https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN33990-ARMY_DIR_2021-33-000-WEB-1.pdf
MEMORANDUM FOR SEE DISTRIBUTION
SUBJECT: Army Directive 2021-33 (Approval and Appeal Authorities for Military
Medical and Administrative Immunization Exemptions)
1. References.
a. Department of Defense Instruction 1300.17 (Religious Liberty in the Military
Services), 1 September 2020
b. Army Regulation (AR) 40–562 (Immunizations and Chemoprophylaxis for the
Prevention of Infectious Diseases), 7 October 2013
c. AR 600–20 (Army Command Policy), 24 July 2020
2. Purpose. To establish approval and appeal authorities for requests for medical
exemptions (temporary or permanent) and administrative exemptions (including
religious accommodations) from mandatory immunizations submitted pursuant to
references 1b and 1c.
3. Applicability. This policy applies to the Regular Army, Army National Guard/Army
National Guard of the United States, and U.S. Army Reserve.
4. Policy.
a. Medical Exemption Requests.
(1) Temporary Medical Exemption Requests (up to 365 days). Healthcare
providers are the approval and denial authorities for all temporary medical exemption
requests. The term “healthcare providers” refers to physicians, physician assistants, and
nurse practitioners.
(2) Permanent Medical Exemption Requests.
(a) The initial approval and denial authority for COVID-19 vaccine permanent
medical exemption requests is the commanding general of the regional health
command where the Soldier is assigned.
(b) The appeal authority for COVID-19 vaccine permanent medical exemption
requests is The Surgeon General, whose decisions are final.
S E C R E T A R Y O F T H E A R M Y
W A S H I N G T O N
SUBJECT: Army Directive 2021-33 (Approval and Appeal Authorities for Military
Medical and Administrative Immunization Exemptions)
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(c) Healthcare providers (as defined in paragraph 4a(1)) are the approval and
denial authority for all other required vaccines.
b. Administrative Exemptions.
(1) Religious Accommodation Requests.
(a) Pursuant to AR 600–20, The Surgeon General is the initial approval and
denial authority for religious accommodation requests for all immunization exemptions.
(b) The appeal authority is the Assistant Secretary of the Army for Manpower
and Reserve Affairs, whose decision is final.
(2) Other Administrative Exemption Requests (other than a religious
accommodation request). The approval and denial authority for an administrative
exemption request as enumerated in reference 1b, table C–2, is the Soldier’s
commander at O-6 level or above unless withheld by other law, policy, or regulation. For
units without a commander at that level, the first general officer in the chain of command
will serve as the approval authority. This decision is final.
5. Supplemental Procedures. Follow the procedures outlined in references 1b and 1c
for immunization exemption requests. As necessary, The Surgeon General will facilitate
publication of supplemental procedures implementing this guidance within 30 days of its
issuance.
6. Proponent. The Surgeon General is the proponent for this policy, responsible for
coordinating with the Deputy Chief of Staff, G-1 to ensure its provisions are incorporated
in AR 40–562 and AR 600–20 within 2 years from the date of this directive.
7. Duration. This directive is rescinded on publication of the revised regulations.
Christine E. Wormuth
DISTRIBUTION:
Principal Officials of Headquarters, Department of the Army
Commander
U.S. Army Forces Command
(CONT)
SUBJECT: Army Directive 2021-33 (Approval and Appeal Authorities for Military
Medical and Administrative Immunization Exemptions)
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DISTRIBUTION: (CONT)
U.S. Army Training and Doctrine Command
U.S. Army Materiel Command
U.S. Army Futures Command
U.S. Army Pacific
U.S. Army Europe and Africa
U.S. Army Central
U.S. Army North
U.S. Army South
U.S. Army Special Operations Command
Military Surface Deployment and Distribution Command
U.S. Army Space and Missile Defense Command/Army Strategic Command
U.S. Army Cyber Command
U.S. Army Medical Command
U.S. Army Intelligence and Security Command
U.S. Army Criminal Investigation Command
U.S. Army Corps of Engineers
U.S. Army Military District of Washington
U.S. Army Test and Evaluation Command
U.S. Army Human Resources Command
Superintendent, U.S. Military Academy
Director, U.S. Army Acquisition Support Center
Superintendent, Arlington National Cemetery
Commandant, U.S. Army War College
Director, U.S. Army Civilian Human Resources Agency
CF:
Director of Business Transformation
Commander, Eighth Army