Immunization to Protect the U.S. Armed Forces: Heritage, Current Practice, Prospects

Immunization protects the personal health of United States military personnel and maintains their mission readiness. The immunization program of the U.S. Department of Defense DoD is broad-ranging, protecting the forces from an array of pathogenic threats. Because the active and reserve components of the U.S. DoD consist of over 2.2 million people at any given time, the program immunizes a significant percentage of the U.S. adult population. This article updates and expounds on previous reviews of the U.S. military immunization program, 1-7 discussing historical perspectives, the rationale for current immunization policies, and future prospects. Military immunization requirements often exceed those provided to civilian adults, because of the travel and other occupational hazards confronted by soldiers, marines, sailors, airmen, and coast guardsmen. Military immunization requirements are quite similar for each of the five Armed Forces i.e., Army, Marine Corps, Navy, Air Force, Coast Guard. The requirements and recommendations are described in a joint immunization regulation, 8 summarized in table 1. Immunizations have both direct benefit to the recipient and indirect benefit to the people in the community the vaccinee resides in or works with i.e., herd immunity. Herd immunity or community immunity results when a decreased number of susceptible people and the decreased excretion of infectious particles impairs disease transmission. In military settings, the indirect benefit takes on an additional dimension, insofar as an immunized service member is less likely to succumb to a disease that threatens his or her teams mission. By staying healthy, the immunized service member helps other team members accomplish their mission and return home safely. Due to both direct and indirect benefits, most U.S. military immunizations are required, rather than voluntary. Figures 1 and 2 illustrate records used to document immunizations of troops during World War II.