Back to Top Skip to main content

DHA’s Vaccine Safety Hubs emphasize safety

Soldier filling a vaccine needle Staff Sgt. Jay Griggs, medical technician with the 911th Aeromedical Staging Squadron, prepares a vaccine at the Pittsburgh International Airport Air Reserve Station, Pennsylvania. Department of Defense issued vaccinations are used to prevent a variety of diseases that military members may encounter in the course of their duties. (U.S. Air Force photo by Joshua J. Seybert)

Recommended Content:

Health Readiness | Immunization Healthcare | Vaccine-Preventable Diseases

“It’s very, very easy to do vaccines wrong; it’s very hard to do it right.”

When Dr. Bruce McClenathan, medical director of the South Atlantic Region Vaccine Safety Hub for the Defense Health Agency’s Immunization Healthcare Division, teaches courses on vaccine safety, he often makes this statement to his students.

To do it right, according to McClenathan, is to know the exceptions to every rule and the nuances of delivering high-quality immunization health care. Within the Military Health System that job falls on the four regional vaccine safety hubs of the DHA, which are strategically located throughout the U.S.

“The vaccine safety hubs are designed to place immunization experts in the field and assist stakeholders with various needs; this could be recommendations on clinical care, education and training, answering questions on policy, providing recommendations on clinic operations, best practices, vaccine hesitancy, conducting vaccine research, etc.,” said McClenathan. “Our team helps with all things related to vaccines.”

A physician serves as medical director in leading each hub, which includes nurse practitioners, registered nurses, immunization health care specialists, education experts, and research assistants, as well as a hub administrator, each having various areas of responsibility.

Military personnel in a classroom setting
The Immunization Healthcare Division's Pacific Region Vaccine Safety Hub held a two-day Immunization Lifelong Learners Course at Camp Pendleton in San Diego County, California, on Sept. 2-3, 2020 for MHS healthcare professionals. (Photo by David Carbungco)

“For example, the South Atlantic Region Vaccine Safety hub, which is based out of Fort Bragg, North Carolina, is responsible for taking care of CENTCOM, SOUTHCOM, and SOCOM, as well as the major commands on Fort Bragg proper, such as the U.S. Army Forces Command, the U.S. Army Special Operation Command, Joint Special Operations Command, and XVIII Airborne Corp. In addition, the hub supports the entire southeastern part of the United States,” he said. “If a stakeholder in any of these Commands or geographic areas has a question or concern about immunizations, we are available to assist and help resolve their issues.”

Behind the scenes, the regional vaccine safety hubs conduct training and quality assurance checks to ensure the delivery of a safe and effective vaccine to the patient. “If you go in to get a vaccine and everything is fine, that means we’ve done our job well,” said McClenathan. “All of the details that a patient doesn’t need to know about vaccines—but your clinic staff who provide it do have to know...we make sure folks are trained.”

While the military medical treatment facilities oversee and manage their day-to-day operations in patient care, such as ordering and managing vaccines, if they run into a problem, the regional immunization health care specialist is there to help. Recently, McClenathan and his team helped an MTF secure enough yellow fever vaccine just before a short-notice deployment of troops; they otherwise would have faced a supply shortage.

“We redistribute vaccines anywhere in the DoD and ensure they go where they are needed so that vaccines don’t go to waste,” he said, adding that by doing so, the hubs save the Department of Defense hundreds of thousands of dollars each year.

Staff from the hub also support the 24/7 vaccine call centerline where clinic staff, patients and other beneficiaries can ask an expert vaccine-related questions.

“Our hubs are critical to the success of our organization and the DoD immunization program as a whole,” said McClenathan. “We are a one-stop shop for all things immunization so that those who do provide the immunizations can do their jobs competently, professionally, and to the standard of care, if not exceeding the standard of care.”

The majority of vaccines do not change frequently, with exception of the flu vaccine that is updated every year to adapt to new virus strains, but vaccine research is evolving, said McClenathan. For example, the Food and Drug Administration recently expanded approval of an HPV vaccine for men and women up to age 45 to prevent certain cancers and diseases; previously the maximum age was 26.

“As more data and research are completed and assimilated, the recommendations for use of a vaccine may change, even though vaccine itself may not be changing,” he said.

The regional vaccine safety hubs also contribute to the overall vaccine research community, especially as it relates to military health beneficiaries. The research topics can vary from genetics to vaccine adverse reactions to the efficacy of vaccines. McClenathan’s team recently completed a five-year clinical trial studying the impact of ibuprofen on a patient’s immune response to the flu vaccine. The results of the study will soon be published in a peer-reviewed journal.

“It’s really never been studied, especially in adults,” he said. “But we give a lot of ibuprofen and we give a lot of vaccines in the military, so we need to know if giving ibuprofen impacts how people respond to the vaccine.”

Currently, all four regional vaccine safety hubs within the DHA are participating in a major study, in collaboration with the federal government’s Infectious Disease Clinical Research Program to assess which form of the flu vaccine is most effective and providing immunity against the virus, whether egg-based, cell-based, or recombinant flu vaccine. “That’s going to be a pivotal study that will change not only which flu vaccine is given in the military but hopefully globally,” said McClenathan.

You also may be interested in...

Ambulatory Visits, Active Component, U.S. Armed Forces, 2017

Infographic
5/23/2018
ACTIVE COMPONENT, U.S. ARMED FORCES, 2017  This report documents the frequencies, rates, trends, and characteristics of ambulatory healthcare visits of active component members of the U.S. Army, Navy, Air Force, and Marine Corps.

ACTIVE COMPONENT, U.S. ARMED FORCES, 2017 This report documents the frequencies, rates, trends, and characteristics of ambulatory healthcare visits of active component members of the U.S. Army, Navy, Air Force, and Marine Corps.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Member, U.S. Armed Forces, 2017

Infographic
5/23/2018
Morbidity Burdens Attributable to Various Illnesses and Injuries, Deployed Active and Reserve Component Service Member, U.S. Armed Forces, 2017

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Absolute and Relative Morbidity Burdens, Attributable to Various Illnesses and Injuries, 2017

Infographic
5/23/2018
Absolute and Relative Morbidity Burdens, Attributable to Various Illnesses and Injuries, 2017

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report

Hospitalizations, Active Component, U.S. Armed Forces, 2017

Infographic
5/23/2018
This report documents the frequencies, rates, trends, and distributions of hospitalizations of active component members of the U.S. Army, Navy, Air Force, and Marine Corps during calendar year 2017.

This report documents the frequencies, rates, trends, and distributions of hospitalizations of active component members of the U.S. Army, Navy, Air Force, and Marine Corps during calendar year 2017.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Heat Illness

Infographic
4/13/2018
Exertional, or exercise-associated, hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 milliequivalents/liter) that develops during or up to 24 hours following prolonged physical activity.

There were a total of 2,163 incident cases of heat illness among active component service members, including 464 cases of heat stroke and 1,699 cases of heat exhaustion.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Rhabdomyolysis

Infographic
4/13/2018
Rhabdomyolysis

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Hyponatremia

Infographic
4/13/2018
Exertional, or exercise-associated, hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 milliequivalents/liter) that develops during or up to 24 hours following prolonged physical activity.

Exertional, or exercise-associated, hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 milliequivalents/liter) that develops during or up to 24 hours following prolonged physical activity.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Cardiovascular Diseases

Infographic
4/4/2018
At the time of entry into military service, many members of the U.S. Armed Forces are young, physically active, and in good physical health. However, following entry, many service members develop or are discovered to have risk factors for cardiovascular disease (CVD). This report documents the incidence and prevalence of select risk factors for CVD among active component (AC) service members and provides estimates of the incidence rates of major categories of cardiovascular diseases themselves.

At the time of entry into military service, many members of the U.S. Armed Forces are young, physically active, and in good physical health. However, following entry, many service members develop or are discovered to have risk factors for cardiovascular disease (CVD). This report documents the incidence and prevalence of select risk factors for CVD among active component (AC) service members and provides estimates of the incidence rates of major categories of cardiovascular diseases themselves.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report

Mental Health Problems

Infographic
4/4/2018
This report summarizes the numbers, natures, and rates of incident mental health disorder diagnoses as well as mental health problems among active component U.S. service members during 2007–2016.

This report summarizes the numbers, natures, and rates of incident mental health disorder diagnoses as well as mental health problems among active component U.S. service members during 2007–2016.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report

Surveillance for Vector-Borne Diseases, Active and Reserve Component Service Members, U.S. Armed Forces, 2010 – 2016

Infographic
2/14/2018
Within the U.S. Armed Forces considerable effort has been applied to the prevention and treatment of vector-borne diseases. A key component of that effort has been the surveillance of vector-borne diseases to inform the steps needed to identify where and when threats exist and to evaluate the impact of preventive measures. This report summarizes available health records information about the occurrence of vector-borne infectious diseases among members of the U.S. Armed Forces, during a recent 7-year surveillance period. For the 7-surveillance period, there were 1,436 confirmed cases of vector-borne diseases, 536 possible cases, and 8,667 suspected cases among service members of the active and reserve components. •	“Confirmed” case = confirmed reportable medical event. •	“Possible” case = hospitalization with a diagnosis for a vector-borne disease. •	“Suspected” case = either a non-confirmed reportable medical event or an outpatient medical encounter with a diagnosis of a vector-borne disease. Lyme disease (n=721) and malaria (n=346) were the most common diagnoses among confirmed and possible cases. •	In 2015, the annual numbers of confirmed case of Lyme disease were the fewest reported during the surveillance period. •	Diagnoses of Chikungunya (CHIK) and Zika (ZIKV) were elevated in the years following their respective entries into the Western Hemisphere: CHIK (2014 and 2015); ZIKV (2016). The available data reinforce the need for continued emphasis on the multidisciplinary preventive measures necessary to counter the ever-present threat of vector-borne disease. Access the full report in the February 2018 MSMR (Vol. 25, No. 2). Go to www.Health.mil/MSMR  Background graphic shows service member in the field and insects which spread vector borne diseases.

This infographic summarizes available health records information about the occurrence of vector-borne infectious diseases among members of the U.S. Armed Forces, during a recent 7-year surveillance period (2010 – 2016).

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report | Preventing Mosquito-Borne Illnesses | Chikungunya | Malaria | Zika Virus

Malaria U.S. Armed Forces, 2017

Infographic
2/14/2018
Since 1999, the Medical Surveillance Monthly Report (MSMR) has published periodic updates on the incidence of malaria among U.S. service members. Malaria infection remains an important health threat to U.S. service members, who are located in endemic areas because of long-term duty assignments, participation in shorter-term contingency operations, or personal travel. This update for 2017 describes the epidemiologic patterns of malaria incidence in active and reserve component service members of the U.S. Armed Forces. Findings •	A total of 32 service members were diagnosed with or reported to have malaria, which is the lowest number of cases in any given year during the 10-year surveillance period. •	Health records documented the performance of laboratory tests for malaria for 22 of the cases. The tests for 17 of the 22 were positive for malaria ( stick figure graphic visually depicts this information). •	In 2017, 75.0% (24 of 32) of malaria cases among U.S. service members were diagnosed during May – October (calendar graphic showing the months visually). •	Of the 32 malaria cases in 2017, more than 1/3 of the infections were considered to have been acquired in Africa. Two bar charts display the following information: •	Bar chart 1: Numbers of malaria cases by Plasmodium species and calendar year of diagnosis/report, active and reserve components, U.S. Armed Forces, 2008 – 2017  •	Bar chart 2: Annual numbers of cases of malaria associated with specific locations of acquisition, active and reserve components, U.S. Armed Forces, 2008 – 2017  The majority of U.S. military members diagnosed with malaria in 2017 were: •	Male (96.9%) •	Active component (81.3%) •	In the Army (75.0%) •	In their 20’s (56.3%) Access the full report in the February 2018 MSMR (Vol. 25 No. 2). Go to www.Health.mil/MSMR  Picture of a mosquito displays on the graphic.

This update for 2017 describes the epidemiologic patterns of malaria incidence in active and reserve component service members of the U.S. Armed Forces.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report

Outbreak of Influenza and Rhinovirus co-circulation among unvaccinated recruits, U.S. Coast Guard Training Center Cape May, NJ, 24 July – 21 August 2016

Infographic
2/5/2018
On 29 July 2016, the U.S. Coast Guard Training Center Cape May (TCCM), NJ, identified an increase in febrile respiratory illness (FRI) among recruits who were unvaccinated against seasonal influenza as a result of the annual vaccine’s expiration. This report characterizes the outbreak and containment measures implemented at TCCM during the outbreak period. In 2016, respiratory infections affected more than 250,000 U.S. service members and comprised approximately 22% of medical encounters among military recruit populations – who are highly susceptible to respiratory infections. Seasonal influenza and rhinovirus are two of the leading respiratory pathogens. During the Surveillance Period: 115 recruits reported respiratory infection symptoms. Pie chart 1 shows the following data: •	41 (35.7%) suspected cases •	74 (64.3%) confirmed cases Among confirmed cases, lab specimens tested positive for: •	Influenza A 34 (45.9%) •	Rhinovirus 28 (37.8%) •	Influenza A and rhinovirus co-infection 11 (14.9%) •	Rhinovirus and adenovirus co-infection 1 (1.4%) Data above depicted in pie chart 2. •	24 July – 6 August, Influenza predominated •	7 August – 20 August, Rhinovirus predominated Although the outbreak significantly affected operations at TCCM, a timely and comprehensive response resulted in containment of the outbreak within 5 weeks. Key Factor for Outbreak Control •	Rapid detection through FRI sentinel surveillance •	Quick decision-making •	Streamlined response by using a single chain of command •	Rapid implementation of both nonpharmaceutical and pharmaceutical interventions Access the full report in the January 2018 MSMR (Vol. 25, No. 1). Go to: www.Health.mil/MSMR

This report characterizes the outbreak and containment measures implemented at the U.S. Coast Guard Training Center Cape May (TCCM), New Jersey, during a July 24 – August 21, 2016 outbreak period.

Recommended Content:

Health Readiness | Medical Surveillance Monthly Report | Integrated Biosurveillance | Influenza Summary and Reports

Department of Defense Global, Laboratory-based Influenza Surveillance Program’s Influenza vaccine effectiveness estimates and surveillance trends, 2016 – 2017 Influenza Season

Infographic
2/5/2018
Each year, the Department of Defense (DoD) Global, Laboratory-based Influenza Surveillance Program performs surveillance for influenza among service members of the DoD and their dependent family members. In addition to routine surveillance, vaccine effectiveness (VE) studies are performed and results are shared with the Food and Drug Administration, Centers for Disease Control and Prevention, and the World Health Organization for vaccine evaluation. This report documents the annual surveillance trends for the 2016 – 2017 influenza season and the end-of-season VE results. The analysis was performed by the U.S. Air Force School of Aerospace Medicine Epidemiology Laboratory, and the DoD Influenza Surveillance Program staff at Wright-Patterson Air Force Base, OH. FINDINGS: A total of 5,555 specimens were tested from 84 locations: •	2,486 (44.7%) negative •	1,382 (24.9%) influenza A •	1,093 (19.7%) other respiratory pathogens •	443 (8.0%) influenza B •	151 (2.7%) co-infections The predominant influenza strain was A (H3N2), representing 73.8% of all circulating influenza. Pie chart displays this information. Graph showing the numbers and percentages of respiratory specimens positive for influenza viruses, and numbers of influenza viruses identified, by type, by surveillance week, Department of Defense healthcare beneficiaries, 2016 – 2017 influenza season displays. The vaccine effectiveness (VE) for this season was slightly lower than for the 2015 – 2016 season, which had a 63% (95% confidence interval: 53% - 71%) adjusted VE. The adjusted VE for the 2016 – 2017 season was 48% protective against all types of influenza.  Access the full report in the January 2018 MSMR (Vol. 25, No. 1). Go to: www.Health.mil/MSMR

This infographic documents the annual surveillance trends for the 2016 – 2017 influenza season and the end-of-season vaccine effectiveness.

Recommended Content:

Health Readiness | Influenza Summary and Reports | Medical Surveillance Monthly Report | Vaccine-Preventable Diseases | Force Health Protection | Global Health Engagement

Insomnia and motor vehicle accident-related injuries, Active Component, U.S. Armed Forces, 2007 – 2016

Infographic
1/25/2018
Insomnia is the most common sleep disorder in adults and its incidence in the U.S. Armed Forces is increasing. A potential consequence of inadequate sleep is increased risk of motor vehicle accidents (MVAs). MVAs are the leading cause of peacetime deaths and a major cause of non-fatal injuries in the U.S. military members. To examine the relationship between insomnia and motor vehicle accident-related injuries (MVAs) in the U.S. military, this retrospective cohort study compared 2007 – 2016 incidence rates of MVA-related injuries between service members with diagnosed insomnia and service members without a diagnosis of insomnia. After adjustment for multiple covariates, during 2007 – 2016, active component service members with insomnia had more than double the rate of MVA-related injuries, compared to service members without insomnia. Findings:  •	Line graph shows the annual rates of motor vehicle accident-related injuries, active component service members with and without diagnoses of insomnia, U.S. Armed Forces, 2007 – 2016  •	Annual rates of MVA-related injuries were highest in the insomnia cohort in 2007 and 2008, and lowest in 2016 •	There were 5,587 cases of MVA-related injuries in the two cohorts during the surveillance period. •	Pie chart displays the following data: 1,738 (31.1%) in the unexposed cohort and 3,849 (68.9%) in the insomnia cohort The highest overall crude rates of MVA-related injuries were seen in service members who were: •	Less than 25 years old •	Junior enlisted rank/grade •	Armor/transport occupation •	 •	With a history of mental health diagnosis •	With a history of alcohol-related disorders Access the full report in the December 2017 (Vol. 24, No. 12). Go to www.Health.mil/MSMR Image displays a motor vehicle accident.

To examine the relationship between insomnia and motor vehicle accident-related injuries (MVAs) in the U.S. military, this retrospective cohort study compared 2007 – 2016 incidence rates of MVA-related injuries between service members with diagnosed insomnia and service members without a diagnosis of insomnia.

Recommended Content:

Armed Forces Health Surveillance Branch | Health Readiness | Medical Surveillance Monthly Report

Seizures among Active Component service members, U.S. Armed Forces, 2007 – 2016

Infographic
1/25/2018
This retrospective study estimated the rates of seizures diagnosed among deployed and non-deployed service members to identify factors associated with seizures and determine if seizure rates differed in deployment settings. It also attempted to evaluate the associations between seizures, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD) by assessing correlations between the incidence rates of seizures and prior diagnoses of TBI and PTSD. Seizures have been defined as paroxysmal neurologic episodes caused by abnormal neuronal activity in the brain. Approximately one in 10 individuals will experience a seizure in their lifetime. Line graph 1: Annual crude incidence rates of seizures among non-deployed service members, active component, U.S. Armed Forces data •	A total of 16,257 seizure events of all types were identified among non-deployed service members during the 10-year surveillance period. •	The overall incidence rate was 12.9 seizures per 10,000 person-years (p-yrs.) •	There was a decrease in the rate of seizures diagnosed in the active component of the military during the 10-year period. Rates reached their lowest point in 2015 – 9.0 seizures per 10,000 p-yrs. •	Annual rates were markedly higher among service members with recent PTSD and TBI diagnoses, and among those with prior seizure diagnoses. Line graph 2: Annual crude incidence rates of seizures by traumatic brain injury (TBI) and recent post-traumatic stress disorder (PTSD) diagnosis among non-deployed active component service members, U.S. Armed Forces •	For service members who had received both TBI and PTSD diagnoses, seizure rates among the deployed and the non-deployed were two and three times the rates among those with only one of those diagnoses, respectively. •	Rates of seizures tended to be higher among service members who were: in the Army or Marine Corps, Female, African American, Younger than age 30, Veterans of no more than one previous deployment, and in the occupations of combat arms, armor, or healthcare Line graph 3: Annual crude incidence rates of seizures diagnosed among service members deployed to Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn, U.S. Armed Forces, 2008 – 2016  •	A total of 814 cases of seizures were identified during deployment to operations in Iraq and Afghanistan during the 9-year surveillance period (2008 – 2016). •	For deployed service members, the overall incidence rate was 9.1 seizures per 10,000 p-yrs. •	Having either a TBI or recent PTSD diagnosis alone was associated with a 3-to 4-fold increase in the rate of seizures. •	Only 19 cases of seizures were diagnosed among deployed individuals with a recent PTSD diagnosis during the 9-year surveillance period. •	Overall incidence rates among deployed service members were highest for those in the Army, females, those younger than age 25, junior enlisted, and in healthcare occupations. Access the full report in the December 2017 MSMR (Vol. 24, No. 12). Go to www.Health.mil/MSMR

This infographic documents a retrospective study which estimated the rates of seizures diagnosed among deployed and non-deployed service members to identify factors associated with seizures and determine if seizure rates differed in deployment settings. The study also evaluated the associations between seizures, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD) by assessing correlations between the incidence rates of seizures and prior diagnoses of TBI and PTSD.

Recommended Content:

Health Readiness | Posttraumatic Stress Disorder | Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 61 - 75 Page 5 of 6

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.