Skip to main content

Military Health System

Important Notice about Pharmacy Operations

Change Healthcare Cyberattack Impact on MHS Pharmacy Operations. Read the statement to learn more. 

Letter to the Editor: Military Health System Exceeded Healthy People 2020 Goal for Rotavirus Vaccination

Image of Logo800x480MSMR. Logo of MSMR, the Medical Surveillance Monthly Report

We read with great interest the Brief Report in the November 2022 issue of the MSMR about pediatric vaccination rates by Romano et al.1 The immunization schedule recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention provides guidance on protecting infants and children from preventable infectious diseases, and well-established national metrics allow assessment of Military Health System performance.

While the authors make some comparisons to national vaccination data, CDC’s Healthy People 2020 goals also provide a benchmark to compare MHS vaccination rates. The Healthy People initiative is the federal government’s prevention agenda, developed and published by the CDC, for building a healthier nation that includes goals to attain longer lives free of preventable disease.2 It is updated every 10 years.

For rotavirus vaccine, the Healthy People 2020 goal was 80% of children receiving two or more doses of vaccine by ages 19-35 months (can receive vaccine up to eight months of age). The data presented by Romano et al. not only show that completion of rotavirus vaccine series well exceeded this metric by 2016 (92.4%), but that compliance with the rotavirus vaccine series was also above 80%. In comparison, at the Healthy People 2020 final review, only 73.5% of children in the U.S. had completed two or more doses of rotavirus vaccine. The data presented by Romano et al. also demonstrate better vaccination rates for polio and DTaP compared to the Healthy People 2020 final review.3

This is an important perspective, as medical care for pediatric dependents of military service members involves extra variables that add complexity to vaccine series completion (e.g. frequent moves, parent deployments). Nevertheless, high vaccination rates for pediatric dependents of military service members occurred, with 82.5% of children receiving care in military clinics, despite 61.1% of children experiencing a change in well-child care location and 16.8% of mothers deploying within 24 months postpartum.1

We concur with Romano et al. to suggest continued efforts for improving pediatric vaccination rates and the removal of barriers delaying vaccination within the MHS. We encourage the authors and other researchers to consider quantifying their data in relation to well-established national metrics to demonstrate MHS successes, as in this case, as well as identifying areas in need of improvement.

Author Affiliations

Air Force Medical Readiness Agency, Falls Church, VA (Lt. Col. Sayers); Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland (Lt. Col. Reynolds).

Disclaimer

The contents described in this publication are those of the authors and do not necessarily reflect official policy of the Department of the Air Force or Walter Reed National Military Medical Center.

References

  1. Romano CJ, Bukowinski AT, Hall C, Burrell M, Gumbs GR, Conlin AVS, Ramchandar N. Brief report: pediatric vaccine completion and compliance among infants born to female active duty service members, 2006-2016. MSMR. 2022;29(11):18-22. 
  2. Centers for Disease Control and Prevention. Healthy People 2020. Updated March 14, 2014. Accessed February 25, 2023. https://www.cdc.gov/dhdsp/hp2020.htm#:~:text=The%20over­arching%20goals%20of%20Healthy,good%20health%20for%20all%3B%20and
  3. National Center for Health Statistics. Healthy People 2020 Final Review. Accessed March 9, 2023. https://dx.doi.org/10.15620/cdc:111173

In Reply

We thank Drs. Sayers and Reynolds for their interest in our brief report, "Pediatric Vaccine Completion and Compliance Among Infants Born to Female Active Duty Service Members, 2006-2016."

We agree with Drs. Sayers and Reynolds that the MHS performed well in relation to the U.S. population. We included comparisons to national estimates throughout the study period to facilitate this assessment, but elected not to include Healthy People 2020-realized estimates for comparative benchmarking because the study period did not fully correlate with the dates for this national framework. We agree, however, that there is added value in contextualizing our measures with Healthy People 2020 targets. Although MHS vaccination coverage did not achieve the Healthy People 90% target for diphtheria, tetanus, and acellular pertussis, MHS coverage surpassed the 90% and 80% targets for inactivated polio virus and rotavirus vaccines, respectively. In our ongoing work on pediatric immunizations, where we extend the study period to include the COVID-19 era and assess the complete pediatric immunization series, we will integrate discussion of Healthy People 2020 and 2030 targets.

Celeste J. Romano, M.S.; Anna T. Bukowinski, M.P.H; Clinton Hall, Ph.D.; Monica Burrell, M.P.H; Gia R. Gumbs, M.P.H; Ava Marie S. Conlin, D.O., M.P.H; Nanda Ramchandar, M.D., M.P.H

You also may be interested in...

Report
Aug 1, 2023

MSMR Vol. 30 No. 8 - August 2023

.PDF | 1.02 MB

The August 2023 MSMR provides the most recent data from the active surveillance program for acute respiratory disease and Group A Beta-Hemolytic Streptococcus among U.S. Army basic trainees; then summarizes the case report of an extensively resistant E. coli in a returning traveler at Hawai'i's Tripler Army Medical Center; followed by a Surveillance ...

Article
Aug 1, 2023

Active Surveillance for Acute Respiratory Disease Detected No Outbreaks at Four U.S. Army Basic Training Installations in 2022

This article presents the 2022 results of the active surveillance program for acute respiratory disease and Group A Beta-Hemolytic Streptococcus conducted by the Defense Centers for Public Health-Aberdeen at the four Army installations responsible for basic combat training or one-station unit training. This ARD surveillance program rapidly monitors, ...

Article
Aug 1, 2023

Case Report: Complicated Urinary Tract Infection Due to an Extensively Resistant Escherichia coli in a Returning Traveler

This article presents the medical case report of a 76-year-old man who returned to the U.S. following overseas travel and was admitted at Hawai'i's Tri­pler Army Medical Center with a complicated urinary tract infection due to an extensively resistant strain of E. coli.

Article Around MHS
Jul 25, 2023

Defense Public Health Experts Investigate If Minority Group Service Members are More Likely to Experience Behavioral Health Problems

A recent Department of Defense study found American Indian and Alaska Native U.S. Army Soldiers had higher rates of suicidal ideation than white soldiers. The DOD is investigating behavioral health disparities among minority groups in the military to see how they might mirror similar disparities in the civilian population. (Graphic illustration: Steven Basso, Defense Centers for Public Health-Aberdeen)

U.S. public health agencies such as the National Institute of Mental Health have recognized that certain minority groups appear to experience greater risk for certain behavioral health disorders. The higher rates of adverse health problems in minority groups are often referred to as “disparities.”

Report
Jul 1, 2023

MSMR Vol. 30 No. 7 - July 2023

.PDF | 1.30 MB

This continuation of the June issue, which published the annual quantification of health care provided by the Military Health System, continues with the impacts of various illnesses and injuries in 2022 among deployed service members; medical evacuations out of theaters of military operation; health care provision to non-service member MHS ...

Article
Jul 1, 2023

Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries Among Non-Service Member Beneficiaries of the Military Health System, 2022

This report represents an updated summary of care provided to non-service members in the MHS during calendar year 2022. MHS beneficiaries are diverse and heterogeneous, including active component service members, activated National Guard and Reserve service members, active component immediate family, retirees, and their family members, with differing ...

Article
Jul 1, 2023

Medical Evacuations out of U.S. Central and U.S. Africa Command Among Active and Reserve Components, U.S. Armed Forces, 2022

This report summarizes the nature, numbers, and trends of conditions for which military members were medically evacuated from the U.S. Central Command (CENTCOM) or Africa Central Command (AFRICOM) operations during 2022, with historical comparisons to the previous four years.

Article
Jul 1, 2023

Morbidity Burdens Attributable to Various Illnesses and Injuries Among Deployed Active and Reserve Component Service Members, U.S. Armed Forces, 2022

This annual estimate of illness- and injury-related morbidity and health care burdens on the U.S. Armed Forces and MHS updates previous analyses of these burden distributions among active and reserve component service members in deployed settings. This report focuses on the health encounters of service members during deployment to U.S. Central Command ...

Article
Jun 23, 2023

Medical Countermeasures for Insect-Borne Diseases: Q&A with Experts

A female Aedes aegypti mosquito

Countermeasures for vector-borne diseases are often offered in the military when a service member is deployed to certain parts of the world. These types of countermeasures were developed to protect from infections spread by insects, rodents, and other animals. Insect-borne diseases, such as yellow fever, tick-borne encephalitis, Japanese encephalitis, ...

Last Updated: July 11, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery