Pentagon Eyes Possible Mandatory COVID-19 Vaccine as FDA Weighs Approval

The Pentagon is considering making COVID-19 vaccinations for troops mandatory once the Food and Drug Administration fully approves the shots, part of ongoing discussions about the next step in the agency’s response.

In a briefing with reporters Tuesday, Pentagon Press Secretary John Kirby said senior leaders within the Defense Department have had "some preliminary discussions" about what would happen if and when full FDA approval comes through.

"Should the FDA approve it, then I am certain that Pentagon leadership will take a look at what our options are going forward, including the potential option of making it mandatory," Kirby said.

But he had no new decisions or procedures to announce Tuesday.

Troops are already mandated to get 17 different vaccines, including shots against measles, mumps, diphtheria, hepatitis, smallpox and the flu.

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So far, COVID-19 vaccines remain voluntary for troops. The FDA has approved multiple COVID-19 vaccines under emergency use authorizations -- a designation that allows for distribution and administration but also requires informed consent by patients. Once the FDA issues full approval, the Defense Department has an obligation to instruct personnel on the benefits and side effects of the vaccine but can make it mandatory, as it does with other mandatory immunizations.

The Defense Department has decided that until the vaccines receive full FDA approval, the services will not require troops to take them.

Army Times last week reported that the Army had sent an order to the force telling commands to prepare to issue mandatory COVID vaccines as early as September.

A DoD official, speaking to Military.com on condition of anonymity because the official was not authorized to discuss ongoing discussions, said parts of the military are starting to make preliminary preparations for the vaccines' full approval.

"We're all just kind of waiting to see what happens with the FDA," the official said. "We're preparing for when and if the FDA makes the decision."

Pfizer and BioNTech on May 7 asked the FDA to consider fully approving their vaccine, and Moderna followed suit June 1. It is unclear when or if the FDA might fully approve the vaccines.

But as people in some parts of the country remain suspicious and hesitant to take the vaccine, pressure is increasing on the FDA to grant full approval. In May, the Kaiser Family Foundation released a poll that found one-third of unvaccinated adults said they would be more likely to get a shot if it were fully approved.

In his briefing, Kirby stressed that more than two-thirds of defense personnel have now received at least one vaccine dose. He encouraged defense personnel and their families to get the shots.

"That's not bad," Kirby said of the percentage in the military. "So we've got work to do. Clearly, we'd like to see that percentage continue to climb, but it's at a healthy 68.8% as of today. ... [The vaccines are] safe, they're effective, and it's really the best incentive to protect you, your families and your teammates."

According to the Pentagon, more than 930,000 U.S. service members have been fully vaccinated across all three components. The DoD has administered more than 4.1 million COVID-19 vaccines to its patient population, which includes service members, retirees and families.

More than 300,000 DoD beneficiaries, civilian workers and contractors have been infected with COVID-19 since the beginning of the pandemic, and 357 have died.

The COVID-19 vaccine has become something of a political football. The 10 states with the smallest fully vaccinated population are all deep red states. Mississippi has the lowest vaccination rate at 38.3%; it is also one of the poorest states in the nation.

In June, Rep. Thomas Massie, R-Ky., introduced legislation that would squash any requirement for troops to be vaccinated against COVID-19; there were 23 Republican cosponsors. However, the bill has virtually no chance of making its way into law given the Democratic majority on Capitol Hill. President Joe Biden has made vaccinating as many Americans as possible a key goal of his term.

But on Saturday, Massie retweeted the Army Times story and said his office had been contacted by service members who said they would leave the military if the vaccine is made mandatory.

"I've been contacted by members of our voluntary military who say they will quit if the COVID vaccine is mandated," he said on Twitter. However, his office declined to provide any of those service members for interviews with Military.com, citing "privacy and confidentiality" concerns.

Massie's tweets drew scorn from two fellow Republicans, former Rep. Denver Riggleman of Virginia and Rep. Adam Kinzinger of Illinois, both veterans.

"They can't just quit," Riggleman tweeted, noting that vaccine requirements are common in the military. "That's the whole oath to the Constitution, service contracts and all that. ... Sick military members affect readiness. Death doesn't help either."

The Biden administration has reported that younger and healthier Americans, who are less likely to suffer from the worst impacts of the virus, are much less likely to get vaccinated. However, they can still carry and transmit the virus to vulnerable people.

In a new ABC News/Washington Post poll, 74% of those who are not vaccinated said they "probably or definitely" won't get a shot. The majority of vaccine-hesitant Americans polled think reports of the risks of the delta variant are exaggerated.

DoD officials said last week that 68% of active-duty personnel have received at least one dose of the vaccine. Broken down by service, the Marine Corps has the worst record, at 58%, while the Navy has the highest vaccination rate, at 77%. Some 70% of soldiers have been vaccinated, while 61% of active-duty airmen have received at least one dose.

Acting Assistant Secretary of Defense for Health Affairs Dr. Terry Adirim said the DoD is greatly concerned over the delta variant of the coronavirus, which originated in India and is significantly more contagious than the original strain.

"The best way to beat the delta variant is to be fully vaccinated," Adirim said at a press briefing June 30 with reporters at the Pentagon. "Studies have shown that one dose of the [Pfizer and Moderna] vaccines are only 33% effective against the delta variant, whereas two are at least 88% effective."

Serious side effects are rare, but the FDA added a warning last month to documentation that accompanies the Pfizer and Moderna vaccines to notify recipients that they carry a risk of developing myocarditis, mainly in young men, after the second dose.

The Pentagon is tracking at least 30 cases of heart inflammation related to COVID-19 vaccines in service members and other DoD patients.

Defense Health Agency Director Lt. Gen. Ronald Place said at the June 30 press briefing that the benefits of the vaccines, which include preventing infection and possible long-term health consequences, far exceed the risks.

"We've seen, in the DoD at least, hundreds of cases of myocarditis and pericarditis for those who were COVID infected," Place said. "When we're talking about relative risk here, that risk to the heart is markedly higher from an infection than it is from a vaccination."

-- Stephen Losey can be reached at stephen.losey@military.com. Follow him on Twitter @StephenLosey.

-- Patricia Kime can be reached Patricia.Kime@Monster.com. Follow her on Twitter @patriciakime.

-- Steve Beynon can be reached at Steve.Beynon@military.com. Follow him on Twitter @StevenBeynon.

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