Navigating Vaccine Exemption in the Military
With the new COVID-19 vaccine on the horizon, being prepared to advocate for yourself is more important than ever. A medical vaccine exemption is a stronger strategy than a religious or personal belief exemption in the military, since force protection is valued above all else. The military places a monetary value on every resource, including people and military working dogs. So while advocating for your own individual health, you will also have to convince the Chain of Command that you are a valuable resource to the unit’s mission to avoid threats of being subject to Chapter Separation Procedures out of the military for a health condition or being punished under UCMJ for disobeying an order.
The Military Vaccine Program
Military personnel are required to get all ACIP recommended vaccines (TDAP, MMR, VAR) to include Influenza (seasonal, northern hemisphere, southern hemisphere) and HPV vaccines that are not mandatory for civilians in the workplace. Military personnel pending deployment also receive additional vaccines that are not common on the civilian schedule: Cholera, Typhoid, Yellow fever. A subgroup of military personnel in Republic of Korea and Japan also receive the Japanese Encephalitis vaccine. In 2018, FORSCOM ended a mandatory routine adult schedule for Anthrax and Smallpox vaccines. Since 2011, new enlisted recruits receive an oral Adenovirus vaccine.
What You Can Do
Print and review these resources when approaching your doctor. First, the Military Immunization Tool Kit includes a Adult Immunization Schedule with contraindications, to include pregnancy and immune compromised individuals. You can use this resource to broach the subject of exemption in any way that may apply to you. Second, you can download and print the DOD (Department of Defense) Form 3111 — an immunization screening form. This form is never used to screen military personnel for general contraindications. It is ignored in military practice much like the screening checklist contraindication form for children in pediatric practice is ignored. There are also screening checklists for each individual vaccine (linked in the toolkit above). These screening tools are a good foot-in-the-door strategy to begin a conversation with a doctor to determine your health dictates a medical exemption.
- Screen for Contraindications. Discuss medical contraindication to a specific vaccine with your preferred doctor. If you do not find support, search for a sympathetic doctor or physician’s assistant at a different Troop Medical Clinic or in the civilian sector under TRICARE. Be prepared to pay out of pocket for a civilian doctor.
- Find Exceptions. Be aware that rank and specialty plays a role in exceptions to every policy in the military. Find an example of a high-ranking officer or a high-value Military Occupational Specialty (i.e. Communications, Physicians, or Pilots) that is exempt from the requirement and seek free legal advice from JAG (Judge Advocate General Corps).
- Cite History & Research. The Anthrax vaccine injured soldiers with long term adverse effects, and Israel compensated $6 million to soldiers who were coerced into the experimental vaccine. Likewise, make your case based on research that animal phase trials of mRNA vaccines have demonstrated irreversible risks to include uncontrolled swelling and clotting, and immune enhancement that causes infection when exposed to wild strain viruses. The current human COVID trials are reporting adverse effects in healthy people and low efficacy as measured in low neutralizing antibodies.
- Develop a Support Network. Create a collaborative network of people working together at your duty station on this issue. If you find a supportive doctor or physician’s assistant, do not publicly announce his or her support. Use discretion in language that indicates that the doctor “values individualized medical treatment” and “proper contraindication screening.” If you develop a hostile strategy of friendly fire, you will not succeed.
- Request Compassionate Reassignment. If you are near retirement, and cannot comply with a COVID vaccine mandate, then ask for a compassionate reassignment to finish your service much like soldiers injured in combat and families of exceptional children.
- Be Indispensable. Perform your duties in such an exemplary way that your commander will rally around you and support you. In my personal military experience, my Chain of Command had to approve my taking a Commander position while I was pregnant and non-deployable. I committed to being fit-to-fight in six weeks after delivery. The day of my return to duty, I led my company on a two-mile run. Demonstrate your value, leadership, and proficiency to the unit.
In conclusion, follow groups such as Children’s Health Defense that provide information on adverse events and efficacy of vaccines for both adults and children so you can bring any potentially relevant side-effects up to your doctor.
Despite the one-size-fits-all approach with vaccines, you can advocate for your personal health effectively if you keep force protection and military readiness in mind. Remember, the military has invested time, training, and education in each service member and does not want to replace or rehabilitate soldiers when injuries or adverse reactions can be avoided. You must make the case that the risk of harm outweighs the intended benefit. Often, the patient knows more about their contra-indications of a vaccine than the medic, nurse, or PA administering the vaccine. For example, you might have an allergy to an ingredient and it would be malpractice to administer the vaccine. Persevere with persuasion.