Anthrax, smallpox vaccine programs expanded by 16 nations

Anthrax, smallpox vaccine programs expanded by 16 nations

U.S. Navy requires merchant mariners working in high-threat areas to be immunized

      The mandatory anthrax and smallpox immunization program for U.S. merchant mariners working under Military Sealift Command and Maritime Administration charter has been expanded to include 16 additional countries.
     Amendments announced Sept. 4 by the office of the Chief of Naval Operations applied the immunization requirement to all civil service and contract officers and crews aboard MSC-owned or chartered vessels and Ready Reserve Force ships operating in U.S. Central Command and U.S. European Command jurisdiction. The RRF ships are owned by MARAD, an agency in the Department of Transportation, but they are under MSC's direct control once underway.
     Added to the initial list of 15 "higher-threat areas" were Afghanistan, Djibouti, Egypt, Eritrea, Ethiopia, Iran, Kazakhstan, Kenya, Kyrgyzstan, Pakistan, Seychelles, Somalia, Sudan, Tajikistan, Turkmenistan and Uzbekistan.
     "Immediately begin mandatory smallpox vaccinations and anthrax immunizations for service members and commander, Military Sealift Command federal employee civilian mariners (CIVMARS) and contract mariners (CONMARS) embarked upon vessels transiting to and in these newly designated countries," said the amendment notice. "All U.S. Navy ships traveling in the 5th Fleet area of responsibility will comply with smallpox vaccinations and anthrax immunizations for personnel." The requirement applies to personnel "in theater for 15 or more consecutive days."
     In addition, anthrax immunizations and smallpox vaccinations are now required of "service members assigned to the Korean Peninsula for 15 or more consecutive days" The requirement applies to "the forward deployed Naval force and selected Military Sealift Command federal employee civilian mariners (CIVMARS) and contract mariners (CON MARS)."
     Individuals who received anthrax immunizations prior to 200-2002 and are now continuing anthrax immunizations under a September 2002 "resumption policy" or under the expanded policy "will continue the dosing series where they left off," the notice said. "These service members do not need to repeat any doses already received in the series. This is consistent with guidance from the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (CDC) and the Food and Drug Administration (FDA)."
     Once the six-shot anthrax immunization series is begun or resumed, the series will continue at the FDA-approved "dosing schedule of zero, two and four weeks, then six, 12 and 18 months, followed by annual boosters," the notice said. "The initial series and boosters must be continued once started, regardless of any change in geographic location or duty status, unless medically or administratively exempted.
     "Before beginning smallpox vaccinations at any installation, coordinate with state, county or host-nation public health departments to explain educational, safety and infection control measures to be followed to prevent inadvertent infection of close contacts of smallpox vaccines," the notice continued.
     "Commanders will follow guidance ... to properly identify and educate service members to be vaccinated, track immunizations, and ensure appropriate medical evaluation if they experience symptoms following any vaccination," the notice said.
     Medical personnel "will assess service members' medical records to identify the need for subsequent doses of anthrax vaccine, unless medically or administratively exempt" on-site, while screening for influenza "or other immunizations," during revue of "electronic immunization tracking system 'shots due' reports," during "deployment readiness processing in preparation for overseas movement," upon "redeployment from combat zone," during audits of medical records and physical examinations, and during "other routine or periodic encounters."

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