The initial doses will go to the “highest risk” populations, including health care personnel, and a “handful” of senior defense leaders, according to Army Lt. Gen. Ronald Place, director of the Defense Health Agency.

Among beneficiaries, residents of Armed Forces retirement homes are among the highest risk populations, Place said, adding that the Military Health System can rely on electronic health records to monitor beneficiaries who are at high risk for COVID-19 based on CDC guidance.

“We know what those [factors] are, and we could bounce that against our database to see who has those particular challenges,” Place said, adding that age, medical issues and locations pose the highest risk.

“The very highest risk beneficiaries to us are in our Armed Forces retirement homes, where the average age is 85, and they're all in the same location all together,” Place said.

Overall, 13 military medical treatment facilities in the U.S. and three overseas were selected for the “controlled pilot” based on ultra-cold storage capabilities, population and availability of an onsite immunization health specialists, Place said.

They include Madigan Army Medical Center at Joint Base Lewis McChord, Washington; Tripler Army Medical Center in Hawaii; Carl R. Darnall Army Medical Center at Fort Hood, Texas; and Womack Army Medical Center at Fort Bragg, North Carolina.

Two National Guard locations, in New York and Indiana, and Army hospitals in Germany and South Korea will also be distribution sites.

“The preliminary data on the safety and effectiveness of the two vaccine candidates is highly encouraging,” Place said. “We're recommending that everyone take the vaccine when it becomes available.”

According to McCaffery, the vaccine is voluntary, which is “standard practice” under emergency use authorization.

“Those who do not get vaccinated ... will be adhering to all of the existing public health mitigation measures that have been in place for months,” McCaffery said.

If the vaccine is granted full licensure by the FDA, its voluntary status may change, McCaffery said, adding that making it mandatory for troops “is a possibility in the future.”

DoD’s phased distribution plan also prioritizes national security capabilities—such as homeland defense forces—and troops deploying overseas. The department plans to eventually make the vaccine available to service members from all components, dependents, civilian employees and “select DoD contract personnel,” McCaffery said.

The Department of Veterans Affairs is following a similar plan, with 37 sites selected around the country to distribute the COVID-19 vaccine.

Frontline workers and veterans living in long-term care facilities will be among the first to get vaccinated, according to the VA. As more doses become available, additional veterans will be able to receive the vaccine.

“I'm extremely confident that department's plan, developed in collaboration with Operation Warp Speed and the CDC, provides a very clear roadmap to protect our entire DoD population across the globe,” McCaffery said.