A little more than a month after the Food and Drug Administration issued emergency use authorization for the Pfizer-BioNTech and Moderna COVID-19 vaccines Dec. 12 and Dec. 17, respectively, vaccines have been increasingly and successfully distributed and administered to Department of Defense personnel worldwide in a safe and effective phased approach.
In the initial controlled distribution and administration phase, DOD delivered its initial allotment of just under 44,000 doses of Pfizer-BioNTech vaccines to 13 select military installations in the continental United States and three international DOD installations.
The 16 DOD locations received their vaccine doses on time and with no loss of product, stated Army Lt. Gen. (Dr.) Ronald J. Place, director of the Defense Health Agency, the week the rollout began, allowing for successful administration to prioritized voluntary populations following Centers for Disease Control and Prevention guidance within 24 hours of receipt. The prioritized recipient population in the initial phase (1A) included critical medical staff and first responders on the front lines of the COVID-19 fight to protect them while they continued to care for their patients.
Phase 1A also included Armed Forces Retirement Home residents; health care and support staff at military hospitals and clinics along with non-clinical staff who support patient care with a high risk of exposure; outpatient health care and support personnel, including National Guard and Reserve personnel as well as active-duty service members deploying or supporting COVID-19 response operations. The data-driven, phased approach to vaccination creates a feasible, scalable, and safe plan for effective vaccine distribution, administration, and monitoring.
“It’s important to protect our health, our families, and our community by making the voluntary choice to get the vaccine when it’s made available to you,” said Place. “The vaccine offers the best-known protection from the effects of COVID-19.”
In early January, the distribution plan was expanded to include hundreds more DOD sites around the world to which DOD can now deliver between 25,000 to 30,000 daily doses depending on allocation. As production increases and more personnel choose to receive the vaccine, those numbers are expected to increase daily until the majority of DOD’s 11.1 million personnel can be vaccinated.
“Over 250 DOD immunization sites have received and are administering COVID-19 vaccines,” said Air Force Col. Tanya Rans, chief of the Defense Health Agency’s Immunization Healthcare Division. “DOD is distributing vaccine to immunization sites globally as quickly as possible.”
However, who can get the vaccine may differ at each immunization site based on quantity of vaccine received, desire for a shot by those in the phase, and throughput, she said.
“Some sites have moved from phase 1A to phase 1B, and others have not yet received vaccine,” she added.
The second phase includes national critical capabilities; personnel preparing to deploy outside the continental United States; personnel preparing to deploy in the next three months, including military civilians and contractors authorized to receive immunization from the DOD; beneficiaries age 75 or older; and front-line essential workers, including those in the education and youth and child services staff sector; eligible defense manufacturing, DOD corrections staff; DOD postal service staff; DOD public transit workers; and commissary and other installation food service or agricultural workers. Although most sites are vaccinating phase 1B recipients, each medical treatment facility has the flexibility to move within the population schema according to its population needs and vaccine availability.
“Each service or the U.S. Coast Guard, as appropriate, determines immunization sites and quantity to be received based on the allocation provided to DOD by the Department of Health and Human Services,” said Rans.
As distribution and administration efforts continue with positive responses and minimal reports of adverse reactions from recipients, those in phase 1C are next in line. These include eligible beneficiaries between the ages of 65-74; eligible beneficiaries between 1664 with increased risk for severe illness as defined by CDC; personnel in the Office of the Secretary of Defense, federal agencies, field activities, Army, Navy, Air Force, Marines, Space Force, Coast Guard, and Reserve component designated as key, essential, or mission-essential; and DOD prisoners.
“Like most vaccines there are some expected adverse effects: Most commonly, soreness at the injection site, headache, and fatigue, but in almost all cases this subsided within two days,” said Place. “We will continue to be fully transparent about our experience within the DOD, and we’ll share that information with the CDC.”
According to the CDC’s COVID Data Tracker, as of Jan. 25—677,025 doses had been distributed among the DOD sites, and 346,180 initial doses had been administered. However, until the risk of the COVID-19 pandemic is reduced based on numbers who have been vaccinated, masks and physical distancing are still necessary for everyone.
“The response from vaccine recipients has been overwhelmingly positive,” said Rans. “The Vaccine Adverse Event Reporting System through CDC is capturing all adverse events reported following receipt of COVID vaccine and will amend clinical recommendations based on any concerns identified.”
“As a physician, I recognize the decision to receive the vaccine is a personal one and the department’s policy is very clear that taking the vaccine is voluntary, but here’s my advice: I encourage you to learn the details of this vaccines’ safety profile,” said Place. “If you have questions, talk to your health care provider. For the huge majority of us, the risk of an adverse event from COVID-19 vaccine is much lower than the short- and long-term risk posed by the disease itself.”