IMMUNIZATION POLICY AND PROCEDURES

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP79-00639A000100030002-8
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 11
• Document Creation Date: December 9, 2016
• Document Release Date: December 8, 2000
• Sequence Number: 2
• Content Type: REGULATION

4
Approved For ReleaseQP01/06/09: CIA-RDP79-00639A000100$6002-8
CONTINUATION OF
DISPATCH
p1,PA IC.11 SYMII'IL ANU NO. _-~
ATTAMIM1 I TO 1)001( I)T3Pi1T(11
A. KUBARK has reviewed its immunization policies with those of ODEARL
25X1A2g and with-used by ODACD) and non-official cover individuals.
All of the usual immunization media have been included, and have
arbitrarily been divided into three possible factors for considera-
tion. These arez
2. Booster intervals or the maximum interval which may
be permitted to elapse before the basic series must
be repeated.
3. Special considerations, such as areas with a high
endemic incidence of the disease, or areas with known
epidemics, in which even more frequent utilization
might be necessary.
B. There are only minor and essentially insignificant differences. in
requirements for completion of the underlying basic series among
ODYOKE programs reviewed. Booster i.ntervala are essentially the
same. The differences lie in the a e~ cial column, most notably, and
are represented by such differences as the fol.l,owing. ODEARL is
using a combined (adult) tetanus-diphtheria toxoid, and so is KUBARK
in some instances. There is a slight danger in this, and KUBARK is
avoiding its use in those who are past 38 years of age, those who
are obese, or those who are known to have sensitivity to diphtheria
toxin. The booster interval for utanus toxoid is academically known
to be somewhat greater than 10 years, but operating with a margin of
safety, ODEARL and insist upon a booster interval of 4 years.
KUBARK is accepting one of 10 years, but boosting the individuals who
have not had an injection during the past year and who are going FJS
overseas or TRY with extensive air travel. On typhoid, typhus, and
cholera, KUBARK is insisting on a booster within 2 years of any ap-
propriate overseas travel, and a much smaller interval in particular
areas. Thus Headquarters is making most of its deviations from the
normal fall upon the side of conservatism, and operating when possi-
ble 2 years ahead of acceptable standards.
C. Some criticism of this approach is the inconvenience of having the
appropriate shots performed at the requisite intervals, and oc-
casional morbidity which follows the use of the various media. How-
ever, for reasons to be explained below, KUBARK proposes to continue
the present policy, which in essence states that all individuals
departing Headquarters must be current in all foreseeable immuniza-
tion needs.
serve maximum protection.
D. In attempting to assess the various groups which KUBARK is immunizing,
and to see if any changes were advisable, the following were considereds
1. TDY personnel will continue to follow the current immuni-
zation policies. These individuals are, on occasion, as-
signed to PCS status in the field, are obligated to meet
world-wide requirements if on standby, and therefore de-
2. PCS personnel serving overseas in areas where KUI3ARK does
not maintain a medical facility, will be regarded in the
same fashion ap(} Ve made current in immunizations upon each
trip through Hea,Neartera, whether it be in preparation for
F9VM
1Q-57 53a
(49(
.. (IASSU IC ATION
USE PREVIOUS fDli l(lN
RFREACES FORMS ~~.
5128, 51-78A AND Y 79 C%I L3i1 ""~'l!
WIIkCII ARF OUS011 11.
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
 Approved For Release Q901/06/09: CIA-RDP79-00639A0001001 002-8
CONFIDE~V11T1 L
CONTINUATION OF
DISPATCH
ATTAC
an entirely new assignment, or TDY through Head-
quarters, returning to the same station.
3. The third category, personnel stationed at overseas
facilities-where KUBARK has a medical officer will.
continue to.be handled as at present.
E. In sulmnary, the field must modify the "special" column as area policies
and/or cover requirements dictate, with Headquarters providing sug-
gestions and guidance periodically.
II. PEDIATRICS
A. Pediatric dosages are presented for typhus, cholera, plague, etc.
For other media, either adult dosages and schedules are followed, or
in the case of DPT and typhoid paratyphoid, alternate programs are
outlinedo
should be given intramuscularly; all others may be given subcutaneously.
C. Avoid fat necrosis along the needle tract by removing antigen from the
outside of the needle and by following the injection with 0.1 to
0.2 cco of air.
D. Egg yolk base vaccines (typhus, influenza, yellow fever) may induce
allergy in susceptible individuals and should be used with caution.
E. The danger of contact of any recently vaccinated individual with an
unvaccinated eczematous child cannot be over emphasized, with the
possibility of eczema vaccinatum.
F. When time permits, immunizations for viral diseases should be at least
2 weeks separated one from another, and also from bacterial immuniza-
tions to provide maximum immunologic response. The same consideration
is not equally important in bacterial immmunizationso
tal may be used prophylactically in such instances.
III. SUMMARY
A. Immunization needs by area are unchaged from the publication of
November 1957, as disseminated to the field. Deviations from this
will be at the discretion of the senior area medical representatives.
B Generally speaking aluminum precipitated or absorbed medications
B. It should be noted that there is a slight change from previous policy
on typhus, cholera, and plague dosages in children.
C? It should be emphasized that typhoid is given to a total of l.0 cc*
in children less than 3. year, and to 1.5 cc* in all others. Consider-
able latitude is allowed in size and number of injections, based on
the reaction to the last shot, provided the desired total is reached.
It is recognized that the dosages of this media as outlined herein
differ from the currently advised ODEit?II pediatric dosages* KUBARK
has been assured that there will be in the near future a change in
the ODEARL schedule, and the American Academy of Pediatrics schedule
is preferable, immunologicul.1y speaking.
D. The use of salicylates in weight-adjusted dosages for a 2k-hour period
after all morbidity-producing in! ctions is important in the pediatric
group*
E. Further fractionation of dosages should be done in infants with a
history of febrile convulsions. A weight-adjusted dose of phenobarbi-
USE PREVIOUS EDITION
REPLACES FORMS
51 2B, 51.79A AuD 51 29
WHIr11 API nrdII FF
IONI 11111111111
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 Approved For Release-wW1/06/09: CIA-RDP79-00639A000100b OO2-8
CONTINUATION OF
DISPATCH
*WM
D SPATCH SYM601 AND NO
TTTACHMI;NT TO BOOK DISPATCH
NO.~ 2 X1A
0. No attempt has been made to advise a chronological program in the
overall basic immunization of children or adults. Specific areas,
time' available, disease incidence, and judgment of the area medical
representative,,.-should all be determining factors in questionable
cases.
L
(~~l WHI(II AR[ 0111)LEIE
FORM R meviva n...
REPLACES FORMS
10-57 53a 1 A - CONTINUED
5 !d 5138A AND 51.79
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 Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
L .RING BASIC SERIES MAXLMUhi INTEHIALSM SPECIAL C ONS
A (3) 0.5 cc. injections at 4-6 wk. 4 years ONLY if Schick positive
intervals after Schick and t loney Be-Schick before boosting
testing.
601 1
TETANUS TOXOID For either medium use (3) 0.5 cc. 10 yearmilitary)
OR shots at 4-6 wks intervals OR (2) (4 in A TEMANUS- at same interval and booster 1 -
IT ITT=A year later.
TMODS
S?9AI?,LPOX (1) Primary take Succeg 3 FacC7s1ai n
every 3 years
0
z=
0
as
7 0.
zLn
z
0
YELLOW FED (1) shot of 0.5 cc.
6 years
Boosters are given to most Head-
quarters departees who have not
had a shot within the past year.
Also used as booster in appropriate
injury-
Contraindicated for those over 40,
obese, or those known to be sensi-
tive to Diph. toxoid. Preliminary
,Schick testing not routinely nec-
essary. DO NOT USE PEDIATRIC TYPE
FOR THIS USE IN ADULTS.
Intervals down -tb 6 months in
special areas.
Four-year intervals in individuals
going to appropriate areas.
~YPROID (3) 0.5 cc. shots at 1-4+ wk. 10 years intervals down to annual in appro-
P OID intervals (4 in military) priate areas. May use 0.1 cc.
intracutaneous as booster
CE
PI AGUE
(2) shots of 0.5 cc. and 1.0 cc. 4 years
at-7-10 day intervals.
Twice annually in epidemic areas.
0
06
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
 0
z
Z
Z
0
V
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
ADULTS (cmITn unn )
N4!MaZi INTERVALS
BE'r' BASIC SERIES
Ideal y 0-' -7 xc t'ss spat' .g. y one booster currently t~,M AT0E in all persons over
3 months, and advisable to boost
Eestart series if over 1 year advised, 1-2 years later.
elapses between :ndiviuual shots. mother during last trimester of
prency. Very rare penict"min
allergy - generally ignored.
Icy be boosted at yearly Should contain at least 220 CCA
intervals at discretion of units Asian strain.
? edical Officer or upon
request.
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
Ion
 Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
00
ZE
CHMM: EN
PAC TEJA S
Dr ''RTA TOKOIDS
SMALT-PU
FEVER
BASIC SERIES
(B?WM PERIODS AS FOR ADULTS)
Used in pediatric group ideally at 3-4-5-18-36 months
of age.
For use as booster in 5-12 age agroup, at 3-4 year
intervals. Adult type may be substitute for use
as booster in children.
Usage identical with adults.
For appropriate wounds boost with adult
tetanus toxoid. Should not ideally be
used after 5 because of reactions to
to pertussis toxoid.
This medium should never be used in
adults without Schick testing.
POLIO
IAFF,U
Use on weight adjusted basis as in adults
Total of.(3) shots at 1-3 wk. intervals
Boost with appropriate dose at intervals
6-mos. - 3 years 0.12 cc.
as used in adults.
3 years- 6 years - 0.25 cc.
6 years- ll years 0.5 cc.
12 years Adult dose
j
Total of (3) shot
s at 7
-10 da
y interv
shot 1/2 of.follo
wing o
nes in
amount.
6 mos. - 3 yrs.
0.06
0.12
0.12 cc.
3 yrs. - 6 yrs.
0.12
0.25
0.25 cc.
6 yrs. - 11 yrr.
0.25
0.5
0.5 cc.
Over 12 yrs. Adult dose
als with first Boost with appropriate dose at intervals
as used in adults.
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
 Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
Less than 1 year
0.2 0.25 0.25 0.3 cc. suggested
and 1-4 wk. intervals OR any combina-
tion of injections to total 1.0 cc.
Greater than 1 year
0.3 0.6 at 1-4 wk. intervals OR
any combination of injections to total
of 1.5 cc.
Total dose felt to be significant here
rather than an age or weight-adjusted
dose. Wide latitude in fractionation
of dose permissible at discretion of
Medica]. Officer. Boosters as in adults,
or 0.1 cc. intracutaneously is permissi-
ble.
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
 Approved For Release ~961/06/09 : CIA-RDP79-00639A0001000`*002-8
CONTINUATION OF
DISPATCH
V, Tic
cL s rAt1
II44UNIZATION POLICY
1. Local Health Department requirements are not listed. However) the
immunizations should cover all countries visited during overseas travel.
2. For the salve of brevity) the following system was devised:
REQUIPIRMS
Smallpox
'.Typhoid paratyphoid
Tetanus
Polio
Diphtheria (if indicated by Schick:
under 35 years of age)
Smallpox
Typhoid paratyphoid
Tetanus
Typhus
Polio
Diphtheria (if indicated by Schick:
under 35 years of age)
Smallpox
Typhoid paratyphoid
Tetanus
Typhus
Cholera
Polio
Diphtheria (if indicated by Schick:
under 35 years of age)
Area 1+-a
Smallpox
Typhoid paratyphoid
Tetanus
Typhus
Yellow Fever
Cholera
Polio
Diphtheria (if indicated by Schick:
under 35 years of age)
Smallpox
Typhoid paratyphoid
Tetanus
Typhus
Yellow Fever
Polio
Diphtheria.(if indicated by Schick:
under 35 years of age)
NOTE: Salk Vaccine is now required for all personnel.
USE PRE VIOI4S.EDITION.
REPLACES F'~'RJ~nS
51-28. 51='IItA"AND 5129
WHICII'AWE OBSOLETE.
Approved For Release 2001/06/b9 TiA-R6~f9J000639A000100030002-8
 Approved For Release 2O1/06/09 : CIA-RDP79-00639A000100GW02-8
CONTINUATION OF
DISPATCH
Dominica #1
Dominican Republic #1
Ecuador
Egypt #4-a
Eire #1
Ellice Islands #3
El Salvador #4
The countries are listed in alphabetical order. The number following the
name of the country indicates the area.
Afghanistan #3
Alaska #1
Albania
Algeria
Andorra
Anglo-Egyptian Sudan
Angola
Arabia, Saudi #3
Argentina #4
Aruba #4
Ascension Island #4
Australia #1
Austria #2
Azores #l
Bahamas #1
Bahrein #2
Barbardost H.W.I.
Basutoland #4
Bechuanaland #4
Belgian Congo #4
Belgium #2
Bermuda #1
Bhutan #4-a
Bolivia #4
Bonaire, N.W.I.
Borneo #3
Brazil #k
#4
#4
British Somaliland #4
Bulgaria
Burma #3
Cameroons #4
Canada #1
Canal Zone #4
Ceylon, #4-a
Chile #4
China #3
Cocos Island #1
Colombia #4
Corsica #2
Costa Rica #4
Cuba #1
Curacao #4
Cyprus #3
Czechoslovakia #2
Dahomey
Denmark
FORM
1057 53a
(40)
Eritrea .#4
Estonia
Ethiopia #4
Fiji Islands #2
Finland
France #2
French Equatorial Africa #4
French Establishment in India
French Guinea #4
French Indochina #3
French Somaliland
French West Africa 1/4
Ghana #4-a
Gamiba
Germany J
/2
Gibraltar #2
Gilbert Islands
Granada, B.W.I.
Greece #2
Greenland #1
Guam #1
DISPAICM SYMBOL AND Ho.
AT]ACRMT TO BOOK DISPATCH
#1
#l
Guatemala #4
Guiana,, French #4
Guiana, British #4
Guiana,, Netherlands #4
Haiti #1
Hawaiian Islands #1
Honduras #4
Hong Kong #4-a
Hungary
Iceland #1
India #4-a
Indonesia #3
Iran 3
Iraq #3
Ireland #1
Israel #3
Italian East Africa
USE PREVIOUS L1)11 ION.
REPLACES FORMS
51 ~28, 51 28A AND 51 29
WHIG II ARL OBSOLLIE.
1x__1 CONTINUED
0
Approved For Release 2001/06/09 : CIA-RDP79-00639A000100030002-8
 ,Approved For Release 2Q41/06/09 : CIA-RDP79-00639A0001000- 02-8
CONTINUATION OF
DISPATCH
DISPATCH SYMBOL AND NO
AL1ACIIMi VTR(
r0 r
71153a
Philippines #4-a
Poland #2
Portugal #4
Peru
#1
#1
Liechtenstein #2
Lithuania #2
Luxembourg 2
Macaa
Madagascar ?4
Malaya #4-a
Malta #2
Manchuria #3
Marianas #3
Martinique, F.W.I. #4
Mauritius #2
Mexico #2
Monaco #2
Mongolia #3
Morocco #2
Mozambique #4
Nepal #3
Netherlands West Indies #4
Netherlands #2
New Caledonia #3
Newfoundland #1
New Zealand #1
Nicaragua #4
Nigeria #4
Norway #2
Nava Scotia #1
Nyasaland #4
Okinawa #3
Pakistan #4-a
Panama #4
Paraguay #4
Labrador #1
Latvia #2
Lebanon #4-a
Levant States
Liberia #4
Libya
Italy #2
Ivory Coast #4
Iwo Jima #1
Jamaica #1
Japan #3
Johnston Islands
Jordan #/4-a
Kenya # !~I
Korea #3
Kwajalwein #1
Italian Somaliland 11-4 ,
USE PREVIOUS EDITION
REPLACES FORMS
5128, 51 78A AND 5129
WHICH ARE OBSOLETE
Portugese Nast Africa
Portugese Guinea #3
Puerto Rico #1
Reunion #4
#4
Rhodesian North and South #4
Rio do Oro #/2
Rio Muni #/"I+
Romania #3
Russia #2
Ryukyus ##3
St. Pierre and Miquelon #1
Saipan #f3
Samoa #1
Santa Lucia, B.W.I. #1
Sarawak ##3
Sardinia #2
Scotland #1
Senegal. #
Seychelles Islands #3
Siam #3
Sierra Leone Africa #4
Singapore #1-4-a
Southwest Africa
Spain #2
Swaziland, Africa
Sweden #2
Switzerland #2
Syria #4-a
l:niti #4
Tanganyika #~F
Tibet #3
#4
#p+
Togoland, British #/4
Togoland, French #4
Transjordan #3
Trieste #/2
Trinidad, B.W.I. #4
Tripoli #3
Tunisia
Turkey
Uganda
Union of South Africa #4-a
United States of America #1
Uruguay #4
Venezuela
Virgin Islands #1
Wales #1
Windward. Islands #4
Yemem #4-a
Yugoslavia #2
Zanzibar #4-a
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 AREA CT
OCEAN
T~LJO SOUTH PACIFIC OCEAN SOUTH ATLANTIC
YYY I I ~ I I
WORLD AREAS FOR WHICH CERTAIN IMMUNIZATIONS ARE REQUIRED
AREA R AREA Y
w uo w .+a ee ioe ae se to aa* o raar
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TAREA T
AREAC,T
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