The Defense Department on Feb. 4 issued an order requiring all service members and civilians on U.S. military installations—whether indoors or outdoors—to wear a mask to try to limit the spread of COVID-19, with limited exceptions. However, vaccines against the new coronavirus remain voluntary, and a number of military family members have told Blue Star Families they don’t plan on getting a shot.

The new order, which Defense Secretary Lloyd J. Austin III announced in a memorandum to senior Pentagon leaders, combatant commanders, and DOD agencies, rescinds looser guidance from last spring, and means masks have to be on even when outside or socially distanced.

“COVID-19 is one of the deadliest threats our nation has ever faced,” Austin wrote in the memo. “As we have done throughout our history, the military will rise to this challenge. It is imperative that we do all we can to ensure the health and safety of our force, our families, and our communities so we can prevail in this fight.”

The only exceptions are when an individual is in their own home, alone in an office with floor-to-ceiling walls and a closed door, when eating and drinking, when a mask must be lowered for identification, or when needed to reasonably accommodate an individual with a disability.

The order states that case-by-case exceptions are possible in environments other than office spaces that are necessary for military readiness, that are related to living on a military installation, and related to children wearing a mask. If there is an exception, “appropriate alternative safeguards” are needed when possible, such as additional distancing or additional testing.

The authority to grant exceptions is delegated to officials at the rank of O-7 or senior executive service official. If there isn’t an official at that level, O-6 installation commanders can grant exceptions.

Masks must cover both the mouth and nose. “Novelty” masks, such as those with ventilation valves, or face shields are not authorized, according to the memo. 

Reassuring Military Families

The same day, First Lady Jill Biden and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, attempted to alleviate military-connected families’ fears surrounding COVID-19 vaccines during a Feb. 4 webinar co-hosted by the nonprofit Blue Star Families and the American Red Cross.

“The fight against COVID is a battle we can win, and brighter days are close, but we need your help,” Biden said. “That’s why we’re encouraging everyone to mask up, socially distance, and get the vaccine when it’s your turn. We can beat this together.”

Two vaccines—one manufactured by Pfizer and the other by Moderna—are currently cleared for emergency use by the Food and Drug Administration.

While a Fall 2020 Gallup poll showed that just over half of Americans would consent to receiving an FDA-approved COVID-19 vaccine, only 33 percent of “Active-duty military family respondents” polled in December for a Blue Star Families “Pulse Check” report said they’d feel comfortable getting vaccinated, the organization wrote in a handout about its findings.

“When asked what additional information would help them decide, more information about side effects and child clinical trials were the most common themes,” the handout stated.

Further, the majority of military family members who said they had no plans to get vaccinated—457 of the 674 people polled—cited worries about the shots’ “safety, side effects, and efficacy.”

The most widely-cited factor impacting these individuals’ decisions not to vaccinate was a lack of faith in the way COVID-19 vaccines were developed or the timeline along which they were created as impacting their decision, BSF data showed.

Factors Influencing Respondents’ decision not to vaccinate

Fauci said he’s often interrogated about the vaccines’ expedited timelines. “‘You always tell us that it takes five to seven years to 10 years—how did that happen? Were you reckless? Did you rush?’” he recalled. But the speedy production was a result of technology, not negligence, he said.

“The speed is completely related to the extraordinary advances in scientific platform technology for vaccines,” he said. “There were no corners cut. We did not sacrifice safety, nor did we sacrifice scientific integrity, and the decision to determine that the vaccine was safe and effective was made by independent bodies of vaccinologists, scientists, immunologists, statisticians, [and] ethicists that were beholden not to the federal government, nor to the companies, but to you, the American public.”

Further, he said, “professional, career scientists at the FDA, in association with their own advisory board” made the ultimate call about whether or not to administer the shots.

“Those decisions were both independent and transparent,” Fauci noted.

Fauci also explained that the FDA-approved COVID-19 vaccines are the first messenger RNA-powered ones ever made available to the American public, but the technology behind them is far from new.

“The science behind the development of this extraordinary new technology dates back well over a decade, and the people at the NIH [National Institutes of Health] who were working on this particular technology had been doing it for at least the last 10 years,” he said. “And it … just so happened that by the time we actually needed it for the vaccine for COVID-19, it just happened to coincide with the scientific culmination of work that had been going on for so long.”

He also said the shots’ safety record “has been quite good” despite their relative newness. While he acknowledged that some people with histories of intense allergic reactions have also had similar reactions to the COVID-19 vaccines, the risk shouldn’t deter people from receiving them.

Instead, he advised individuals with histories of such reactions to still get vaccinated, but to do so “in a place that has the capability of treating an allergic reaction,” such as a clinic. 

“That’s a very rare adverse event,” he said. “For everybody else, the vaccine looks quite safe.”

Fauci also addressed concerns about a shortage of pediatric clinical trial data. 

“In general, when you do vaccine studies, you don’t put children right into the trial because children are vulnerable, so you wait until you get pretty confident that you’re dealing with a safe and effective vaccine, and then you could start trials in children—which we have already done and will be doing over the next month or two—in what’s called an ‘age deescalation study,” he explained. 

According to Fauci, these studies begin trials “with older children,” and then eventually progress down to “really young children.” Researchers then pull data on safety and “immunogenicity,” which the FDA defines as substances’ “tendency to trigger an unwanted immune response against themselves” from the trials. 

From there, he explained, researchers connect that data “to the efficacy data from the big trial, which means you don’t have to test 30,000 or 44,000 children—you can get enough data from a small trial.”

He also noted that vaccine trials on pregnant women are currently underway and expected to wrap in March.

“There have been about 10,000 pregnant women out of the 32 million … vaccinations that were given, and there have been no red flag signals,” he said. “The FDA is monitoring that, so thus far, it looks quite safe for pregnant women.”

Senior Leaders Weigh In

Regardless of which way military families might lean with regards to the COVID-19 vaccine, Chairman of the Joint Chiefs of Staff Army Gen. Mark A. Milley urged them to make their ultimate choice carefully.

“Getting the vaccine is a personal decision, so we both encourage you to consult your primary care physician to address any concerns about being vaccinated, arm yourself with credible information about the COVID-19 vaccine so you can be well equipped to make the right decision for you and your family,” he said during pre-recorded remarks that were also aired during the event. “Protect yourself, protect your families, and protect our community. Together, we can all lead the way for the nation in the fight against COVID-19.”

His wife, Hollyanne—a practicing nurse—also encouraged audience members to mask up, social distance, and practice good hygienic practices, including handwashing. At the mention of masks, both she and her husband donned face coverings, which they kept on for the remainder of their remarks.

Senior Enlisted Adviser to the Chairman of the Joint Chiefs of Staff Ramón Colón-López, who also delivered pre-recorded remarks alongside his wife Janet, urged the audience to “stay vigilant and continue engaging this enemy we call COVID-19.”

His wife also cautioned them against letting social media influence their decisions about whether or not to get vaccinated, and to bring any concerns to their primary care physicians directly. She emphasized the importance of cultivating a healthy immune system to deter the virus. 

“Do not let quarantines, lockdowns, and social distancing keep you from staying active,” she said. “Get creative and develop the right habits to stay fit all while staying safe.”

And Defense Health Agency Director Army Lt. Gen. Ronald J. Place, who also appeared at the event, urged military family members to use their power as influencers to help inspire others within their circles to get vaccinated.

“Data show that the likelihood of individuals receiving this vaccine and sharing their experiences have a statistically significant effect on the likelihood of family, friends, and colleagues deciding to get the vaccine,” he said. “As a physician, I know that patients are likely to listen to me, but your community is likely to listen to you, as well. So however works best for you —in person, in your place of worship, on your social media sites, or a simple email.”