Government policy requires mariners sailing into high-threat areas to be vaccinated for smallpox, anthrax

Government policy requires mariners sailing into high-threat areas to be vaccinated for smallpox, anthrax

New federal policy applies to Military Sealift Command, Ready Reserve Force fleets

      The following is the federal government's smallpox and anthrax vaccination policy for all mariners serving aboard Military Sealift Command and Ready Reserve Force vessels deploying to high-threat areas. This policy was issued to ship operators and signed by MSC Contracting Officer Jeffrey Bartz. In summary, this policy requires all mariners working aboard MSC and RRF vessels deploying to high-threat areas to be vaccinated for both smallpox and anthrax. Mariners will have to undergo medical screening before receiving the vaccinations to determine whether they exhibit any medical contraindications to receiving the vaccine. In some cases, a mariner may be excluded from vaccination if a member of his or her household exhibits certain medical conditions. If the screening process reveals that a mariner is ineligible to receive one or both of these vaccinations, of if a mariner has an adverse reaction to the vaccination at the time of the vessel's deployment, he or she will not be permitted to sail on an MSC or RRF vessel into a high threat area and must be replaced.
     In support of our nation's "war on terrorism," the Military Sealift Command (MSC) has begun preparations to implement the Department of Defense (DOD) smallpox vaccination program and resume anthrax vaccinations for U.S. merchant mariners. The programs support the President's national smallpox preparedness plan and overall total force protection objectives. The DOD program, tailored to meet the needs of the military, is designed to ensure that America's armed forces, and civilians who have critical mission functions, are protected from the biological threat of smallpox and anthrax. Therefore, like our men and women in uniform, DOD recognized that it is critically important to protect U.S. merchant mariners, both MSC CIVMARs and contract mariners, who may be deployed on sealift ships essential to the accomplishment of its missions. Vaccinating before an attack is the best way to ensure that our troops and mariners can continue their missions if a smallpox or anthrax outbreak occurs.
     We must vaccinate merchant mariners sailing on government or commercial ships in potential high threat areas. Pursuant to your contracts with MSC, you are responsible to ensure that all crewmembers embarked on vessels sailing into a high threat area for MSC comply with these immunization requirements.
     Smallpox is a very serious disease that is contagious and sometimes fatal. It is caused by a virus that spreads by contact with infected persons. The smallpox program implementation calls for vaccinations and follow-on care to be administered in accordance with Food and Drug Administration guidelines, and best medical practices, through DOD authorized medical personnel and facilities. Individuals must have both a medical prescreening before a vaccination review is necessary to assure it has successfully taken. The overall consequence is that these vaccinations are being strictly controlled and prioritized. Nonetheless, it is important we not hesitate in this regard.
     The smallpox vaccine is a live virus, which requires that it be administered by certified medical personnel and rechecked at 6 to 7 days to ensure the vaccination "takes." This means it must be administered at a pre-designated center at least 7 to 10 days before a seaman deploys. The initial vaccinations for both smallpox and anthrax can be administered simultaneously. MSC intends to administer these vaccinations using medical teams at designated government facilities or at vessel lay berths.
     DOD healthcare access for all smallpox vaccine-related matters will be provided for all merchant mariners affected by this policy. CIVMARs and contract mariners alike will be entitled to the same treatment and necessary medical care as given to armed service members in response to these vaccinations. This includes follow-up and/or emergency medical treatment from a military treatment facility (MTF) or their personal healthcare providers or non-military treatment facilities for emergency medical care as a result of smallpox immunizations.
     Tracking and recording vaccination documentation is the responsibility of the military treatment facilities. However, mariners should be advised to maintain their own vaccine information. Operating companies or their respective unions should track this information as well. At the time of immunization, mariners are to be provided documentation that identifies date and location of immunization, general information on typical responses to vaccination, common and serious adverse events, location of the nearest MTF, and the toll-free telephone number of the Military Medical Support Office (MMSO), in the event medical treatment is required from non-military treatment facilities. Once the vessel is operational and heading into the AOR, Navy fleet medical personnel will provide follow-up care and successive immunizations.
     Anthrax is also serious and sometimes fatal. It is not contagious. The anthrax vaccine immunization program is a series of six shots at roughly 0, 2, 4 weeks, 6, 12, 18 months, plus annual boosters, which successively builds up the effective protection. The first immunization provides approximately 87 percent protection and the second shot builds up to 95 percent protection.
     A certain percentage of mariners will not be able to receive either vaccine due to existing medical conditions and a certain slight percentage of mariners could have a severe reaction to a vaccine prior to deployment. In either case, they will not be permitted to sail on an MSC vessel into a high threat area. Pursuant to your contracts, these mariners must be replaced.
     Some of the conditions that can exclude an individual from one of these vaccines are:

Serious reaction from a prior dose;
Pregnant and breast feeding women
Immune system not fully working due to disease, medication, chemotherapy or radiation (e.g. HIV/AIDS, leukemia, cancer, organ transplant, immune deficiency);
Current or previous eczema or atopic dermatitis;
Other skin conditions, such as burns, impetigo, contact dermatitis, chicken pox, shingles, psoriasis or uncontrolled acne, until the condition clears up;
Recovering from cutaneous skin anthrax;
People with a household contact that meets any of these conditions

Additional general guidance and information on the program and medical eligibility for receiving the vaccines can be found at the following Internet Web sites:

Smallpox: www.vaccines.army.mil
Anthrax: www.anthrax.mil

Medical screening before vaccination for contraindications in vaccine recipients and their household contacts is essential to prevent serious complications. Medical screening, including HIV screening, will be required before immunization. HIV screening must be conducted no more than a week before immunization. Infection with human immunodeficiency virus (HIV) is a contraindication to smallpox vaccination. Screening can be conducted by a mariner's personal healthcare provider or will be offered by MSC in a confidential setting with results communicated to the individual before vaccination. It will be conducted in a manner that allows mariners to freely ask questions and get reliable answers. Unique for smallpox vaccine is the need to screen for risks among household contacts. Screening will serve to document medical conditions for which immunization exemption (temporary or permanent), or further medical evaluation before immunization is indicated.
In summary, the military's overall force protection plan includes:

Merchant mariners crewing sealift ships supporting the deployment of U.S. forces that will sail into known threat and risk areas, will be required to be vaccinated for anthrax and smallpox.
Access to immunization medicine by merchant mariners will be of high priority, similar to armed forces scheduled to deploy to high threat areas.
Administering the vaccination, recording and tracking proper immunization, and access to military treatment facilities for adverse reactions and follow-on necessary care will be provided for all mariners.

Critical to the success of our national strategy is the continuing ability of the U.S. merchant marine to answer the call, time and time again, to crew ships sailing into dangerous waters to defend and protect the interests of the United States of America. MSC is committed to the enormous logistical effort posed by this plan, and the necessity to avoid any delay in immunizing, as a priority, those mariners who might be called upon to sail into high threat areas. We also solicit your input and ideas on how to best meet this critical force protection effort. MSC can only be successful with your cooperation.

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