM IN SEPTEMBER 2002.  THIS NUMBER
SHOULD NOT REFLECT PERSONNEL WHO INITIALLY REFUSED 
THE VACCINE, BUT LATER ACCEPTED VACCINATION AFTER
FURTHER EDUCATION AND COUNSELING.
E.  COMUSMARCENT ASSUMES RESPONSIBILITY FOR REPORTING
OF UNITS/PERSONNEL UPON ACCEPTANCE OF OPCON FOR EMPLOYMENT.
COMMARFORLANT AND COMMARFORPAC RESUME RESPONSIBILITY 
FOR REPORTING UNITS/PERSONNEL UPON THEIR RETURN TO HOME
STATION.  COMMARFORRES IS ONLY RESPONSIBLE FOR REPORTING
RESERVE PERSONNEL IN A PRE-ACTIVATION STATUS, AND WILL
SUPPORT COMMARFORLANT AND COMMARFORPAC BY COMMUNICATING
RESERVE UNITS  INOCULATION STATUS TO THEM.  COMMARFORLANT
AND COMMARFORPAC ASSUME REPORTING RESPONSIBILITY FOR
MOBILIZED RESERVE UNITS UPON THE DAY THE UNIT IS ACTIVATED.  
F.  THIS REPORTING REQUIREMENT DOES NOT ALLEVIATE USMC
COMPONENT COMMANDERS FROM OTHER MANDATORY COCOM REPORTING
REQUIREMENTS.
8.  THIS MARADMIN IS APPLICABLE TO THE TOTAL FORCE MARINE
CORPS.
9.  EXPIRATION DATE:  INDEFINITE.