1. Introduction Director’ s Welcom e INFLUENZA Department of Defense Seasonal Influenza Vaccination Program Leaders Briefing 2011-12 UNCLASSIFIED

2. 2 Outline 1. Influenza Disease 2. DoD Influenza Policies 3. DoD Vaccines 4. Vaccination Screening 5. Documentation PURPOSE: to inform command leadership about the details of the DoD Seasonal Influenza Vaccination Program.

3. 3 Influenza Season 2011-12 “Annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications” “Influenza viruses can cause disease among persons in any age group, but rates of infection are highest among children. Rates of serious illness and death are highest among persons aged >65 years, children aged <2 years, and persons of any age who have medical conditions that place them at increased risk for complications from influenza. An annual average of approximately 36,000 deaths during 1990–1999 and 226,000 hospitalizations during 1979–2001 have been associated with influenza epidemics.” ACIP Recommendations for Prevention and Control of Seasonal Influenza with Vaccines MMWR, August 2010

4. 4 Influenza Virus Respiratory disease caused by influenza type A or B viruses Transmitted person to person by airborne droplets Direct or indirect contact with secretions Symptoms  Abrupt onset of fever (101-102°F)  Muscle pain  Sore throat  Nonproductive cough  Headache WHO selects prevalent strains for vaccine  2- Influenza A, 1- Influenza B virus Advisory Committee on Immunization Practices  Recommends annual vaccination to all persons 6 months and older

5. Department of Defense (DoD)  Guidance for the use of Influenza Vaccine for the 2011-2012 Influenza Season (2 Aug 11) Air Force  Air Force 2011-2012 Influenza Immunization Program Guidance (25 Jul 11) Army  2011-2012 Influenza Vaccine Immunization Program Operations Order 11-50 (17 Jul 11) Coast Guard  2011-2012 Seasonal Influenza (Flu) Immunization Program ALCOAST (01 Aug 11) Navy / Marines  2011-2012 Navy Influenza Vaccination and Reporting Policy BUMED (13 Jul 11) Tricare Management Activity  32 CFR Part 199 (13 Jul 11) DoD Influenza Policies 5

6. 6 Vaccine Manufacturers DoD contracted with three manufacturers Inactivated, Injectable vaccine  Sanofi-Pasteur - Fluzone  CSL Biotherapies – Afluria Live, Intranasal Vaccine  MedImmune – Flumist 2011-2012 Trivalent Influenza Vaccine  A/California/7/2009 (H1N1)  A/Perth/16/2009 (H3N2)  B/Brisbane/60/2008

7. 7 Prioritization No vaccine shortage is anticipated this year Continue until vaccine supply is exhausted or expired Should an unexpected vaccine shortage occur, DoD will follow ACIP guidelines and continue to reserve first available vaccine for deployed, deploying, mission essential and medical high risk personnel. In accordance with (IAW) HA Policy 08-005, “Policy for Mandatory Seasonal Influenza Immunization for Civilian Health Care Personnel Who Provide Direct Patient Care in Department of Defense Military Treatment Facilities”, military treatment facilities are directed to require all civilian health care personnel (HCP) who provide direct patient care in DoD MTFs be immunized against seasonal influenza infection each year as a condition of employment, unless there is a documented medical or religious reason not to be immunized.

8. 8 Screening Health Status evaluated for Individual allergies (eggs, thimerosal, vaccine components, latex) Individual medical conditions (pregnancy, history of Guillain- Barre’ Syndrome, asthma, immune-compromised) Appropriate exemptions protect the service member

9. 9 Adverse Event after Vaccination Most common adverse reactions with influenza vaccinations Injectable: Soreness, tenderness, pain and swelling at the injection site. Tiredness, headache and muscle aches Intranasal: Runny nose or nasal congestion in all ages and sore throat in adults Vaccine Adverse Event Reporting System (VAERS) www.vaers.hhs.gov Contact VAERS 1-800-822-7967 Vaccine Healthcare Centers (VHC) Network 1-866-210-6469 (24 hrs) www.vhcinfo.org

10. 10 Immunization Tracking and Reporting Service members should receive influenza vaccination by 1 December 2011 Services will monitor influenza immunization compliance through their respective Immunization Tracking Systems On 1 December 2011 compliance will be categorized as  Green (≥ 90% immunized)  Amber (80-90% immunized)  Red (<80% immunized) Proper documentation Date, location, vaccine brand, lot number and signature MILVAX will report influenza vaccination compliance rate to the Surgeons General as requested

11. 11 Exemption Documentation Regional Analyst POC Map Medical Exemption Codes  Medical Temporary (MT) - Recent live virus vaccine, referred for medical consultation, antiviral treatment  Medical Permanent (MP) - Medical contraindication by physician Administrative Exemption Codes  Administrative emergency leave (AL) - up to 30 days  Administrative PCS (AP) - up to 90 days  Administrative separation (AS) - 60 or 180 days

12. 12 Contact Us For more information about DoD Influenza Vaccination Program, or if you have any vaccine related questions please contact the MILVAX Agency. vaccines@amedd.army.mil (877) GET-VACC (877) 438-8222 www.vaccines.mil/flu

13. 13 www.vaccines.mil www.vaccines.mil