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Appenzeller emphasizes: Get COVID-19 vaccine, no matter where

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Army Major Gen. (Dr.) George "Ned" Appenzeller would love it if the military administered every COVID-19 vaccine to every service member.

But the assistant director for combat support at the Defense Health Agency told those in attendance at the third Military Health System and Military OneSource COVID-19 Town Hall that the "where" is not important.

"I would love to be the one to put the vaccine in everyone's arm, but if it's available to you in your local community, I suggest you go ahead and get it wherever you can get it first," he said during the event, held live on streaming platforms on April 14.

"What we do ask is if you get your vaccine outside of our DOD system ... bring us those records so we can get it documented in your medical records for all of your future encounters ... and that we can track you along with everyone else who is getting the vaccine within the system." He stressed that there is no pre-authorization needed for a vaccine taken outside the DOD - the DHA recently approved a blanket waiver removing that requirement.

Appenzeller, who is board certified in emergency medicine, was interviewed by Bruce Moody, public affairs specialist for the Department of Defense Office of Military Community and Family Policy. Appenzeller's team oversees the DOD COVID-19 Operational Planning Team, which built the DOD COVID-19 vaccination plan.

"We look at the overall allocations to the DOD, provide those allocations to the services, we give them guidance, and help them in the actual execution of the mission at all of the individual vaccination sites," Appenzeller said.

The vaccination efforts at 350-plus DOD sites across the world are paying off. To date, more 26 percent of all active duty, National Guard, and Reserves are now fully vaccinated, with a total of more than 2.4 million doses administered to service and family members, civilians, and contractors.

Appenzeller said that military installations around the country and the world were at different phases of the prescribed schema (who can get a shot, and when), but that on April 19 the DOD's "ultimate goal" will be to make COVID-19 vaccine appointments available to all who are authorized and eligible. Those individuals will be able to make an appointment by contacting their local military medical treatment facility directly or using those facilities' appointing processes. Appointments will be based on the local availability of vaccines. To find a DOD location offering COVID-19 vaccines in your area, check TRICARE.mil.

Leaving "as little on the shelf as possible"

April 19 "will coincide with [President Joe Biden's] guidance for the nation," he said. "Like all of the nation and the world, in fact, there's more demand than there is supply. We get our allocation from [the Department of Health and Human Services], just like ... all the other jurisdictions," weekly, and push them out as quickly as possible into as many arms as possible.

"Overall, we've been able to move everything out, every week, as much as they can give us, and we are averaging between 83% and 85% usage every single week."

For those having trouble booking appointments for a vaccine, Appenzeller said every hospital or clinic is different, and he urged people to contact their local DOD vaccination site directly.

Regarding acceptance of the voluntary vaccine, Appenzeller said military personnel reflect American society as a whole: a lot of interest and some reluctance, though recently he said there has been an "increasing rate of acceptance." Some service members still have a wait-and-see approach, particularly the younger population.

"Senior leaders are out there talking to people, giving them their experiences," he said, adding that outreach, along with sustained social media, daily talking points, and other methods are helping to get the message out that the vaccines are safe and effective. "It's a personal decision that people have to make."

Headshot photo of Maj. Gen. (Dr.) George "Ned" Appenzeller
Maj. Gen. (Dr.) George “Ned” Appenzeller: “I would love to be the one to put the vaccine in everyone’s arm, but if it’s available to you in your local community, I suggest you go ahead and get it wherever you can get it first.”

"I can tell you, unequivocally, I got it," he said of the vaccine, recommending once again that service members receive whatever shot is available, and to weigh the risk of getting COVID-19 versus whatever side effects that may result from a jab. "I will acknowledge that after my second dose, I felt pretty poorly for about 12 to 24 hours after it. A lot of people get that - that's normal."

Addressing the recent news that the Food and Drug Administration and the Centers for Disease Control called for an immediate pause in using the Janssen (Johnson & Johnson) single-dose vaccine, Appenzeller said the DOD was naturally following suit. He said the move was done out of an "abundance of caution" because of the "rare but significant event" resulting from six people experiencing serious blood clots after having the J & J vaccine.

"They're taking prudent action, to make sure there's not something more that needs to be done," Appenzeller said. "We will continue to follow CDC and FDA guidance."

Don't be a spreader

Acknowledging that no one knows what the long-term effects of COVID-19 will be for those previously infected, or those vaccinated or not, Appenzeller noted that the risk of the virus to the older population is undoubtedly greater.

"Even though you're at a lower risk, young and healthy, you've got to remember that another point of getting the vaccine is so you don't spread it to others," he said. "I would recommend to the young folks to go ahead and get your vaccine, because what you're really trying to do is not spread it to your mother, your father, your grandmother ... those people who are at a higher risk."

He urged individuals with questions of risk to seek out a medical professional. "An informed decision is always a better decision."

Appenzeller said that "all of the things that have so far protected us continue to protect us," such as hand-washing, mask use, and physical distancing when not with one's immediate family. As more people get vaccinated, he advised service members pay close attention to locally specific COVID-19 rules and guidelines provided by their individual post commanders, even if those rules loosen in time.

In the meantime, he said he's been inspired to watch military medical personnel truly embrace their mission of inoculating millions of fellow service members and civilians.

"It's actually been very cool to go out and see what these young docs and young medics and these young nurses are really accomplishing," he said. "Just incredible work by a lot of people who are out there helping the nation."

Appenzeller's remarks can be seen in full here.

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This Practice Management Guide does not supersede DOD Policy. It is based upon the best information available at the time of publication. It is designed to provide information and assist decision making. It is not intended to define a standard of care and should not be construed as one. Neither should it be interpreted as prescribing an exclusive course of management. It was developed by experts in this field. Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of this guideline is responsible for evaluating the appropriateness of applying it in the setting of any particular clinical situation. The Practice Management Guide is not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions within this guide does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor.

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Last Updated: December 29, 2022
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