U.S. military vaccination policy

The US military vaccination policy is nearly as old as the nation’s military itself. The US military has had a vaccine requirement since 1777. US troops failed to capture Quebec in 1776 when more than half the Continental Army in the area became ill with smallpox. Meanwhile, most British troops were immune because of either having the disease or being vaccinated against it. The following year, General George Washington ordered mandatory inoculation for all soldiers who had not already had the disease.

The US military policy on vaccines became an issue in 2021. Vaccine misinformation prompted some service members to refuse the COVID-19 vaccines during the global pandemic that infected hundreds of millions and left millions dead worldwide. As of 2024, more than 450,000 members of the US military—active duty, reserve, and National Guard—had contracted COVID-19 and ninety-three had died.

Background

The concept of immunization, or the creation of immunity to a disease or infection through the use of a vaccine or similar method, developed about one thousand years ago, although practitioners did not yet understand the science. Smallpox was the impetus for developing methods that offered some protection against contagious illness. Smallpox has plagued humans for thousands of years. Evidence of the disease has been found on three-thousand-year-old mummies in Egypt. It had a 30 percent fatality rate and was common as recently as the early twentieth century.

Smallpox is a highly contagious disease caused by the variola virus, which can be transmitted by droplets in the air from an infected person who coughs, sneezes, or simply speaks. Symptoms of smallpox include fever, headache, back pain, and severe fatigue. A few days after the illness develops, blisters form on the skin. These fill with pus, scab over, and leave deep scars. Although most people survive a smallpox infection, some varieties have high fatality rates. Beyond the severe scarring, survivors may also become blind.

Possibly as early as 1000 CE, people in China developed ways to reduce the likelihood of a smallpox infection and improve one’s chances of survival if infected. A method called variolation, which gets its name from the variola virus, involved infecting individuals with pus from patients with mild cases of the disease. After this, individuals would likely develop mild symptoms such as fever and a rash, but variolation greatly reduced fatal cases. Variolation was practiced in other parts of the world and later reached Europe.

In 1796 English doctor Edward Jenner noticed that women who milked cows rarely came down with smallpox if they had already had a disease called cowpox, which is caused by a virus in the same family as variola, Orthopoxvirus. Jenner hypothesized that exposure to cowpox offered some protection against smallpox and conducted an experiment. Jenner later developed a vaccine, which replaced variolation.

The US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) define immunization and vaccination similarly. Vaccination is the use of vaccines to cause one’s immune system to work to protect against disease or infection. Immunization is the process of making individuals immune or resistant to infectious disease. This usually involves a vaccine. The term inoculation is used interchangeably with immunization. Multiple types of vaccines have been developed; some contain weakened or dead forms of a virus, certain parts of the microbe, genetic material, or ribonucleic acid.

Overview

Members of the US military receive vaccinations in basic training, in part because they live in very close quarters. They may also receive shots that individuals normally receive during childhood. For example, the US Army and Army National Guard inoculate all recruits against measles, mumps, and rubella (MMR) even if they have already been vaccinated. Service members also can expect routine booster shots, such as annual flu shots. Before they are deployed, they may also receive hepatitis A, meningococcal, and typhoid shots and any vaccines required by a host country or deemed necessary because of potentially dangerous work conditions, such as rabies, plague, and anthrax. Furthermore, the US military encourages individuals to receive vaccines such as the human papilloma virus (HPV) series.

In early 2020, a new coronavirus began spreading across the United States and in many other countries. On March 11, the WHO announced that the world was experiencing a pandemic of illness from this virus, dubbed COVID-19. Vaccines were approved for use months later and became widely available in April 2021. Two of the three were administered as two doses spaced three or four weeks apart.

Despite ample evidence of the effectiveness and safety of the vaccines, disinformation proliferated on social media and with some broadcasters, as well as through rumors. These included false death and illness rates, claims that the vaccine caused infertility, and conspiracy theories that the vaccine contained magnetic 5G tracking microchips or altered one’s DNA. Such false information caused many people to hesitate or refuse to be vaccinated.

The Pentagon characterized vaccination as necessary for troop readiness and set a goal of 100 percent vaccination of active-duty troops in 2021. US Defense Secretary Lloyd Austin reported in July 2021 that only 70 percent of active-duty troops had received at least one shot of a COVID-19 vaccine. On August 25, Lloyd ordered service members to receive the COVID-19 vaccines and instructed service leaders to set timelines for troops to be fully immunized. By the start of 2022, more than 97 percent of active-duty forces had received at least one dose. The total force, which includes the National Guard and reserves, was about 90 percent vaccinated.

Branches of the military permitted individuals to seek an exemption based on religious beliefs. Many who applied for this waiver said they opposed the vaccine because development relied on cells from aborted fetuses. While the Johnson & Johnson single-dose vaccine was produced using laboratory-grown fetal cell lines obtained from abortions decades earlier, the Moderna and Pfizer-BioNTech vaccines did not. Critics noted that the same fetal cell lines were used to develop over-the-counter medications, including aspirin and ibuprofen.

Several Republican governors refused to accept the Department of Defense mandate for the National Guard. Some service members who went to court to avoid vaccination or separation received injunctions. While almost 5,900 service members had received temporary exemptions as of late January 2022, 3,350 refused to be vaccinated.

In February 2022, the US military announced that fifteen of the sixteen thousand requests for religious exemptions had been approved. Six approvals were for marines and nine were for members of the air force. The US Army began to separate soldiers in February 2022. By this time, more than six hundred marines and one hundred and sixty air force service members had been separated.

Bibliography

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