Many Servicemembers Are Saying ‘No’ to Voluntary Shot

By: Celeste E. Whittaker

Navy Damage Controlman 3rd Class Alexandro Fajardo, right, receives the COVID-19 vaccine from Hospital Corpsman Seaman Henry Mason in the mess decks aboard the ship in Newport News, VA, last month. The Navy now is incentivizing sailors to be vaccinated. U.S. Navy photo by Mass Communication Specialist Seaman Crayton Agnew

WASHINGTON — The Navy became the first U.S. military branch to change policy so that servicemembers who are fully vaccinated against COVID-19 have more freedom of movement.

New guidance eases up on predeployment restriction of movement (ROM)-sequester, health protection measures (HPM) and port visits. For the first time, some requirements are different for vaccinated vs. nonvaccinated sailors.

“With more than a year operating in the COVID environment, we have gained significant expertise in mitigating and preventing the spread of COVID-19,” said Vice Adm. Phil Sawyer, deputy chief of naval operations for Operations, Plans and Strategy. “Now with vaccines and CDC scientific data, we are able to relax many of the procedures we put in place and still provide for the health protection of the force.”

For example, predeployment ROM-sequester is no longer required for immunized individuals, although nonimmunized personnel will still conduct a 14-day ROM-sequester with test-in and test-out prior to deployment. That’s to ensure they embark ships COVID-free, according to the document.

In addition, based on unit size and immunization rate, Naval Component Commands (NCC) are allowed to authorize relaxation of some HPM measures to train sailors and operate in a more “realistic and unimpeded shipboard setting,” the Navy noted in a statement. Furthermore, commanding officers can opt to permit immunized sailors making port calls in safe haven ports overseas—including Guam, Bahrain, Yokosuka, Rota or Sasebo—to take advantage of base services such as gyms, laundry facilities, commissary access and other base amenities. 

The Navy emphasized that none of the more than 230,000 fully immunized sailors and marines have been hospitalized to date for COVID-19, which underscores the operational importance of widespread vaccination. It is unclear if or when the other military services will follow the Navy’s lead in providing some vaccination incentives.

The DoD has suggested that all military personnel could be fully vaccinated by early summer, even though about one-third of military members who have been offered the vaccine have expressed strong hesitancy, and many have declined. Exactly how that will occur remained unknown.

The COVID-19 vaccine is currently being administered under emergency use authorization (EUA), without full approval from the U.S. Food and Drug Administration. Once full approval is gained, the military could make the vaccine mandatory for its members.

While the vaccines are available under prelicensure status, such as an EUA, they remain voluntary for servicemembers but are highly encouraged by military leadership.

“Based on the projections that we have, both supply side and vaccination side, we do fully expect to be open to all … of our DoD eligible populations on or before the first of May,” said Army Lt. Gen. Ronald J. Place, director of the DHA. “At current uptake rates for those who want to get it, we think by the middle of July or so … the department will be vaccinated.”

As of May 24, the DoD had administered nearly 3.5 million vaccine doses to servicemembers, family members, eligible civilian employees and retirees. Out of about 1.4 million active-duty servicemembers, 760,249, or slightly more than half, had been fully vaccinated, with another 316,479 having received a first shot. That was a significant jump from the month before, with the increase in vaccinations credited to a Pentagon decision to open up vaccines to all servicemembers, not just those at higher risk.

The vaccination rate for the Marines, where hesitancy reportedly has been the greatest problem, remains under 45%, however.

While some in Congress had suggested they could take action to mandate military vaccinations, that has not occurred. President Joe Biden also addressed the issue but said he does not plan to order servicemembers to get the vaccine, although he didn’t 100% rule that action out.

“I don’t know,” Biden said when asked the question by “Today” host Craig Melvin on April 30. “I’m going to leave it to the military.”

It also is possible that the vaccine could become mandated for the military sooner than expected because of FDA approval. Pfizer Chairman and CEO Albert Bourla said in April that the company now has enough data to “confirm the favorable efficacy and safety profile” of its COVID-19 vaccine to apply soon for full approval from the FDA. The EUA was issued in December 2020.

Also, Moderna released results of its vaccine trials after six months in mid-April, its next step in seeking full FDA approval for its COVID-19 vaccines. When the vaccines were first rolled out, it was predicted that the process for receiving full FDA approval could take more than a year.

Accurate Information

Until that occurs, DoD officials suggest that getting accurate information out about the vaccine is important, based on the assumption that educated servicemembers are more likely to opt for the vaccines.

Testifying before Congress in March, Air Force Maj. Gen. Jeff Taliaferro, vice director for operations for the Joint Chiefs of Staff, said the acceptance rate was about two-thirds, although it was early in the process.

In May, Secretary of Defense Lloyd J. Austin III said the military’s top priority is to defend the nation, protect its interests and that “today, the most urgent challenge that we face is COVID-19, and so the department has stepped up to save American lives through vaccination.”

“We’ve also been moving out quickly to vaccinate the force and our broader DOD family,” he said. “We’ve administered more than 3 million shots to DOD personnel.”

The DoD has had 293,788 cases of COVID-19 in its community, including servicemembers, dependents, employees and contractors. There have been 351 deaths, including 26 servicemembers across all components and branches.

Austin was asked about hesitancy among military personnel and their families to get the vaccine and why he has not mandated it.

“Regarding the COVID vaccine, as you know … it’s still under the emergency use authorization,” the Austin said. “We’ve been constantly reviewing our performance and our options, and we look at the data every day. We still believe that the right focus is to provide the best information available, and this will help our troops to make informed decisions. It’s certainly, you know, the approach I took when I elected to take the vaccine very early on when it was available.

“I think armed with the—with the right information, accurate information, troops will make—will make good choices. And so our plan currently is to continue on the path that we’re on. You know, we have—we’re using about 80% of the vaccines that we’ve been provided; vaccines are going into arms at a good rate. So, I think, you know, the wise thing to do is to continue to evaluate and follow the course that we’re on right now.”

Both Terry Adirim, MD, MPH, MBA, acting assistant secretary of Defense for Health Affairs and Place underscored the word voluntary multiple times when speaking about vaccinations among members of the military.

Prior to the Navy’s actions, the two DHA officials had said no additional incentives were being added to the mix.

“The vaccine is voluntary; that’s part of the EUA that the vaccine is voluntary, so that is department policy,” Adirim said. “And I think I’d like to quote Secretary Austin, who said that the greatest incentive to getting vaccinated is that it saves your life, and it saves the lives of the folks that mean a lot to you. So, getting the vaccine in of itself should be an incentive and that’s our stand in the department.

“Right now, the policy is no additional incentives beyond getting vaccinated,” he added, although he pointed out that the military services have amended the force health protection guidance for travel, in line with the national Centers for Disease Control and Prevention policy. That states that those who have been vaccinated do not need to do pretravel quarantining, so that, she said, is an “example of a benefit of getting vaccinated.”

Place added that the vaccine being voluntary “means that commanders have to be very careful not to exert what we call undue command influence. And so the right and left limits for them is informing their servicemembers, informing their community information for people to make decisions on their own.

“But we’re very careful as leaders in uniform, as commanders, to not exert undue command influence on a thing that is voluntary.”

In explaining the Navy’s action to relax restrictions for vaccinated servicemembers, Sawyer said, “The science is pretty clear: Vaccinations are key to best protecting our sailors. The more sailors that are vaccinated, the better for them, their families, the Navy and the nation.”