Introduction

1. Introduction Department of Defense Seasonal Influenza Vaccination Program Leaders Briefing Director’s Welcome INFLUENZA 2010-11 UNCLASSIFIED

2. 1. Influenza Disease 2. DoD Influenza Policies 3. DoD Vaccines 4. Vaccination Screening 5. Documentation Outline PURPOSE: to inform leaders about the details of the 2010-11 DoD Seasonal Influenza Vaccination Program.

3. Influenza Season 2010-11 “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. 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 Annual vaccination to all persons 6 months and older Influenza Virus

5. Air Force Policy for the Use of the Influenza Vaccine 2010-2011 Influenza Season 23 Aug 10 Army 2010-2011 Influenza Vaccine Immunization Program Operations Order 09-65, 30 Jul 10 Coast Guard 2010-2011 Seasonal Influenza (Flu) Immunization Program ALCOAST, 29 Jul 10 Navy / Marines Initial Policy for the Use of the Seasonal Influenza Vaccine for 2010-2011 BUMED, 26 Jul 10 DoD Influenza Policies

6. DoD contracted with three manufacturers Inactivated, Injectable vaccine Sanofi-Pasteur - Fluzone CSL Biotherapies - Afluria Live, Intranasal Vaccine MedImmune – Flumist 2010-2011 Trivalent Influenza Vaccine A/California/7/2009 (H1N1) A/Perth/16/2009 (H3N2) B/Brisbane/60/2008 Vaccine Manufacturers

7. Prioritization No vaccine shortage is anticipated this year • Should an unexpected vaccine shortage occur, directions will be provided by ASD (HA) and will be consistent with recommendations published in subsequent issues of the Morbidity and Mortality Weekly Report. • 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. Injectable vaccines (Fluzone, Afluria) 50% AUG 30% SEP 20% OCT Intranasal (Flumist) 35% AUG 25% SEP 30% OCT 10% NOV Expected Shipment Dates CENTCOM, Korea, Naval Vessels Afloat and Naval Expeditionary Forces, PACOM, Coast Guard, EUCOM, and AFRICOM

9. 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 Screening

10. 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 Adverse Event after Vaccination

11. Service members should receive influenza vaccination by 1 December 2010 Services will monitor influenza immunization compliance through their respective Immunization Tracking Systems On 1 December 2010, DoD will include influenza compliance in FMR calculations for all components Compliance will be categorized as Green (≥ 90% vaccinated) Amber (80-90% vaccinated) Red (<80% vaccinated) MILVAX will report influenza vaccination compliance rate to the Surgeons General as requested Immunization Tracking and Reporting

12. 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 Exemption Documentation

13. 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 Contact Us (877) 438-8222 www.vaccines.mil/flu

14. www.vaccines.mil www.vaccines.mil