Expansion of Smallpox Immunization Program and Authorization to Begin Immunizations 60 Days Prior to Deployment

1. BACKGROUND
A. PURSUANT TO REFS A, B, AND C, OSD HAS EXPANDED THE 
ADMINISTRATION OF THE SMALLPOX VACCINATION PROGRAM (SVP) 
INITIALLY DIRECTED IN REF D, NOW TO INCLUDE THE KOREAN 
PENINSULA.  SVP GUIDANCE CONTAINED IN REF E FOR CENTCOM 
AOR REMAINS IN EFFECT.
B. THIS MARADMIN DISSEMINATES GUIDANCE REGARDING EXPANSION 
OF SVP FOR DOD PERSONNEL. THE PAUSE IN THE ADMINISTRATION 
OF THE ANTHRAX VACCINE IMMUNIZATION PROGRAM (AVIP) 
DIRECTED IN REFS F AND G REMAINS IN FORCE.
2. CMC INTENT.  IMPLEMENT THE DOD SVP AS SOON AS POSSIBLE 
IOT PROTECT PERSONNEL AND PRESERVE COMBAT EFFECTIVENESS IN 
THE EVENT OF A SMALLPOX ATTACK.  WHILE THE THREAT OF A 
SMALLPOX ATTACK CANNOT BE QUANTIFIED, THE EARLY VACCINATION 
OF OUR FORCES REMAINS THE MOST EFFECTIVE COUNTERMEASURE.
3. EXECUTION  
A. VACCINATE UNIFORMED DOD PERSONNEL ASSIGNED TO THE KOREAN 
PENINSULA FOR 15 OR MORE CONSECUTIVE DAYS, OR DESIGNATED AS 
EARLY DEPLOYERS (C-DAY TO C+20), AGAINST SMALLPOX.  THIS 
INCLUDES ACTIVE AND RESERVE PERSONNEL THAT ARE PERMANENT, 
ON TEMPORARY DUTY, OR ON ANNUAL TRAINING (AT), AND U.S. 
PACIFIC COMMAND FORWARD DEPLOYED NAVAL FORCES. BEGIN 
SMALLPOX VACCINATIONS FOR EARLY DEPLOYING PERSONNEL ONLY 
AFTER CONFIRMATION BY APPROPRIATE OPERATIONAL HEADQUARTERS 
THAT THE INDIVIDUAL OR UNIT IS LISTED ON C-DAY TO C+20 FORCE 
FLOW PLANS AS DESIGNATED BY THE SUPPORTED COMBATANT 
OMMANDER.
B. VACCINATE EMERGENCY-ESSENTIAL AND EQUIVALENT DOD CIVILIAN 
EMPLOYEES ASSIGNED TO KOREA AGAINST SMALLPOX FOLLOWING 
REQUIRED CONSULTATION PROCEDURES. 
C. VACCINATE DOD CONTRACTOR PERSONNEL CARRYING OUT MISSION 
ESSENTIAL SERVICES AND ASSIGNED TO KOREA.  VACCINATION FOR 
THESE PERSONNEL SHALL BE A REQUIREMENT OF THE APPLICABLE 
CONTRACT.  
D. OFFER VOLUNTARY VACCINATIONS AGAINST SMALLPOX TO FOLLOWING 
PERSONS LOCATED IN KOREA: (1) APPROPRIATE FAMILY MEMBERS OF 
DOD MILITARY PERSONNEL, (2) APPROPRIATE FAMILY MEMBERS OF 
EMERGENCY-ESSENTIAL AND EQUIVALENT DOD CIVILIANS, (3) OTHER 
DOD CIVILIAN EMPLOYEES AND THEIR FAMILY MEMBERS, AND (4) 
NON-ESSENTIAL CONTRACTOR PERSONNEL.    
E. FOR PERSONNEL WITH ORDERS TO ANY AREA CURRENTLY DESIGNATED 
FOR SVP, VACCINATIONS AGAINST SMALLPOX SHOULD BEGIN 60 DAYS 
PRIOR TO SCHEDULED DEPARTURE DATE.     
F. THE SVP REMAINS A COMMANDER S FORCE HEALTH PROTECTION 
RESPONSIBILITY. COMMANDERS WILL FOLLOW GUIDANCE PROVIDED IN 
REFS A-E AND REF H TO PROPERLY IDENTIFY, EDUCATE, AND TRACK 
MARINES, SAILORS, CIVILIANS AND FAMILY MEMBERS TO BE 
VACCINATED.  COMMANDERS SHOULD REVIEW THE 
 EDUCATION TOOL KIT  AND THE  QUESTION AND ANSWERS  POSTED 
ON THE MILVAX WEBSITE (WWW.SMALLPOX.MIL).  REFERENCES AND 
PROCEDURES ARE AVAILABLE AT WWW.VACCINES.MIL OR 
WWW.HQMC.USMC.SMIL.MIL/PLN/PLN_HOME/HTM.
G. COMMANDERS MUST ENSURE PROPER PLANNING AND TRAINING TAKE 
PLACE PRIOR TO ADMINISTERING SMALLPOX VACCINATIOS.  
H. WHEN NEEDED, COORDINATE WITH STATE, COUNTY, OR HOST 
NATION PUBLIC HEALTH DEPARTMENTS TO EXPLAIN EDUCATIONAL AND 
INFECTION-CONTROL MEASURES TO BE FOLLOWED TO PREVENT 
INADVERTENT INFECTION OF CLOSE CONTACTS OF SMALLPOX 
VACCINEES.
4. ADMINISTRATION AND LOGISTICS     
A. TRANSMISSION OF IMMUNIZATIONS DATA.  REF H PROVIDES 
DETAILED INFORMATION ON THE PROCESS TO ENSURE THAT 
IMMUNIZATIONS ARE TRACKED AND RECORDED INTO THE SHIPBOARD 
NON-TACTICAL AUTOMATED PROCESSING (SNAP) AUTOMATED MEDICAL 
SYSTEM (SAMS), VIA NAVY MEDICINE ONLINE (NMO) THROUGH THE 
NAVAL MEDICAL INFORMATION MANAGEMENT CENTER (NMIMC) FOR FINAL 
SUBMISSION INTO THE DEFENSE ENROLLMENT ELIGIBILITY REPORTING 
SYSTEM (DEERS).  ACTIVITIES ADMINISTERING IMMUNIZATIONS MUST 
VERIFY THAT INFORMATION ENTERED INTO SAMS IS REFLECTED IN 
DEERS. THE COMMAND ADMINISTERING VACCINATION IS RESPONSIBLE 
TO DOCUMENT AND ENTER INTO SAMS FOR ALL DOD MEMBERS 
REGARDLESS OF HOME COMMAND.  THE IMMUNIZATIONS PROCESS IS 
NOT COMPLETE UNLESS THE VACCINATIONS ARE DOCUMENTED IN DEERS.  
B. MARINE CORPS ACTIVITIES WILL CONTINUE USING LOGISTICS 
GUIDANCE IN ACCORDANCE WITH THE MARINE CORPS SMALLPOX 
IMPLEMENTATION PLANS IN 
REF E. 
C. POCS FOR THIS MESSAGE ARE: 
(1) HQMC (DC PP&O)- LTCOL D. A. BETHEL OR 
MR F. J. LEPE, SERVICE PROGRAM MANAGERS, (703) 695-0221 
(DSN 225) AND (703) 614-5157 (DSN 224); 
(2) HQMC (HS) - CDR DAVE MCMILLAN (USN), PREVENTIVE MEDICINE 
OFFICER, (703) 614-4478 (DSN 224); 
(3) HQMC (LPC-3) - HMC JOE PALMARES, MEDICAL LOGISTICS 
(703) 695-8926 (DSN 225). 
5. COMMAND AND SIGNAL. THIS MARADMIN IS APPLICABLE TO THE 
MARINE CORPS TOTAL FORCE AND IS EFFECTIVE IMMEDIATELY UPON 
RECEIPT. EXPIRATION DATE CANNOT BE DETERMINED.