NAVPERS 1070/613 Administrative Remarks Form — U.S. Navy SEALs 1-26 v. Biden (Dkt. 1.3)

Summary

A NAVPERS 1070/613 Administrative Remarks form, page 2 of 2, filed 11/09/21 in Case 4:21-cv-01236-O, with the subject COVID-19 Vaccination Administrative Counseling/Warning. The form states that the Navy medical record indicates the recipient is not fully vaccinated and, absent an approved exemption, orders full vaccination by 28 November 2021 for the Active Component or 28 December 2021 for the Ready Reserve. It states that refusal is punishable under the Uniform Code of Military Justice and lists medical, legal and chaplain contacts for questions. It also states that special operations duty personnel who refuse the vaccine based solely on personal or religious beliefs will be disqualified from special operations duty.

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Case 4:21-cv-01236-O Documenti1-3 Filed 11/09/21 Page 2of2 PagelD 46

ADMINISTRATIVE REMARKS

NAVPERS 1070/613 (REV. 08-2012) PREVIOUS EDITIONS ARE OBSOLETE SUPPORTING DIRECTIVE MILPERSMAN 1070-320
SHIP OR STATION: =

SUBJECT: [] PERMANENT TEMPORARY

COVID-19 Vaccination Administrative Counseling/Warning | AUTHORITY (F PERMANEN?):

1. The U.S. Food and Drug Administration (FDA) approved the first COVID-19 vaccine, Pfizer-BioNTech, for the prevention of COVID-19 in individuals 16 years
of age and older, and announced that the vaccine will be marketed as Comirnaty. Accordingly, the Secretary of Defense (SECDEF) has directed full vaccination of
all service members in the Armed Forces on active duty or in the Ready Reserve who are not fully vaccinated against COVID-19. Mandatory vaccination can only
use COVID-19 vaccines that receive full licensure from the FDA, in accordance with FDA-approved labeling and guidance. Per the FDA's guidance, the
Pfizer-BioNTech and Comimaty vaccines have the same formulation and are interchangeable, Navy medical providers are authorized to use Pfizer-BioNTech doses
distributed under the Emergency Use Authorization to administer mandatory vaccinations.

2. ALNAV 062/21 and NAVADMIN 190/21 implemented the SECDEF's mandate for the Department of the Navy (DON) and the Navy, respectively.

3. The following information is provided for your consideration:

a. Your health and safety are the Navy's number one concem.

b. The threat from COVED-19 is deadly and real. . .

s. Vaccination has proven to be the most effective defense against serious illness caused by COVID-19.

d. Administering the COVID-19 vaccine is in the interest of national security and protection of the force. Receiving the vaccine helps protect your family, fellow
Sailors and Marines, and associated DON civilians.

e. Per FDA guidance, the Pfizer-BioNTech and Comimaty vaccines are the same, and can be used interchangeably without any safety or effectiveness concerns.

£ DoD will administer COVID-19 vaccinations consistent with FDA approved dosing schedules and current standards of medical practice. Pfizer-BioNTech and
Comimaty are two-dose vaccines; full vaccination is achieved two weeks after completing the second dose.

g. Additionally, per MANMED 15-105, special operations (SO) duty personnel (SEAL and SWCC) who refuse to receive the COVID-19 vaccine based solely on
personal or religious beliefs will be disqualified from SO duty (unless the disqualification is separately waived by BUMED). This will affect deployment and special
pays. This provision does not pertain to medical contraindications or allergies to vaccine administration.

4. Your Navy medical record indicates you are not fully vaccinated against COVID-19. Unless you have an approved medical or administrative exemption, or a
pending exemption request, or you elect the option in paragraph 7 to request an exemption within 10 calendar days of signing this Page 13, you are hereby ordered to
become fully vaccinated for COVID-19 no later than (circle applicable deadline):

28 November 2021 for the Active Component 28 December 2021 for the Ready Reserve
Proof of vaccination must be provided to your command no later than the next duty day following vaccination for Active Component or 7 days for Ready Reserve.

5. This a lawful order. Refusal to be fully vaccinated against COVID-19, absent an approved administrative or medical exemption, will constitute a failure to obey a
lawful order and is punishable under the Uniform Code of Military Justice and/or may result in administrative action.

6. If you have concerns about the COVID-19 vaccine or have questions about an administrative or medical exemption, you may contact the following:
a. Medical. Healthcare professionals at any local DoD Military Treatment Facility (MTF) are available to answer questions regarding the risks of COVID-19 and
the benefits of COVID-19 vaccinations, or any other medical questions you have related to the vaccine.
b. Legal. You may seek the advice of a Navy judge advocate at your nearest Defense Service Office (DSO). A DSO locator search tool is available online at:
c. Chaplain. You may seek religious counsel from a Navy chaplain at any base chapel.

7. You must initial the following, as applicable:
I acknowledge the above counseling/warning and understand its contents
i acknowledge that I may submit a statement in response to this counseling/warning (initial one below).
I intend to submit a statement within 10 calendar days of the date of my signature below.
I do not intend to submit a statement,

a: intend to request an administrative or medical exemption, as indicated in paragraph $ é date of my signature below.

ENTERED AND VERIFIED IN ELECTRONIC SERVICE RECORD:

VERIFYING OFFICIAL RANK OR GRADE/TITLE: DATE:
NAME (LAST, FIRST, MIDDLE): SOCIAL SECURITY NUMBER: | BRANCH AND CLASS:
FOR OFFICIAL USE ONLY
PRIVACY SENSITIVE


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