occupational groups. Reimmunizations are given at 6-month intervals to all personnel who must travel to or reside in a plague-infested areas.
SPECIAL IMMUNIZATIONS
Besides the routine immunizations given to personnel, you may be responsible for the administration of additional vaccines as determined by the Surgeon General.
Measles and Rubella Vaccines
Administer the measles-rubella vaccine, or measles or rubella vaccine(s), to all male recruits early in recruit processing or training. It is permissible to wait for the results of rubella or measles antibody titers prior to administering the appropriate vaccine(s) to susceptible individuals only, provided that a reliable screening test is used and provided that such susceptibility testing does not unduly delay vaccine administration. Such susceptibility testing is not mandatory for male recruits and should be done only where practical and cost-effective. Female recruits will be asked about possible pregnancy and will undergo rubella antibody testing and a screening test for pregnancy prior to administration of any vaccine containing the rubella antigen. The measles-rubella vaccine, or measles or rubella vaccine(s) will be subsequently administered to susceptible individuals only. Administer the rubella vaccine to all susceptible persons engaged in health care, regardless of age or sex. Demonstrated rubella titers or a documented history of prior receipt of the rubella vaccine or the measles-mumps-rubella vaccine is adequate evidence of immunity for such individuals, regardless of age or sex. Potentially pregnant females will be asked about possible pregnancy prior to administration of the rubella vaccine.
Mumps Vaccine
Administer the mumps vaccine in dosages as recommended by the manufacturer to all probably susceptible persons engaged in health care. A previous history of mumps or a documented history of prior receipt of the live virus mumps vaccine or the measlesmumps-rubella vaccine is adequate evidence of immunity for such individuals. Institute this policy in health care settings for all probably susceptible personnel, regardless of age or sex. Ask potentially pregnant females about possible pregnancy prior to administration of the mumps vaccine.
Human Diploid Cell Rabies Vaccine
Individuals in occupational groups at high risk for contact with potentially rabid animals or laboratory specimens potentially contaminated with the rabies virus should receive the human diploid cell rabies vaccine (individual booster doses) in a regimen as recommended by the Advisory Committee on Immunization Practices (ACIP) and the manufacturer. Individuals who have received this regimen still require the postexposure human diploid cell rabies vaccine prophylaxis in conjunction with appropriate rabies immune globulin, in accordance with the most current recommendations of the ACIP and the manufacturer.
Hepatitis B Virus Vaccine
The hepatitis B virus vaccine should be administered to individuals in “high risk” situations characterized by frequent contact with human blood or blood products (usually associated with certain health care occupational specialties). The dosage regimen consists of three doses of 1.0 ml each, administered intramuscularly; the second dose is given 1 month after the first dose, and the third dose is given 6 months after the first dose.
Adenovirus 4/7 Vaccine
Administer adenovirus 4/7 vaccines to all male recruits within the first 3 days of recruit processing or training. If epidemiologically indicated, and as recommended by the cognizant area Navy Environmental and Preventive Medicine Unit, adenovirus 4/7 vaccines may be administered to nonpregnant female recruits and to student officers in some settings. However, there is no current epidemiologic evidence to suggest that these vaccines arc routinely needed in most settings outside the recruit center. NOTE: Current (1987) military policy mandates testing of all recruit populations for the presence of the antibody to the HIV (HTLV-3) virus, which is associated with the acquired immune deficiency disease (AIDS). Because there is concern that live virus vaccines may adversely affect recruit individuals who unknowingly have an altered or decreased immune system, it is current policy that any live virus vaccine, with the exception of adenovirus, will not be administered to recruits until the results of the HIV antibody testing are known. These live virus vaccines include those against yellow fever, measles, rubella, polio, and smallpox. As a result
