Re: Military Exemptions

[Guest guest]

My apologies to the group for stating there was not a religious exemption for the military; thank you Alan, for correcting me. There is (I've copied portions below from the DODI). That however said, it is important to understand that religious exemptions may be yanked at any time deemed appropriate by the military because the mission will come first. I have personally seen this scenario played out on numerous occassions. And in cases, medical exemptions may be yanked as well. You have to read further below beyond the (2 types of exemptions available to read about the religious exemption). Also to follow that will be the link (for any interested) clarifying how the DoD will come into play in case of "national emergencies" and what that entails between either forced treatment or quarantine. PREPA didn't seem too clear about if forced

vaccination would occur or what 'quarantine' actually meant - this seems to clarify it a bit more. (Made availabe to the public, March 2010)

http://www.vaccines.mil/documents/969r40_562.pdf

2–6. Exemptions

There are 2 types of exemptions from immunization: medical and administrative. Granting medical exemptions is a

medical function that can only be validated by a health care professional. Granting administrative exemptions is a

non–medical function, usually controlled by the individual’s unit commander.

a. Medical exemptions. A medical exemption includes any medical contraindication relevant to a specific vaccine or

other medication. Medical exemptions will be customized to the health of the vaccine candidate and the nature of the

immunization considered. Medical exemptions may be temporary (up to 365 days) or permanent. General examples of

medical exemptions include those in (1), (2), and (3), below. Standard exemption codes appear in appendix C.

(1) Underlying health condition of the vaccine candidate (for example, based on immune competence, pharmacologic

or radiation therapy, pregnancy, previous response to immunization).

(2) Evidence of immunity based on serologic tests, documented infection, or similar circumstances.

(3) An individual’s clinical case is complex or not readily definable. In such cases, consult appropriate medical

AR 40–562/BUMEDINST 6230.15A/AFJI 48–110/CG COMDTINST M6230.4F • 29 September 2006 3

specialists; additional clinical support is available from medical subspecialists including specialists in immunization

health care.

(4) The primary care provider or a physician specialist may grant temporary or permanent medical exemptions. If

additional clinical consultation is needed to assess a patient’s condition, the primary care provider will perform the

initial clinical workup appropriate to the presenting symptoms and grant a temporary medical exemption pending the

results of a referral to a medical specialist appropriate to the individual’s clinical condition (for example, dermatology,

neurology, rheumatology, allergy–immunology). Specialists in immunization health care can facilitate these referrals.

Multidisciplinary consultations may be appropriate. A follow–up visit by the patient to his or her primary care provider

is not required if the specialist grants a permanent medical exemption. Cases warranting permanent medical exemption

due to a vaccine–related adverse event will be reported to the Vaccine Adverse Events Reporting System (VAERS).

Electronic and paper health records will be annotated regarding temporary and permanent medical exemptions and the

vaccines to which they apply. When no longer clinically warranted, medical exemptions will be revoked. Air Force:

military members with permanent medical exemptions require a medical evaluation board and/or a flying waiver in

accordance with AFI 48–123.

(5) Individuals who disagree with a provider’s/consultant’s exemption recommendations may be referred for a

second opinion to a provider experienced in vaccine adverse–event management, such as specialists in immunization

health care at a medical center.

(6) Personnel will appropriately annotate electronic ITS and paper–based health records with exemption codes

denoting evidence of immunity, severe adverse event after immunization, other temporary or permanent reasons for

medical exemption, and other appropriate categories.

b. Administrative exemptions. Standard exemption codes appear in appendix C.

(1) Separation or retirement. Within 180 days before separation or retirement, Service personnel may be exempt

from deployment (mobility) immunizations (see app D) if the following conditions are met:

(a) They are not currently assigned, deployed, or scheduled to perform duties in a geographical area where an

immunization is indicated.

( The commander has not directed immunization because of overriding mission requirements. Personnel meeting

these requirements and desiring an immunization exemption must identify themselves to their commander. The member

must have approved retirement or separation orders. Active duty personnel continuing duty in the Reserve Component

(RC) are not exempted on this basis.

(2) Thirty days or less of Service remaining. Exemptions apply to civilian employees and contractor personnel who

will leave a position subject to immunization with 30 days or less.

(3) Religious.

(a) For Service personnel, immunization exemptions for religious reasons may be granted according to Service–

specific policies to accommodate doctrinal religious beliefs. This is a command decision made with medical and

chaplain advice.

1. Requests for religious exemption must include name, rank, social security number (SSN), occupational specialty

code or branch, and a description of the religious tenet or belief contrary to immunization. Army: (see AR 600–20,

para 5–6). Air Force: Permanent exemptions for religious reasons will not be granted. The major command (MAJCOM)

commander is the designated approval and revocation authority for temporary immunization exemptions. Coast

Guard: CG–122 is the designated approval and revocation authority for temporary immunization exemptions.

2. A military physician must counsel the applicant. The physician should ensure that the Service personnel is

making an informed decision and should address, at a minimum, specific information about the diseases concerned;

specific vaccine information including product constituents, benefits, and risks; and potential risks of infection incurred

by unimmunized individuals.

3. The commander must counsel the individual and recommend approval or denial of the exemption request, by

endorsement. The commander must counsel that noncompliance with immunization requirements may adversely impact

deployability, assignment, or international travel, and that the exemption may be revoked under imminent risk

conditions. The commander, in making his or her recommendation, should consider the potential impact on the

individual, the unit, and the mission.

4. Forward exemption requests through command channels to the respective Service approval authority for decision.

Individuals with active requests for religious exemption are temporarily deferred from immunizations pending outcome

of their request. For USCG, forward through appropriate chain to G–WPM, via CG–1121.

------------------------------------------------------

http://www.dtic.mil/whs/directives/corres/pdf/620003p.pdf (page 17-18)

h. Military personnel may be ordered to submit to diagnostic or medical treatment, subject to any applicable Food and Drug Administration rules in accordance with DoDI 6200.02 (Reference (u)). Persons other than military personnel may be required as a condition of exemption or release from restriction of movement to submit to vaccination or treatment diagnostics as necessary to prevent transmitting a communicable disease and enhance public health and safety. The submission to vaccination or treatment diagnostics may be a requirement to return to work or gain access to a DoD installation or facility. Qualified personnel shall perform vaccination and treatment, consistent with appropriate medical standards, including appropriate exemption criteria. DoDI 6205.4

(Reference (v)) does not apply to vaccinations under this paragraph.

Randi J. Airola, © 517-819-5926

[Guest guest]

My apologies to the group for stating there was not a religious exemption for the military; thank you Alan, for correcting me. There is (I've copied portions below from the DODI). That however said, it is important to understand that religious exemptions may be yanked at any time deemed appropriate by the military because the mission will come first. I have personally seen this scenario played out on numerous occassions. And in cases, medical exemptions may be yanked as well. You have to read further below beyond the (2 types of exemptions available to read about the religious exemption). Also to follow that will be the link (for any interested) clarifying how the DoD will come into play in case of "national emergencies" and what that entails between either forced treatment or quarantine. PREPA didn't seem too clear about if forced

vaccination would occur or what 'quarantine' actually meant - this seems to clarify it a bit more. (Made availabe to the public, March 2010)

http://www.vaccines.mil/documents/969r40_562.pdf

2–6. Exemptions

There are 2 types of exemptions from immunization: medical and administrative. Granting medical exemptions is a

medical function that can only be validated by a health care professional. Granting administrative exemptions is a

non–medical function, usually controlled by the individual’s unit commander.

a. Medical exemptions. A medical exemption includes any medical contraindication relevant to a specific vaccine or

other medication. Medical exemptions will be customized to the health of the vaccine candidate and the nature of the

immunization considered. Medical exemptions may be temporary (up to 365 days) or permanent. General examples of

medical exemptions include those in (1), (2), and (3), below. Standard exemption codes appear in appendix C.

(1) Underlying health condition of the vaccine candidate (for example, based on immune competence, pharmacologic

or radiation therapy, pregnancy, previous response to immunization).

(2) Evidence of immunity based on serologic tests, documented infection, or similar circumstances.

(3) An individual’s clinical case is complex or not readily definable. In such cases, consult appropriate medical

AR 40–562/BUMEDINST 6230.15A/AFJI 48–110/CG COMDTINST M6230.4F • 29 September 2006 3

specialists; additional clinical support is available from medical subspecialists including specialists in immunization

health care.

(4) The primary care provider or a physician specialist may grant temporary or permanent medical exemptions. If

additional clinical consultation is needed to assess a patient’s condition, the primary care provider will perform the

initial clinical workup appropriate to the presenting symptoms and grant a temporary medical exemption pending the

results of a referral to a medical specialist appropriate to the individual’s clinical condition (for example, dermatology,

neurology, rheumatology, allergy–immunology). Specialists in immunization health care can facilitate these referrals.

Multidisciplinary consultations may be appropriate. A follow–up visit by the patient to his or her primary care provider

is not required if the specialist grants a permanent medical exemption. Cases warranting permanent medical exemption

due to a vaccine–related adverse event will be reported to the Vaccine Adverse Events Reporting System (VAERS).

Electronic and paper health records will be annotated regarding temporary and permanent medical exemptions and the

vaccines to which they apply. When no longer clinically warranted, medical exemptions will be revoked. Air Force:

military members with permanent medical exemptions require a medical evaluation board and/or a flying waiver in

accordance with AFI 48–123.

(5) Individuals who disagree with a provider’s/consultant’s exemption recommendations may be referred for a

second opinion to a provider experienced in vaccine adverse–event management, such as specialists in immunization

health care at a medical center.

(6) Personnel will appropriately annotate electronic ITS and paper–based health records with exemption codes

denoting evidence of immunity, severe adverse event after immunization, other temporary or permanent reasons for

medical exemption, and other appropriate categories.

b. Administrative exemptions. Standard exemption codes appear in appendix C.

(1) Separation or retirement. Within 180 days before separation or retirement, Service personnel may be exempt

from deployment (mobility) immunizations (see app D) if the following conditions are met:

(a) They are not currently assigned, deployed, or scheduled to perform duties in a geographical area where an

immunization is indicated.

( The commander has not directed immunization because of overriding mission requirements. Personnel meeting

these requirements and desiring an immunization exemption must identify themselves to their commander. The member

must have approved retirement or separation orders. Active duty personnel continuing duty in the Reserve Component

(RC) are not exempted on this basis.

(2) Thirty days or less of Service remaining. Exemptions apply to civilian employees and contractor personnel who

will leave a position subject to immunization with 30 days or less.

(3) Religious.

(a) For Service personnel, immunization exemptions for religious reasons may be granted according to Service–

specific policies to accommodate doctrinal religious beliefs. This is a command decision made with medical and

chaplain advice.

1. Requests for religious exemption must include name, rank, social security number (SSN), occupational specialty

code or branch, and a description of the religious tenet or belief contrary to immunization. Army: (see AR 600–20,

para 5–6). Air Force: Permanent exemptions for religious reasons will not be granted. The major command (MAJCOM)

commander is the designated approval and revocation authority for temporary immunization exemptions. Coast

Guard: CG–122 is the designated approval and revocation authority for temporary immunization exemptions.

2. A military physician must counsel the applicant. The physician should ensure that the Service personnel is

making an informed decision and should address, at a minimum, specific information about the diseases concerned;

specific vaccine information including product constituents, benefits, and risks; and potential risks of infection incurred

by unimmunized individuals.

3. The commander must counsel the individual and recommend approval or denial of the exemption request, by

endorsement. The commander must counsel that noncompliance with immunization requirements may adversely impact

deployability, assignment, or international travel, and that the exemption may be revoked under imminent risk

conditions. The commander, in making his or her recommendation, should consider the potential impact on the

individual, the unit, and the mission.

4. Forward exemption requests through command channels to the respective Service approval authority for decision.

Individuals with active requests for religious exemption are temporarily deferred from immunizations pending outcome

of their request. For USCG, forward through appropriate chain to G–WPM, via CG–1121.

------------------------------------------------------

http://www.dtic.mil/whs/directives/corres/pdf/620003p.pdf (page 17-18)

h. Military personnel may be ordered to submit to diagnostic or medical treatment, subject to any applicable Food and Drug Administration rules in accordance with DoDI 6200.02 (Reference (u)). Persons other than military personnel may be required as a condition of exemption or release from restriction of movement to submit to vaccination or treatment diagnostics as necessary to prevent transmitting a communicable disease and enhance public health and safety. The submission to vaccination or treatment diagnostics may be a requirement to return to work or gain access to a DoD installation or facility. Qualified personnel shall perform vaccination and treatment, consistent with appropriate medical standards, including appropriate exemption criteria. DoDI 6205.4

(Reference (v)) does not apply to vaccinations under this paragraph.

Randi J. Airola, © 517-819-5926

[Guest guest]

Yes, military exemptions, when approved, can be pulled if the mission later

requires it. But this is true with civilian exemptions, too--vaccines can be

mandated in a declared emergency without exemptions in most states, and the

unvaccinated can be quarantined in government facilities--there are no absolute

rights to a vaccine exemption (possible exception for medical exemptions, but

some laws even throw those out the window in emergencies!). This is a

legislative problem--we need to enact laws providing more freedom of choice. See

the Pandemic Response Project to get involved: www.pandemicresponseproject.com

With military exemptions (and immigration, healthcare employees, and students in

many states)--anywhere that you have to state your beliefs--it is important to

get reliable information about how to do that, to provide what is needed, and to

avoid the pitfalls that can cost you the exemption; you need to know what

qualifies legally and what doesn't. This is a question of law, not of one's

personal opinion about what should or shouldn't qualify legally. Statements of

religious beliefs need to be unique (the quickest way to lose an exemption is to

copy something off of the Internet!), so get reliable information before

submitting your exemption for approval in any situation where the agency

involved (DoD, USCIS, health department, school system, etc.) has authority to

scrutinize the exemption. Not all have authority to scrutinize exemptions, it

depends on the specific wording of the applicable exemption law. see The

Authoritative Guide to Vaccine Legal Exemptions for more on how this works at

www.vaccinerights.com/e-book.html)

Alan , J.D.

>

> ...religious exemptions may be yanked at any time deemed appropriate by the

military because the mission will come first.

[Guest guest]

Yes, military exemptions, when approved, can be pulled if the mission later

requires it. But this is true with civilian exemptions, too--vaccines can be

mandated in a declared emergency without exemptions in most states, and the

unvaccinated can be quarantined in government facilities--there are no absolute

rights to a vaccine exemption (possible exception for medical exemptions, but

some laws even throw those out the window in emergencies!). This is a

legislative problem--we need to enact laws providing more freedom of choice. See

the Pandemic Response Project to get involved: www.pandemicresponseproject.com

With military exemptions (and immigration, healthcare employees, and students in

many states)--anywhere that you have to state your beliefs--it is important to

get reliable information about how to do that, to provide what is needed, and to

avoid the pitfalls that can cost you the exemption; you need to know what

qualifies legally and what doesn't. This is a question of law, not of one's

personal opinion about what should or shouldn't qualify legally. Statements of

religious beliefs need to be unique (the quickest way to lose an exemption is to

copy something off of the Internet!), so get reliable information before

submitting your exemption for approval in any situation where the agency

involved (DoD, USCIS, health department, school system, etc.) has authority to

scrutinize the exemption. Not all have authority to scrutinize exemptions, it

depends on the specific wording of the applicable exemption law. see The

Authoritative Guide to Vaccine Legal Exemptions for more on how this works at

www.vaccinerights.com/e-book.html)

Alan , J.D.

>

> ...religious exemptions may be yanked at any time deemed appropriate by the

military because the mission will come first.