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Frontline health care workers among first in DOD for COVID-19 vaccine

Image of Man getting vaccine. Army Capt. (Dr.) Isaiah Horton, an internal medicine provider at Walter Reed National Military Medical Center, receives a COVID-19 vaccination, Walter Reed National Military Medical Center, Bethesda, Maryland, Dec. 14, 2020. (Photo by Lisa Ferdinando, DOD.)

U.S. military communities in Washington, D.C., San Diego, and San Antonio are among the first in the Department of Defense to receive the COVID-19 vaccine Dec. 14 as part of the DOD’s initial distribution plan.

Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland, started vaccinating select medical staff for COVID-19 Monday, with acting Secretary of Defense Christopher Miller on hand to witness the initial shots and receive one himself.

"This is a very important day, not just for the Department of Defense, but for our nation," Miller said before getting his vaccination.

Seven months after President Donald Trump announced Operation Warp Speed and the goal to deliver a vaccine by January 2021, "today ... the very first Americans are being inoculated by a safe and highly effective vaccine," Miller said.

"Our service members, DOD civilians, and their families have demonstrated remarkable endurance and sacrifice throughout the pandemic," he added. "We know that our collective sacrifice would accelerate the path to a cure and save lives."

Miller said that because of the DOD's precision logistics, "the first shipments of vaccines are arriving securely at hundreds of distribution sites around the country as we speak," he added.

In addition to WRNMMC, Naval Medical Center San Diego in California and the Air Force's 59th Medical Wing in San Antonio, Texas, also received their first shipment Monday and expect to begin vaccinations Tuesday.

These are the first of an initial 16 DOD sites to receive authorized COVID-19 vaccines as part of the DOD’s phased approach to distribute and administer COVID-19 vaccines.

Last week, the Pentagon outlined the DOD's plan to vaccinate its population of approximately 11.1 million. 

“Our goal is to be transparent with the force about what is happening and to encourage our personnel to use the vaccine,” said Pentagon Spokesman Jonathan Hoffman during a DOD press briefing last week with Assistant Secretary of Defense for Health Affairs Thomas McCaffery and Army Lt. Gen. Ronald Place, Defense Health Agency director.

McCaffery and Place said the phased, standardized, and coordinated strategy for prioritizing, distributing, and administering COVID-19 vaccines was developed in collaboration with Operation Warp Speed, the Centers for Disease Control and Prevention (CDC), and the DOD’s COVID Task Force assessment of unique mission requirements.

It “will provide the COVID vaccine to DOD uniformed service members, both active and selective reserve components, including members of the National Guard, dependents, retirees, civilian employees, and select DOD contract personnel as authorized in accordance with DOD policy,” added McCaffery.

Man getting vaccine in arm Acting Defense Secretary Chris Miller receives a COVID-19 vaccine from Navy Hospitalman Samantha Alvarez, Walter Reed National Military Medical Center, Bethesda, Maryland, Dec. 14, 2020. (Photo by Lisa Ferdinando, DOD.)

Priority populations and selected locations

Based on the limited initial availability, DOD is slated to receive an allotment of just under 44,000 doses of the Pfizer vaccine for this first week, which will be distributed in proportion to population size of selected sites. The Pfizer vaccine was approved for emergency use authorization Dec. 11 by the U.S. Food and Drug Administration.

The DOD locations were selected because they meet several unique criteria that best support the initial distribution and administration plan, according to McCaffery. For example, all 16 locations meet the unique supply-chain requirements for initial vaccines, such as the capability for ultra-cold storage.

Additionally, all sites serve a sizable DOD population with priority personnel across all military services who will receive the vaccine before other members of the healthy DOD population — including health care providers and support personnel, residents and staff of DOD long-term care facilities, other essential workers such as emergency responders and security personnel, and high-risk beneficiaries. And they all have sufficient medical personnel to administer the vaccines and monitor recipients.

The DOD sites selected for initial distribution to priority populations, including locations they will distribute to, are:

  • Darnall Army Medical Center, Fort Hood, Texas 
  • Wilford Hall, Ambulatory Surgical Center, Joint Base San Antonio, Texas 
    • Brooke Army Medical Center, Texas (distribution from Wilford Hall)
  • Madigan Army Medical Center, Joint Base Lewis-McChord, Washington  
  • Womack Army Medical Center, Fort Bragg, North Carolina 
  • Navy Branch Health Clinic, Naval Air Station, Jacksonville, Florida 
  • Base Alameda Health Services (clinic), U.S. Coast Guard Base, Alameda, California 
  • Naval Medical Center, San Diego, California
    • Naval Hospital, Camp Pendleton, California (distribution from San Diego)
  • Naval Hospital Pensacola, Pensacola, Florida 
    • Keesler Air Force Base, Florida (distribution from Pensacola)
    • Armed Forces Retirement Home, Gulfport, Mississippi (Keesler AFB will administer) (distribution from Keesler)
  • Walter Reed National Military Medical Center, Bethesda, Maryland 
    • Armed Forces Retirement Home, Washington, DC (distribution from Walter Reed)
  • Portsmouth Naval Medical Center, Portsmouth, Virginia 
    • U.S. Coast Guard Base Clinic, Portsmouth, Virginia (distribution from Portsmouth Naval Medical Center)
  • Indiana National Guard, Franklin, Indiana 
  • New York National Guard Medical Command, Watervliet, New York 
  • Tripler Army Medical Center, Honolulu, Hawaii
  • Allgood Army Community Hospital, Camp Humphreys, Korea 
  • Landstuhl Regional Medical Center, Germany 
  • Kadena Medical Facility, Kadena Air Base, Japan 

Vaccine safety

Even though the vaccine cannot be mandated under the terms of the emergency use authorization, the department is strongly encouraging everyone to get it to “protect yourselves, your families, your shipmates, your wingmen, your battle buddies, and your communities,” said Place. “The preliminary data on the safety and effectiveness of the two vaccine candidates is highly encouraging.”

As with most vaccines, Place explained, there is a chance some recipients will experience slight adverse effects, such as arm soreness, fatigue, and fever.

“The department will be fully transparent about any adverse effects that are reported and share this information with the CDC,” said the DHA director. However, as a physician, he advised everyone to get the vaccine. “The risk of these vaccines, from what we know, is much less than the risk of the actual disease process.”

Vaccines are only available after they are demonstrated to be safe and effective in phase 3 clinical trials, have been authorized by FDA, and have been manufactured and distributed safely and securely. Additionally, the DOD has decades of experience with conducting global vaccine programs — whether it’s annual flu campaigns or protection against novel diseases around the world.

“We vaccinate millions of our service members and families and retirees of every age every year, and we have systems in place to monitor the health of everyone who receives a vaccine,” Place said.

Mitigation during phased distribution

As a result of the gradual approach, DOD will continue to distribute vaccines in a phased format, “adding additional prioritized personnel and additional prioritized locations until allocations of the vaccine reach 60 percent of our DOD, roughly 11.1 million personnel," explained McCaffery.

Once the 60 percent threshold is reached, DOD anticipates vaccine manufacturing rates to support full-scale, unrestricted vaccine distribution to department personnel. At that point, DOD intends to distribute the vaccine in the same way it conducts its annual flu vaccine program.

“I’m extremely confident the department’s plan … provides a very clear roadmap to protect our entire DOD population across the globe against the pandemic,” said McCaffery. “This has been a tough year for all Americans, and I’m inspired by the perseverance and commitment of the men and women of the department and the Military Health System. Together we’re working as a team to protect all entrusted to our care.”

DOD health officials stressed the need to continue wearing appropriate face coverings, practice physical distancing, wash hands, and following local and installation force health protection guidelines until a large portion of the DOD population is vaccinated. 

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