From: Department of Defense Pilots Concerned by the COVID-19 Vaccine Mandate
To: Members of United States House and Senate
As the Department of Defense continues to mandate the COVID-19 vaccine, a clear and concerning
trend of vaccine-induced injuries has become apparent across the force. As more vaccine injuries are
discovered, it is apparent that the vaccine poses a great risk to our Nation’s Security both by forcing the lossof highly qualified service members and causing potentially career-ending or life-threatening injuries to those
who remain in service.
Enclosed in this report are: 7 written statements from military pilots and other service members
injured by the vaccine, an Aviation Safety Officer’s discovery of vaccine injuries that have gone unreported in
VAERS, and multiple anecdotal reports of individuals injured by COVID-19 vaccines. This is just a small
sample of many vaccine injured service members who have decided to come forward and share theirheartbreaking stories.
Amongst these reports is a service member who experienced four strokes after vaccination, a Marine
officer who has been denied a medical exemption from his second Pfizer dose despite developing Pericarditis
from the first, and a US Navy O-6 with grave concerns about the damage this vaccine mandate has done tothe force. The enclosed reports are broken into four Tiers:••••

Tier 1: Written reports from injured service members about their injury and subsequent
negative consequences for themselves and their mission.
Tier 2: Messages from direct communication with injured service members who fear reprisal
for writing about their injuries and thus declined to make a written report
Tier 3: Detailed, anecdotal stories on injured service members
Tier 4: Anecdotal stories of injury collected from members across the DoD

Far too many, who felt compelled or forced to take the vaccine, have been injured and maimed
permanently. Furthermore, those that remain unvaccinated will be driven out by the tens of thousands overreligious convictions, justifiable fears for their safety, or concerns over bodily autonomy. From a National
Security and readiness perspective, this mandate is unsafe, illogical, and puts our military and ourcountry at untold risk. Our military cannot and should not injure its service members en masse throughcompelled vaccination. We encourage you to take the following measure to assist our service members:•••

Inquire with the DoD on tracking of vaccine injuries and what is being done about it
Bring the issue of vaccine injuries to the attention of the public
Propose legislation to end the vaccine mandates for service members. The vaccine’s
benefits for America’s most, healthy professionals simply do not outweigh the risks of losing
them over injury or unlawful mandates

In this contentious global environment, we cannot afford to lose any service members, especially those
who are highly qualified and extremely dedicated to upholding and defending our Constitution, and we
certainly cannot continue to knowingly mandate something that injures them.

Respectfully,
Concerned DoD Pilots

TIER 1 REPORTS
Written Stories from Injured Service Members

DEPARTMENT OF THE AIR FORCE
AIR FORCE RESERVE COMMAND

09 Jan 2022
MEMORANDUM FOR THOSE CONCERNEDFROM: VACCINE INJURED SERVICE MEMBERSUBJECT: COVID-19 vaccine injury of an Air Force MSgt
1. To whom it may concern and in a position to affect policy change. I am a Reservist in the
United States Air Force where we “drill,” or report for duty, one weekend a month. The following captures the events leading up to my injury and the negative impact on my life and the Air
Force mission. On Saturday Sept 11.2021: The Air Force advised all airmen that tomorrow, Sept
12, all unvaccinated service members would be shuttled to the Fitness Center to get their firstdose of the vaccine. We were told that if we choose not to get the vaccine, we could file for a
Medical or Religious Exemption, or reject the shot without trying for an exemption and face discharge (with an undetermined discharge status).
2. Sept 12: Sunday: I decided I would pursue a Religious Exemption based on my sincerely held
belief. I met with a base Chaplain, as required by the USAF, and spent the next month preparing
and writing my request for accommodation.
3. On Saturday Oct 2.2021, Air Force leadership advised that if we were planning to refuse theshot, or planning to file for an exemption, we must attend a mandatory briefing first thing thismorning. We were shuttled over to another building where personnel started to brief us. First,
the briefing advised us that the information we are choosing to believe is incorrect and we only
see what we are looking for. They called it “confirmation bias.” They proceeded to advise us
that the Russians and the Chinese have a big hold over our social media, and we need to be following medical websites, not just “Google.” They however did not provide any evidence to thisclaim. Halfway through the briefing, they stopped briefing the concept of confirmation bias andchanged to the benefits of the vaccine and how the benefits by far outweigh the risks. When
members of the audience asked legitimate questions regarding the safety and efficacy of thevaccines, or the illegal use of EUA injections in the place of only approved vaccines that havereceived full licensure from the FDA, the presenter shut us down claiming it was “disinformation.” No more questions were asked.
4. At the end of the briefing our Wing Commander got up to say a few words, which turnedmore into a Q&A. The room collectively wanted to know if we rejected the shot entirely, or if
our exemptions got approved, what would happen? His words were, “not being vaccinated is
not conducive to military service” along with “this is a lawful order by the officers appointed
over you.” He continued to advise that if exemptions were approved, you’d have to be reclassed to a non-deployable career field if one was available. If not, you’d be discharged. If you

2
rejected the shot without requesting an exemption, then we would be discharged under an undetermined service characterization (he couldn’t advise if it was honorable, dishonorable, or
anywhere in between). Based on what the Wing Commander briefed us, I felt that even if I had
an approved accommodation, my career in the military was effectively over and pursuing an accommodation would be frowned upon.
5. I slept poorly that night as I was trying to weigh my options and decide what to do. I could
not risk a dishonorable discharge as that is equivalent to a felony on the civilian side. But I also
did not want the vaccine based on my firmly held belief. Thus, I made a very difficult decisionthat went against my conscience; and I regretted that decision ever since. But as my Wing
Commander put it, “not being vaccinated is not conducive to military service” and I loved serving in the military.
6. The following morning on 3 October, I reported for duty. Within 30 minutes of arrival, allunvaccinated members had to report to the fitness center again to either file an exemption or
get the vaccine. Based on my options, I felt coerced to get the vaccine. I cried all the way to thefitness center. Medical personnel asked which vaccine I was wanted, and I said “Pfizer, it’s the
only FDA approved one” and then received my first of two vaccinations. The fact that they
were offering a choice between the different vaccines despite the SECDEF stating that only vaccines that have full FDA approval will be used to fulfill the order did not dawn on the medical
providers. Knowing now that they coerced hundreds of my fellow service members into getting
an experimental drug without their informed consent is criminal. My initial reaction to the injection was mild with typical fatigue and body aches that subsided after a day or two.
7. However, during our next drill the following month on Nov 7, I was shuttled to the fitness
center again to get my second shot of the Pfizer vaccine. A headache soon developed on myway home, and I soon fell asleep. The next morning, I woke up like I hardly slept that night, butmore concerning was that I was experiencing very unusual symptoms with my vision. Objects
appeared to be waving like when you can see a mirage above hot pavement. This continued
through the night. The following morning on Nov 9, I woke up at 1AM to utilize the bathroom.
My vision had become so off that I was unable to balance. I fell out of the bed, fell again at thefoot of the bed, and even fell off the toilet while sitting. I was experiencing extreme vertigo
where I was unable to balance and unable to see straight. I literally crawled on the floor back to
bed where I tried to research if this was a normal reaction after the vaccine, but my vision was
so bad I could not read my computer device. I fell back asleep and woke up at 5AM and foundthat I had my vertigo subsided – but my vision was still the same as it was 48 hours prior.
8. My vision remained unusual through noon on Friday November 12th. To describe my vision;
it appeared to be bouncing up and down. For example, a four foot tall fence post appeared tobe eight feet tall while bouncing up and down. I asked my husband if he could see my eyes
shaking and he said no. The next morning, I accompanied my husband for a retreat, but I could
barely walk. I again asked him to look at my eyes and this time, he confirmed they were bounc-

3
ing up and down. We then proceeded to the Emergency Room fearing I was having some adverse reaction to the vaccine. The doctors there diagnosed me with Vertical Nystagmus. Vertical Nystagmus is very rare compared to Horizontal Nystagmus; so rare that doctors came in tosee me out of curiosity just to observe my eyes as they’ve never seen it in all their combined
medical careers. The doctors ordered a CT scan, which came back inconclusive but referred me
to a Neurologist the following Monday.
9. Monday, Nov 15, the neurologist recognized my Nystagmus and ordered an MRI, MRV, MRA,EKG and extensive blood-work which were completed over the next three weeks. The results of
the MRI showed I had two strokes! One in my occipital lobe was identified by the MRI but theother was in my Brain Stem and too small to show on the MRI. The doctors concluded this because Vertical Nystagmus is only present with a stroke in the Brain Stem. The Vertical Nystagmus slowly subsided over the next few days.
10. On Saturday, Dec 4 I woke up with terrible nausea and my vision reverted to how it was
three weeks prior. I was terrified I had another stroke. My brother rushed me to the ER where
they too thought I had another stroke. They admitted me for observation the next two nights tomonitor my heart as I was at an increased risk for AFib. I remained in observation until they
could perform an MRI on Monday.
11. That Monday, the results of the MRI showed I did not show any new strokes; but instead I
had suffered more strokes than originally diagnosed during my first MRI. They advised thatsince some of the swelling had subsided, they were able to see three strokes in my Occipital
Lobe in addition to the one in the brain stem that was still undetectable by MRI. Four total
strokes within hours of receiving my second dose of the COVID vaccine. The doctors discharged
me with a heart monitor to be worn for the next two weeks and put me on a 75mg blood thinner to take in conjunction with 81mg of Aspirin daily. This they said to reduce the risk of further blood clotting as a result of the vaccine.
12. On Thursday Dec 9, I had a tele-med appointment with my neurologist. I asked why I
seemed to have regressed in symptoms if I did not have an additional stroke, and she statedthat if I am stressed, fatigued, tired, etc., that my stroke symptoms can reappear. She ordered
Occupational Therapy for my vision and referred me to a Neuropthamalogist. I had my first Occupational Therapist appointment on Jan 5.2022. The therapist is not optimistic I will see
improvement but will know more in follow on appointments as they continue to monitor mycondition. I am still waiting to see the Neuropthamalogist.
13. My future in the military is now uncertain as I am unable to drive, move confidently
through dynamic terrain, or articulate my thoughts in the manner I am accustomed to. In the
military we are taught the 9-Line Medivac report in ad nauseam. “Urgent” deals with wounds
that are most severe to include anything that deals with the possible loss of life, limb, or eyesight. Knowing that my eyesight may forever be affected by this is devastating. My AFSC requires that I drive heavy machinery as well as scrutinize technical data. How am I expected to4
do that with compromised vision? How am I to continue serving the country that I love, muchless live a normal fulfilling life? My civilian career has been placed in jeopardy as well as my military career. I chose to serve in the United States armed forces and put it all on the line for mycountry. I never thought a vaccine mandate would be what brought that all to an end. Not only
am I no longer able to fulfill my responsibilities to my employer, and the Airforce; I also can nolonger take part in many hobbies that made me who I am today.
To my congressional delegates: We have all stuck our neck out in one way or another inorder to better serve this great nation. I call on you now to do just that. These mandates are aglaring overreach of executive power. Please fight for our constitutional rights. Please fight foryour constituents. Please stop these mandates. Please fight for me: if we can avoid one morecase like mine, we will have succeeded. You have the power to stop this, so my family and I
simply ask that you use it. To maintain our individual sovereignty, we always must have a
choice. Freedom of choice is what this nation was built on, and the belief that I held close whenvolunteering to serve in the military. Please fight for others to have the choice I wasn’t afforded.

Attachments:

1.Medical Letter
2.VAERS Report1/10/22, 6:49 PM

Gmail - VAERS Report Confirmation

VAERS Report Confirmation
1 me

age

info@vaers.org <info@vaers.org>
To:

Mon, Jan 10, 2022 at 6:48 PM

Report Confirmation EmailThank you for using the VAERS on-line report submission system. The information you have provided will assist
the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) in their effort tomonitor the safety of all US-licensed vaccines. Your report was submitted on the date indicated below, anda igned a temporary E Report Number Plea e refer to the a igned E Report Number below if you need tocontact us regarding this report.
If you have additional information that will contribute to our understanding of the reported event, or if you would liketo obtain the permanent VAERS ID Number that was assigned to this report, please contact VAERS.

Date Form Completed
Temporary VAERS
E-Report No:

01/10/2022
769810For additional information on vaccine afety contact CDC INFO by calling (800) 232 4636 or vi it the CDC'
Vaccines and Immunizations website. The National Vaccine Injury Compensation Program (VICP) is a separate
program from VAERS and is administered by the Health Resources and Services Administration (HRSA).
Reporting an adverse event to VAERS does not constitute filing a claim with the VICP. For more information about
the VICP, call (800) 338 2382 or vi it the VICP Web ite

Patient identity is confidential

USN Pilot & Unit Commander, Captain, 44y/o Male- O-6: Senior Leader in the USN- Single dose of J&J vaccine, mild symptoms within 12 hours, but at day 4, sent to theER- Diagnosed with pancytopenia and a rare autoimmune disorder triggered by vaccine- Unable to exercise and suffers from lingering side effects- Has first person contact with other vaccine injured DoD members10/14/2021

UNCLASSIFIED//ROUTINER 132050Z OCT 21 MID600051034536U
FM CNO WASHINGTON DC
TO NAVADMININFO SECNAV WASHINGTON DC
BT
UNCLAS
NAVADMIN 225/21
MSGID/NAVADMIN/CNO WASHINGTON DC/CNO/OCT//SUBJ/COVID-19 CONSOLIDATED DISPOSITION AUTHORITY (CCDA)//REF/A/DOC/SD/24AUG21/
REF/B/MSG/SECNAV/302126ZAUG21/
REF/C/MSG/CNO/311913ZAUG21/
REF/D/DOC/BUMED/7OCT13//
REF/E/DOC/BUPERS/16MAR20//
REF/F/DOC/OPNAV/15AUG20//
NARR/REF A IS THE SECRETARY OF DEFENSE MEMO MANDATING
CORONAVIRUS DISEASE 2019 VACCINATION FOR DEPARTMENT OF
DEFENSE SERVICE MEMBERS.
REF B IS ALNAV 062/21, 2021 2022 DEPARTMENT OF NAVY MANDATORYCOVID-19 VACCINATION POLICY.
REF C IS NAVADMIN 190/21, 2021-2022 NAVY MANDATORYCOVID-19 VACCINATION AND REPORTING POLICY.
REF D IS BUMEDINST 6230.15B, IMMUNIZATIONS AND CHEMOPROPHYLAXISFOR THE PREVENTION OF INFECTIOUS DISEASE.
REF E IS BUPERSINST 1730.11A, STANDARDS AND PROCEDURES
GOVERNING THE ACCOMMODATION OF RELIGIOUS PRACTICES.
REF F IS MILPERSMAN 1730 020, IMMUNIZATION EXEMPTIONSFOR RELIGIOUS BELIEFS.//
POC/OPNAV/CAPT STEVEN TARR III, (703) 614-9250//EMAIL:
STEVEN.TARR1.MIL(AT)US.NAVY.MIL
RMKS/1. Purpose. This NAVADMIN announces the assignment of the
Chief of Naval Personnel as the COVID Consolidated Disposition
Authority (CCDA), and provides procedural guidance and reporting
requirements for administrative disposition of individual Navy
service members, active duty and Selected Reserve, who are notfully vaccinated per references (a) through (c).
2. Policy. In order to maximize readiness, it is the policy goalof the U.S. Navy to achieve a fully vaccinated force against thepersistent and lethal threat of COVID-19.
2.a. In support of the above stated policy, and as directed by
the Secretary of the Navys lawful order, the Navy has commenced
a mandatory vaccination campaign per references (a) through (c).
Navy service members refusing the COVID-19 vaccination, absent
a pending or approved exemption, shall be processed for
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10/14/2021

5.a. Designation of the CCDA. The Chief of Naval Personnel(CNP) is the CCDA. The Chief of Navy Reserve (CNR) will provide
support to the CCDA for cases involving Navy service membersin the Selected Reserve.
5.b. Authorities for Vaccination Refusal. The CCDA is theofficer show cause authority and enlisted separation authority
for Navy service members who refuse the COVID-19 vaccine,
except Entry Level Separation (ELS). For ELS, commanders
and commanding officers are separation authorities per
paragraph 6.b. Commanders and commanding officers will
initiate administrative separation processing per paragraphs
7.a. and 7.b. The Vice Chief of Naval Operations retains
authority for non judicial punishment and courts martial.
Involuntary extension of enlistments is not authorized on
the basis of administrative or disciplinary action for vaccination
refusal. The CCDA may seek recoupment of applicable bonuses,
special and incentive pays, and the cost of training andeducation for service members refusing the vaccine.
5.c. Other Misconduct. The withholding of disposition authority
in reference (c) and this NAVADMIN does not extend to othermisconduct, which may include misconduct related to vaccine
refusal such as failing to wear a mask when required, falsifying
vaccination records, or not complying with COVID testing
requirements. If in doubt, commanders, commanding officers,
and officers in charge should consult with their servicing staff
judge advocate in determining disposition authority.
5.d. Separation Authority for Vaccine Refusal That Includes
Other Misconduct. If a Navy service member is processed foradministrative separation because of vaccine refusal that
includes other misconduct, the CCDA will serve as the officer
show cause authority or enlisted separation authority inaccordance with paragraph 5.b.
5.e. Professional Qualifications. For Navy service members
refusing the vaccine, the CCDA retains the authority foradministrative processes regarding removal of warfare qualifications,additional qualification designations (AQD), Navy Enlisted
Classifications (NEC), or sub-specialties, except in cases
where removal authority is otherwise authorized by law or
Executive Order (e.g. Director, Naval Nuclear Propulsion
Program regarding nuclear qualifications).
5.f. Other Armed Forces Members Assigned to Navy Commands. For
vaccine refusal cases involving Soldiers, Airmen, Guardians, Marines,
or Coast Guardsmen assigned to Navy commands, the Navy commander,
commanding officer, or officer-in-charge will report the case to
the CCDA.
5.g. Navy Service Members in Non-Navy Billets. The CCDA will
be responsible for identifying, coordinating, and adjudicating
Navy service members refusing the vaccine while serving in non
Navy billets (e.g., Joint, NATO).
6.

Administrative Disposition Guidance; Immediate Actions.

6.a. Unvaccinated Senior Leaders. An unvaccinated senior leader
without a pending or approved exemption calls into question the
Navys trust and confidence regarding their ability to ensure
unit readiness or to maintain good order and discipline. Thesesenior leaders must begin vaccination immediately. This constitutes
a lawful order. The immediate superior in command (ISIC), commander,
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10/14/2021

or commanding officer, as applicable, will notify in writing seniorleaders refusing the vaccine that they have five (5) calendar days
to initiate corrective action. If the senior leader does not begin
a vaccination series or request an exemption within that five-day
period, the ISIC, commander, or commanding officer will relieve thesenior leader and initiate detachment for cause (DFC) per MILPERSMAN
1611-010, MILPERSMAN 1611-020, and MILPERSMAN 1616-010, as applicable.
6.a.(1). A sample report of misconduct is available at:https://www.mnp.navy.mil/group/navy-covid-19-reporting. The
report will note that authority for disciplinary action is withheld
by reference (c) and this NAVADMIN, and as such no disciplinary
action was taken.
6.a.(2). Established notification procedures for relief ofcommand triad members apply. The relief of any flag officer
or officer selected for promotion to O-7 under this paragraphwill be reported to the Naval Inspector General for review per
DoDI 1320.04 and SECNAVINST 5800.12C.
6.b. Entry Level Separation (ELS). ELS processing is authorized
per paragraph 5.b above per MILPERSMAN 1910-154 for Navy service
members in an entry level status refusing the vaccine. ELS shallbe reported per paragraph 9.
6.c. Because COVID-19 vaccination is now mandatory, commanders,commanding officers, or officers in charge, with the concurrence ofthe first flag officer in the chain of command, are authorized totemporarily reassign Navy service members who refuse the COVID-19
vaccine, regardless of exemption status, based on operational
readiness or mission requirements.
6.d. Promotion, Transfer and Reenlistment. Commands shall notallow those refusing the vaccine to promote/advance, reenlist, or
execute orders, with the exception of separation orders, until
the CCDA has completed disposition of their case. Transfer orders
may be cancelled by Navy Personnel Command.
7. Administrative Disposition Guidance; Future Actions.
actions in this paragraph shall be executed per
paragraph 4.

The

7.a. Officer Administrative Separation. In the case of any
officer, including any officer senior leader, who is refusing
the vaccine, the cognizant commander or commanding officer shallsubmit a report of misconduct to Commander, Navy Personnel Command(PERS-834) per MILPERSMAN 1611-010. A template report is available
at: https://www.mnp.navy.mil/group/navy-covid-19-reporting.
Per SECNAVINST 1920.6D, the CCDA, as the show cause authority,
has directed mandatory show cause processing for all officers on
the bases of Misconduct, Moral or Professional Dereliction, andSubstandard Performance, with the least favorable characterizationof service as GENERAL (under honorable conditions), unlessinclusion of another basis for separation warrants other thanhonorable. Additionally, report flag officers or officers selected
for promotion to O-7 who are refusing the vaccine to the Naval
Inspector General for review per DoDI 1320.04 and SECNAVINST
5800.12C. Officers separated under this subparagraph will not
be eligible for involuntary separation pay and will be subject
to recoupment of any unearned special or incentive pays.
7.b. Enlisted Administrative Separation. In the case of any
enlisted service member, including any enlisted senior leader,
who is refusing the vaccine, the cognizant commander orcommanding officer shall initiate the process for administrative
4/6

10/14/2021

separation under MILPERSMAN 1910-142, Commission of a Serious
Offense, plus any additional basis known at the time of processing.
The provisions of MILPERSMAN 1910 (series) apply; treat vaccine
refusal cases as though they were listed in MILPERSMAN 1910-233.
The CCDA is the separation authority unless a higher separation
authority is required by MILPERSMAN 1910-704. The least favorable
characterization of service shall be GENERAL (under honorable
conditions), unless inclusion of another basis for separation
warrants other than honorable. Enlisted service members separated
under this subparagraph will not be eligible for involuntary
separation pay and will be subject to recoupment of any unearned
special or incentive pays.
7.c. Officer Promotion Delay. Per SECNAVINST 1420.3 or
SECNAVINST 1412.6M, commanders and commanding officers shalldelay the promotion of any officer refusing the vaccine.
Delays shall be based upon pending administrative action andphysical qualification. PERS-833 will make formal written
notice to the officer following written notice by thecommanding officer.
7.d. Enlisted Advancement Withhold. Per BUPERSINST 1430.16G,
commanding officers shall withhold the advancement of any
enlisted member refusing the vaccine. Advancement withholds
shall be based upon pending administrative action and physicalqualification.
7.e. Documentation in Fitness Reports and Enlisted Evaluations.
Per MILPERSMAN 1610-015, failure to comply with individual
medical readiness responsibilities will be documented in fitnessreports and evaluations. Failure to be fully vaccinatedagainst COVID-19 is a medical readiness failure.
7.e.(1). Commanding officers shall identify those refusing
the vaccine and verify that the members have an initialcounseling NAVPERS 1070/13 per MILPERSMAN 1610-015 in theirlocal file (Page 13). If necessary, the initial NAVPERS
1070/13 directed in MILPERSMAN 1610-015 shall be issued.
The NAVPERS 1070/13 counseling and warning ordering
vaccination per NAVADMIN 190/21 may serve as the subsequent
formal counseling required in MILPERSMAN 1610-015.
7.e.(2). Within 30 days of a Navy service member refusing thevaccine, reporting seniors shall issue a Special Fitness
Report/Evaluation per MILPERSMAN 1610-015 and BUPERSINST
1610.10E. In addition to documenting failure to comply withindividual medical readiness responsibilities, the reportshall document other facts as appropriate, including any
misconduct related to UCMJ Art. 92.
7.f.
Terminal Leave. Navy service members who commenceterminal leave on or before the applicable deadline in paragraph
4 are administratively exempted from vaccine requirements
per BUMEDNOTE 6150 of 21 Sep 21 and BUMEDINST 6230.15B.
7.g. The authority for commanding officers in MILPERSMAN
1730-020 to revoke an approved religious accommodation exemption
from COVID-19 vaccination is withheld.
8.

Reporting

8.a. Officers and E-6 through E-9. Per MILPERSMAN 1611-010
and MILPERSMAN 1616-040, commands are required to inform PERS-834(officers) and PERS-832 (enlisted) of incidents that could resultin adverse action. This applies to vaccine refusal. Reports
5/6

COVID-19 mRNA Vaccine Provider Medical Exemption Guidance 11SEP2021
Permanent Medical Exemption• Documented anaphylaxis after receipt
of first COVID-19 vaccination or
symptoms less than 4 hours after
vaccination including hives/swelling,wheezing/shortness of breath,vomiting/diarrhea, hypotension. Can bevaccinated under guidance of Allergist,
if available.
• Diagnosed with myocarditis /pericarditis after first COVID-19
vaccination or infection including ST
elevation and/or enzymes.
• Temporal association of StevensJohnson Syndrome (SJS) or Guillain
Barre Syndrome (GBS) that cannot be
attributed to another underlying cause• Thrombosis with Thrombocytopenia
Syndrome (TTS)

Temporary Medical Exemption• Currently in isolation / quarantine for
COVID-19. Recommend they get
vaccinated as soon as off isolation /quarantine.
• Pregnancy, although strongly
recommend vaccination per ACOG /CDC guidance• Monoclonal antibody administration
against COVID-19 (90 days). Renewal of
temporary medical exemption will be
required every 30 days.
• If required for travel to be vaccinated in
hospital Immunizations Clinic underguidance of Allergist• If required to gather more information
regarding special medical
considerations on limited basis

Refer questions to email: usn.Jacksonville.navhospjaxfl.list.covid-medical-waiver@mail.mil
or DHA Global Teleconsultation Portal: https://help.nmcp.med.navy.mil/path/user/Login.action

Definitely Vaccinate• Symptoms following first COVID-19
vaccination more than 4 hours after
shot including malaise, fever, report ofcontracting COVID-19 from thevaccine, isolated throat tightness selfresolved, vasovagal reaction• Currently breastfeeding• Personally immunocompromised• Concerns regarding infertility• Concerns regarding medicallyvulnerable family members• Reaction to other vaccines /medications / allergens that do notcontain shared ingredients• Allergic reaction to any foods,
including eggs and gelatin, latex,
preservatives, antibiotics, or metals
including iron, nickel, cobalt, lithium,rare earth alloys

DEPARTMENT OF THE NAVY

BUREAU OF MEDICINE AND SURGERY
7700 ARLINGTON BOULEVARDFALLS CHURCH VA 22042
IN REPLY REFER TO

6300
Ser M00/21M00035
3 Sep 21
MEMORANDUM FOR COMMANDER, NAVAL MEDICAL FORCES ATLANTICCOMMANDER, NAVAL MEDICAL FORCES PACIFIC
COMMANDER, NAVAL MEDICAL FORCES SUPPORTCOMMAND
Subj: INTERCHANGABILITY OF FOOD AND DRUG ADMINISTRATION-APPROVEDPFIZER-BIONTECH VACCINE COMIRNATY® AND FOOD AND DRUG
ADMINISTRATION-AUTHORIZED PFIZER-BIONTECH VACCINE UNDER
EMERGENCY USE AUTHORIZATION
Ref:(a) Comirnaty® Biologics License Application(b) Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine of
23 Aug 2021

1. Purpose. Address the interchangeability of the Food and Drug Administration (FDA)approved Comirnaty® and FDA-authorized Pfizer-BioNTech Coronavirus Disease 2019
(COVID-19) vaccine.
2. Background. On 23 August 2021, the FDA approved the Biologics License Application
submitted by Pfizer-BioNTech for individuals 16 years of age and older, reference (a). On thesame day the FDA revised the Emergency Use Authorization (EUA) for the Pfizer-BioNTech
COVID-19 vaccine for individuals 12-15 years of age and for a third dose inimmunocompromised individuals, reference (b).
3. The FDA-approved vaccine, and the vaccine used under the EUA, have the same
formulation, and can be used interchangeably to provide the COVID-19 vaccination series
without presenting any safety or effectiveness concerns. Navy medical providers can use PfizerBioNTech doses previously distributed under the EUA to administer mandatory vaccinations.

Copy to:
COMPACFLT
COMUSFLTFORCOM
OPNAV (N3N5)HQMC HSDEPARTMENT OF THE NAVY
BUREAU OF MEDICINE AND SURGERY
7700 ARLINGTON BOULEVARDFALLS CHURCH VA 22042

Canc: Nov 2021
IN REPLY REFER TO

BUMEDNOTE 6000
BUMED-M3
16 Nov 2020
BUMED NOTICE 6000
From: Chief, Bureau of Medicine and Surgery
Subj: IMPLEMENTATION OF ELECTRONIC MEDICAL EVALUATION BOARDREPORTRef:(a) DoD Instruction 1332.18 of 17 May 2018(b) SECNAVINST 1850.4F(c) SECNAV M-1850.1(d) NAVMED P-117(e) BUMEDINST 6000.19(f) DTM 18-004, Revised Timeliness Goals for the Integrated Disabiity Evaluation
System of 30 Jul 2018(g) DEPSECDEF memo of 13 Dec 18

1. Purpose. Navy Medicine Readiness and Training Commands (NAVMEDREADTRNCMD)
must utilize the electronic Medical Evaluation Board Report (eMEBR) application in Limited
Duty Sailor and Marine Readiness Tracker (LIMDU SMART) for all new cases where Service
members are being considered for Disability Evaluation System (DES) referral (pre-DES), or
when referred into the DES, and process cases per references (a) through (d), and enclosure (1)of reference (e). Reference (e) requires LIMDU SMART for processing Medical Evaluation
Board (MEB) activities, where this notice provides direction on phased implementation timelines
for use of eMEBR application in LIMDU SMART, by NAVMEDREADTRNCMD.
2. Scope and Applicability. This notice is applicable to patient administration departments,
MEB offices, all healthcare providers (including operational medicine healthcare providers)delivering care to Sailors or Marines in medical treatment facilities. In addition, this noticeprovides a process to fulfill DES requirements as outlined in references (a) through (f).
3. Background. Expeditious processing of ill and injured Service members through the DES
facilitates appropriate adjudication of their ability to continue naval Service, and additionallyensures we maintain a ready and lethal force. In reference (g), the Deputy Secretary of Defense
directs Military Service Departments to complete DES processing within 180 calendar days fromdate of referral.
4. Action. To standardize, systemize, and optimize DES processing and meet quality andtimeline goals in references (a) through (c), (f), and (g), Bureau of Medicine and Surgery(BUMED) directs Naval Medical Forces Atlantic and Naval Medical Forces Pacific toimplement use of the asynchronous eMEBR application in LIMDU SMART across all

BUMEDNOTE 6000
16 Nov 2020
NAVMEDREADTRNCMDs in three phases by site, as outlined athttps://esportal.med.navy.mil/bumed/rh/m3/M34/MEBs/DES/SitePages/Home.aspx. In addition,
Naval Medical Forces Atlantic and Naval Medical Forces Pacific must ensure NAVMEDREADTRNCMDs provide support to operational medicine healthcare providers for integration into the
MEB and LIMDU SMART processes.
5. Records Management
a. Records created as a result of this notice, regardless of format or media, must be
maintained and dispositioned per the records disposition schedules located on the Department of
the Navy Directorate for Administration, Logistics, and Operations, Directives and Records
Management Division portal page at https://portal.secnav.navy.mil/orgs/DUSNM/DONAA/
DRM/Records-and-Information-Management/Approved%20Record%20Schedules/Forms/
AllItems.aspx.
b. For questions concerning the management of records related to this notice or the records
disposition schedules, please contact the local records manager or the Department of the Navy
Directorate for Administration, Logistics, and Operations, Directives and Records Management
Division program office.

Releasability and distribution:
This notice is cleared for public release and is available electronically only via the Navy
Medicine Web site, http://www.med.navy.mil/directives/Pages/BUMEDNotes.aspx

2

USAF Fighter Pilot, Major, 36y/o Male- Single dose of J&J, within 10 hours, forced to call paramedics and sent to ER- Grounded from flight status for over a month- Flight medicine, despite his adverse reaction, will not grant an exemption from further shots- On 21 December, diagnosed with pericarditis and anaphylaxis

28 Oct 2021
MEMORANDUM FOR THOSE CONCERNEDFROM: VACCINE INJURED AIR FORCE FIGHTER PILOTSUBJECT: Summary of impact after COVID-19 vaccine to an Air Force Fighter Pilot
1. This memorandum will highlight a substantial and specific danger to the safety of our armed
services and is being submitted under protected communication with congressional members. I
request to have my identity redacted if this memorandum is shared outside of these protected
communication channels in accordance with the Whistle Blower Protection Act.
2. I am a current and qualified A-10
instructor pilot stationed at
I hold advanced qualifications as a Formal Training Course Instructor Pilot,
Mission Commander, Rescue Mission Commander Instructor, Forward Air Controller-Airborne
instructor, and. I have 1,958 flight hours, 864
instructor hours, trained hundreds of wingmen, flight leads, instructors, JTACs, and Ground
Force Commanders. I have 219 combat hours in Syria and Iraq, and have been awarded
multiple air medals and awards. The total cost of my training based on hours, qualifications,and ordinance is estimated to be $25M. I am one of many pilots across the DoD that are now
recovering from a vaccine injury.
3. In order to be a fighter pilot, we must go through rigorous mental and physical medical
screenings to fly high performance aircraft. As such, I have passed stringent initial screenings
and yearly exams as exemplified in my medical records and physical fitness reports. I was able
to perform in the excellent category of physical fitness my entire career and have excellent
history of cardiovascular and muscular fitness. The day prior to taking the vaccine, I could run a
1.5 mile in less than 10.5 minutes and max out the high score in push-ups and sit-ups for ourphysical fitness evaluations. I rarely became ill and had no preconditions that threatened myhealth. I was a healthy 6’1”, 190 lb 36-year-old. I have never been diagnosed with COVID-19
or received a positive COVID-19 test result.
4. In accordance with the Department of the Air Force’s policy to vaccinate against COVID-19
as required by the SECDEF mandate, I received an order to receive two doses of a fully FDA
licensed COVID-19 vaccine or vaccine still under an EAU to meet deadlines as outlined by the
Department of the Air Force. Knowing the risks of side effects of taking COVID-19
vaccinations, I was reluctant to take the vaccine but was informed failure to comply would
result in non-judicial punishment or court martial under Article 92 of the UCMJ, andadministrative discharge from military service. On 2 October 2021, I was ordered by my directsupervisor to take a COVID-19 vaccine by 18 Oct 2021 or face termination of my 13-year
military career. Thus, on 8 October, I reluctantly took the Johnson and Johnson COVID-19
vaccine in order to preserve my career and only source of income. I now regret that decision.

3
experienced instructors into critical instructor roles. Additionally, this vaccine mandate isforcing some of our experienced instructor pilots with over 19 years of military service to leave
the military. If we lose these instructors in addition to those suffering injuries, we will get into
severe mission degradation territory.
7. I implore members of Congress to consider the effect this policy is having on our nation’s
fighting force. We are being forced to take a vaccine that is still under EUA to meet deadlines
outlined by our service departments. The immediate impact on our readiness and health isstaggering. No doubt I am not alone in these struggles as I have been in contact with several
other members of the military that are also suffering from vaccine injury. I have encouraged
them to also come forward despite the risk to their careers. I humbly request the DoD
immediately cease the COVID-19 vaccine program to assess their safety, perform a mission
impact and readiness study, and conduct a DoD wide survey of those that have been injured by
the vaccine and are scared to come forward in fear of losing their careers. We must determine
the true effects of these vaccines on our health, our readiness, and national security.

A-10C Instructor Pilot

Attachments:
1. Medical Records
3. Order to vaccinateUSN Pilot, Commander, 42y/o Male
- Constant tightness in chest, heart palpitations, difficulty breathing five days after second Pfizer dose
- Service member’s cardiologist suspects Myocarditis- Grounded from flying for months

17 DEC 2021
MEMORANDUM FOR THOSE CONCERNEDFROM: VACCINE INJURED U.S. NAVY PILOTSUBJECT: Summary of Adverse Reaction to COVID-19 mRNA Vaccine
1. The intent of this memorandum is to highlight the potential dangers the mRNA vaccines pose to ouryoung, healthy, active, and all-volunteer force. I understand that this memorandum is being
submitted under protected communication with members of congress and request to have myidentity redacted if shared outside of these protected communication channels in accordance with
the Whistleblower Protection Act.
2. I am a current and qualified MH-60R Seahawk helicopter pilot in the U.S. Navy, and currently serve
I have served proudly, and honorably, for more than 19 years, and amscheduled for retirement in September of 2022. Throughout my career, I have obtained every
advanced flight, instructor, and tactical qualification available to me while accumulating nearly
2,600 flight hours, with more than 1,000 instructor hours. Unfortunately, I am one of manymembers across the DoD who are now recovering from adverse effects, directly linked to the mRNA
vaccine, specifically, the Pfizer vaccine authorized under the Emergency Use and Authorization Act.
3. As an active duty Naval Aviator, I have endured my fair share of physical and mental challenges to
get where I am today. I have always passed my medical screenings without issue, and without
delay, avoiding any unnecessary “groundings” in my flight status as a result of my physical andmental health. I have not had any issues or concerns in passing physical fitness tests, nor annual
flight physicals. Throughout my entire flying career, I cannot recall a single time where I was “sick inquarters”, resulting in missed flying or impacts to my job, related to any medical illness. Up until mysecond dose of the Pfizer vaccine, I was a healthy, 5’9”, 155 lb, 41 year old aviator. Additionally, I
have never been diagnosed with COVID-19, nor received a positive COVID-19 test result, during anyof the PCR test screenings.
4. When the DoD introduced the mRNA vaccines to us in February of 2021, I volunteered to receive
this vaccine based on the information available at that time, and the promise that receiving those,
would allow for us (as Navy members), to avoid what was known as “pre-deployment sequester”, orisolating in a hotel room for a minimum of 14-days prior to deployment. This “carrot”, whendangled in front of me, along with the four-star leadership stating that we would return to preCOVID life on deployment (foreign port visits), led me to believe that it was in my best interest toreceive the experimental vaccine. I took my first dose of the Pfizer vaccine on 19 Feb 2021, and thesecond dose on 03 Mar 2021. I now regret this decision, and the thought process that led me tovoluntarily accepting the vaccination.
5. Within five days of receiving the second dose of the Pfizer mRNA vaccine, I began to experience
what I considered serious, adverse side effects. I began feeling constant tightness in my chest, heart
palpitations, what felt to me like an extremely elevated heart rate, dizziness, and difficulty
breathing. As previously stated, these symptoms began within five days of the second dose andcontinued to plague me for more than a month before I sought medical attention. I recall a Sunday
afternoon, when I was driving my kids to the beach, when I had a sudden onset ofall the symptoms described above. The heart palpitations and difficulty breathing became sosevere, that my vision became blurred and I felt as though I was nearing the point of losing
consciousness. I was able to fight through the symptoms, and the very next day, I reported to
medical6. The Senior Medical Officer
ran some basic diagnostic tests and ultimately
determined that I should immediately report to an Emergency room at the nearest Naval Hospitalwhich wasOn the morning of 03 May, 2021, I was admitted
into the Emergency Room for observation and testing. While in the ER, I received an EKG test,
monitored for all vitals, and had an ultrasound performed on my heart. The heart was scanned
using a cardiac ultrasound, x-rays, and data collected on heart activity with a standard 12-lead EKG.
In addition, blood samples were collected to run lab tests for pericarditis indicators. No obvious
abnormalities were detected, and all indications showed normal functionality of the heart. Basedon no life-threatening or serious issues discovered in the Emergency Room, the direction was for afollow-on consultation with a cardiologist to further examine the symptoms I was experiencing.
Following this visit to the Emergency Room, and the ongoing heart complications from the vaccine,the Senior Medical Officer (Flight Surgeon)
delayed the approval of myannual flight physical, and I found myself “grounded” from all flight duties, until the issue wasresolved.
7. During the month of May 2021, I had two visits with a Cardiologist, and a final consult with the
Cardiologist in early June 2021. The first visit was a standard consultation to review the ER findings
and discuss treatment and options going forward. During this consultation, I was given a Holter
monitor, that I wore on my chest to capture a minimum of 72 hours-worth of heart activity andreturned to the medical treatment facility for analysis. Follow-up data from the monitor did notindicate anything alarming or abnormal. The second visit was to run an extensive, 30-minuteechocardiogram, to obtain quality images of my heart and observe all functionality of the heart. The
third and final visit was to conduct a “stress test”, where I had a 12-lead EKG monitor my heart
activity while running on a treadmill at increasing speeds and incline levels, to “stress” the heart,and observe its response. Overall findings concluded that no acute coronary syndrome existed, andthe Doctor mentioned “it is possible that the Pfizer vaccine could have caused a case of myocarditis,but due to the length of time since symptoms began, difficult to directly link the two together.”
8. It should be noted that at no point, did any of the medical professionals, volunteer to enter any of
my adverse side effects into the VAERS system for properly documenting and reporting adverse side
effects. When I asked about this, it was quickly dismissed, and again, none of the medical
professionals wanted to document the adverse side effects and link it to the COVID-19 vaccine. I
personally submitted a VAERS report for my symptoms on 27 JUN 2021, and the case number for myreport is 572027.
9. The symptoms I experienced within days of receiving my second mRNA vaccine dose were serious
adverse side effects and completely unnecessary given my previous health history. I humbly request
the members of congress look into the effects of the COVID-19 vaccines on the overall health risks
and benefits they may have on our service members. Forcing military service members to choose
between vaccinations for a virus which they statistically have an extremely low risk of death orserious injury and their careers is unthinkable. Many, to include our current Commander-in-Chief,
told us that the vaccines were voluntary and would never be mandated. Unfortunately, ourleadership throughout the chain of command has changed their policy, and now demands weDocument info
Result type:

Cardiology Outpatient Note

Result date:
Result status:

modified

Cardiology Office Visit Note
Patient:

Chief Complaint
Palpitations and chest tightness

DOB:

Problem List/Past Medical History
Ongoing
No qualifying data
HistoricalNo qualifying data

History of Present Illness
42-year-old active-duty male presents for evaluation of 2 months of
palpitations accompanied with a sensation of chest tightness, continue totake another larger breath. Occurs spontaneously, no inciting orProcedure/Surgical History
relieving factors, resolves quickly. Does not travel to back or arm.
• total hip left (05.2002)
Palpitations feel like rapid heartbeat, he wears a heart monitor watch andsays that he is normally in the 50s to 60s and will see his rate jump into the Medications
120s. These symptoms occur daily, not associated with exertion, able to Pepcid 20 mg oral tablet, 20 mg= 1
tab(s), Oral, Daily
exercise regularly without symptoms. . No other associated symptoms.
patient notes that symptom onset started approximately 7-10 days after heAllergies
received second Pfizer Covid 19 vaccine dose. No other significant life
No Known Medication Allergies
changes or stressors, past medical history only notable for benign tumor ofSocial History
left hip requiring reconstruction and retained hardware.
AlcoholOccasional Use, 05/24/2021
Never smoker, rare alcohol use, family history of heart disease and HTN in
Tobaccohis maternal grandmother, cancer in his father and paternal grandfather.
Smoking tobacco use: Never (less thanPatient was prescribed Pepcid in the ER but did not pick it up due to long
100 in lifetime)., 05/24/2021
lines the pharmacy that day.
Smoking tobacco use: Never (less than
Review of Systems
100 in lifetime)., 05/24/2021
General: no fatigue, weight gain, weight loss, fever, chills
Family History
HEENT: no eye pain, blurry vision, hearing loss, sore throat
Cancer: Father - FH.
Cardiac: + palpitations, + chest tightness, no lightheadedness, syncope,
Colon cancer: Paternal Grandfather - FH.
claudication, orthopnea, PND
Heart disease: Maternal Grandmother Chest: no cough, wheezing, sputum production
FH.
Abd: no pain, reflux, anorexia, dysphagia, constipation, diarrhea, nausea,
Hypertension: Maternal Grandmother vomiting
FH.
GU: no dysuria, incontinence, nocturia, urinary retention
Heme: no easy bruising, bleeding, lymphadenopathy
EKG
MSK: no arthralgias, back pain, limb pain, myalgias
24 May 2021: Sinus rhythm with
Neuro: no weakness, headache, seizure, tremors, falls, neuropathy, vertigo,
ventricular response 66 bpm, PR
imbalanceinterval 132 ms, QRS 96 ms, QTC 381

Psych: no anxiety, depression, insomnia, hypersomnolence, psychosis, SI,
HI
Physical Exam
Vitals & Measurements
HR: 66(Peripheral) BP: 121/80 SpO2: 99% HT: 173 cm
WT: 70.00 kg(Dosing) WT: 70 kg(Measured)
General: NAD, AAOX4, Well nourished, Not ill appearing.
Pulmonary: normal respiratory effort, CTA bilaterally, no wheezes, rales, orrhonchi.
Cardiac: Normal S1/S2, no murmurs, rubs, or gallops. No JVD, no caroitd
bruits. No edema, normal radial/DP/PT pulses, warm, well perfused.
Gastrointestinal: Normal bowel sounds, soft, non-tender, non-distended, no
abdominal bruits
Neuro: MAEx4, strength equal bilaterally, appears grossly neurologicallyintact.
Psychiatric: No depression, normal affect
Assessment/Plan
1. Chest pain, unspecified
Palpitations and chest pain occur spontaneous and multiple times a day,not associated with exertion, ongoing for 2 months since receiving second
dose of Pfizer Covid-19 vaccine. No significant findings in the emergency
department. Patient notes tachycardia at rest according to heart ratemonitor watch.
Recommend 48 hour Holter monitor for evaluation of arrhythmia, antransthoracic echocardiogram.
Findings not suggestive of acute coronary syndrome.
Recommend patient trial Pepcid and evaluate for any change in his
symptoms, will reorder in case prior prescription is no longer available.
No indication for duty restrictions at this time.
Will follow-up with patient once results of Holter monitor andechocardiogram available.
Ordered:Pepcid 20 mg oral tablet, 1 tab(s), Oral, Daily, # 30 tab(s), 0 total refill(s),Maintenance, 1 tab(s) Oral Daily, Pharmacy: DOD SAN DIEGO PHARMACY[Last filled 05/24/21]
CV Echocardiogram Transthoracic
2. Palpitations
Ordered:CV Extended Holter Monitor
Screening due
Ordered:CV Electrocardiogram
A total of 30 minutes was spent during this encounter. >50% of the time wasspent coordinating care and/or counseling the patient on the diagnosis,
evaluation and therapeutic options.
Patient verbalized understanding and agreement with diagnosis andtreatment plan. Discussed red flag warning signs, reason to return to clinic orpresent to emergency room. Verbalized importance of obtaining follow up
after studies and consultation are complete. No barriers to understanding
identified.
Signed by

ms, normal axis, no significant ST or
T-wave changes, no evidence ofpreexcitation.

Cardiology

Addendum by
On the date of this encounter, I was immediately available to assist the resident in the care of the patient, and havereviewed the resident’s findings and agree with the plan of care except where noted.

Staff Cardiologist

Document info
Result type:

ED Note Provider

Result date:
Result status:

authenticated

Performed by:
Verified by:
Modified by:

ED/UC Provider Note
Patient:

DOB:

Basic Information
Time Seen:

Chief Complaint
cp, sob x 7 weeks
History of Present Illness
42 yo previously healthy male presenting to the emergency department forevaluation of 7 weeks of intermittent mitten substernal, pressure-like chest
pain and associated shortness of breath. Patient reports over the past 7
weeks he has had intermittent episodes of palpitations relative
tachycardia and mild to moderate chest pain which is occasionally exertionalin nature. Patient brought this up with his primary care physician who
referred him to the emergency department for further work-up. He reports
no associated nausea, vomiting, fevers, chills, recent cough, abdominal
pain or back pain associated with this.

Problem List/Past Medical History
Ongoing
No qualifying data
HistoricalNo qualifying data
Allergies
No Known Medication Allergies
Social History
TobaccoSmoking tobacco use: Never (less than
100 in lifetime)., 05/03/2021
Lab Results

Review of Systems
Constitutional: no fever, no chills, no temperature
intolerance, no sweats, no weakness/fatigue, normal appetite, nothirst, unchanged weight.

Automated LATEST
Hematolog RESULTSy
WBC
05/03 4.9
/21
14:16

Skin: no Jaundice, no rash, no lesions, no itching, no hair/nailchanges, no bed sores.

RBC

ENMT: no ear pain/ringing, no sorethroat, no congestion, no hoarseness, no dry mouth, no mouth sores.
Respiratory: no shortness ofbreath, no cough, no orthopnea, no wheezing, no sleep apnea.
Cardiovascular: moderate chest
pain, mild palpitations, no edema, nodyspnea with exertion.

05/03 5.1
/21
14:16

Hemoglobin 05/03 15.4
/21
14:16

Gastrointestinal: no nausea, no vomiting, no diarrhea, no GI
bleeding, no abdominal pain, no difficulty swallowing, no constipation.
Musculoskeletal: no back pain, no trauma, no muscle/joint pain, no falls.
Neurologic: no headache, no dizziness, no numbness, no weakness.

Hematocrit 05/03 45.5
/21
14:16
MCV

05/03 88.9
/21
14:16

MCH

05/03 30.1
/21
14:16

MCHC

05/03 33.8
/21
14:16

RDW CV

05/03 13.3
/21
14:16

Platelets

05/03 364
/21
14:16

MPV

05/03 9.1
/21
14:16

Psychiatric: no sleeping problems, no irritability, no moodswings/depression.
Heme/Lymph: no bleeding tendency, no bruisingtendency, no petechaie, no swollen nodes.
Allergy/Immunologic: no seasonal allergies, no food allergies, no recurrent
infections, no impaired immunity.
Additional ROS info: Except as noted in the above Review of Systems andin the History of Present Illness and all other systems have been reviewed
and are negative or noncontributory.
Physical Exam
Vitals & Measurements
T: 36.7 °C (Oral) HR: 69(Peripheral) RR: 16 BP: 128/84 SpO2: 99%
WT: 70.5 kg(Measured) WT: 70.50 kg(Dosing)
General: alert, no acute distress, oriented x 4.
Skin: warm, dry.
Head: no trauma, normocephalic.
Neck: trachea midline, no adenopathy, no JVD.
Eye: equally reactive pupils, sclera clear.
Cardiovascular: regular rate and rhythm, absent murmurs.
Respiratory: lungs CTA, respirations normal work of breathing.
Abdomen: soft, non distended, no tenderness, present bowel sounds.
Extremities: edema absent, pulses normal.
Neurological: LOC _, CN II-XII intact, motor strength equal &normal bilaterally, sensation equal & normal bilaterally, speech normal.
Psychiatric: cooperative yes, affect normal, _ judgment, _ psychiatricthoughts.
Procedure
PROCEDURE NOTE: ED Cardiac Ultrasound
Performed by:
Indication: chest pain and palpitations
Consent: Verbalconsent obtained from the Patientprior to the procedure.
Indications, risks, and benefits explained at length.
Technique:
Universal Protocol: A time out was performed and the correct patient wasverified.
Sonographic Views: 3 view
Findings:
The patient's heart was scanned utilizing the above noted probe. The
following views were obtained and evaluated. Cardiac activity

Neutrophil 05/03 50.8
% Auto/21
14:16
Lymphocyte 05/03 35.3
% Auto/21
14:16
Monocyte% Auto05/03 9.4
/21
14:16

Eosinophil 05/03 3.5% Auto/21
14:16

Routine
LATEST
Chemistry RESULTS
Sodium05/03 138
/21
14:16
Potassium 05/03 4.2
Lvl
/21
14:16
Chloride05/03 98
/21
14:16

CO2

05/03 31
/21
14:16

AGAP

05/03 9
/21
14:16

BUN

05/03 12/21
14:16

Creatinine 05/03 0.9
Level
/21
14:16
BUN/Creat 05/03 13.3
Ratio
/21
14:16
eGFR AA

05/03 122
/21
14:16

eGFR
Non-AA

05/03 105
/21
14:16

Glucose
Lvl

05/03 97/21
14:16

Calcium

05/03 10.0
/21
14:16

ProteinTotal

05/03 7.3
/21
14:16

Albumin05/03 4.5
/21
14:16

A/G Ratio

05/03 1.6
/21
14:16

Bilirubin
Total

05/03 0.35
/21
14:16

Bilirubin
Direct05/03 <0.2
/21
14:16

Alk Phos

05/03 68
/21
14:16

ALT

05/03 26
/21
14:16

AST

05/03 30
/21
14:16

Globulin

05/03 2.8
/21
14:16

Cardiac
LATEST
Isoenzyme RESULTSs
Troponin-T 05/03 <0.010
/21
14:16

Diagnostic Results
XR Chest 2 Views
05/03/21 11:11:36
XR Chest 2 Views
REFERRING PROVIDER
CLINICAL INFORMATION
Shortness of breath
COMPARISON
04/26/2016
TECHNIQUE
Frontal and lateral view chest.
FINDINGS
Lungs: Clear.
Pleura: Unremarkable. No effusion or
pneumothorax.
Cardiomediastinal Silhouette:
Unremarkable.
Bones: Normal for age.
Soft Tissues: Normal.
IMPRESSION* Normal.
Result Category: Routine
Final Report by:
Signed By:
ECG
Sinus rhythm rate of 55, normalintervals, normal axis, normal
precordial progression. Upward
sloping ST segment elevation, notconcerning for acute ischemia. No
significant ST segment elevation or T
wave inversion otherwise. Ischemic
ECG obtained at 1250. Comparedwith previous ECG

obtained on patient's ship by primarycare physician with no dynamicchangesUSAF Instructor Pilot, Major, 40y/o Male- Single dose of J&J vaccine, mild symptoms within 24 hours, but on day 4, sent to the ER- Suffering from ongoing neurological condition that is causing numbness in extremities, headache,shaking, and dizziness.

- Grounded from flying despite critical role as instructor pilot, requires waiver to return to flying that
could take years

DEPARTMENT OF THE AIR FORCE
AIR FORCE RESERVE COMMAND

10 Nov 2021

MEMORANDUM FOR THOSE CONCERNEDFROM: CONCERNED AIR FORCE INSTRUCTOR PILOTSUBJECT: Impact summary after COVID-19 vaccine to an Air Force Instructor Pilot

1. This memorandum is a short summary of the vaccine injury that I incurred after receiving a
COVID-19 vaccination. It is being submitted under the provisions of the Whistle Blower
Protection Act and I request to have my identity redacted if it is shared with these protectedchannels.
2. I am a current and qualified T-6A instructor pilot stationed. I have served
honorably for over 19 years in the USAF in three separate career fields as both enlisted andofficer. As such, I have passed stringent medical screenings and I live a healthy lifestyle andhave never experienced any significant health issues to date as a very healthy 40 year old male.
3. In accordance with the Air Force’s policy to vaccinate against COVID-19 as required by the
Secretary of Defense’s mandate, I received an order to receive two doses of a fully FDA
licensed COVID-19 vaccine or a vaccine still under an EAU to meet deadlines as outlined by
the Department of the Air Force. Knowing that there is currently no FDA approved vaccine
available within the DoD, I was reluctant to take the vaccine but was informed failure tocomply would result in non judicial punishment or court martial. The Air Force threatened mewith eventual dismissal from military service. Therefore, I reluctantly took the Johnson andJohnson COVID-19 vaccine on 24 September at 4 PM in order to preserve my career and only
source of income. The following occurred after I received the vaccine.
4. The first 4 days after the injection, I had fever, chills, body aches, and a moderate headachewith no apparent severe side effects. On the 4th day that rapidly changed. I suddenly felt as if alarge knife was shoved through my head, both of my arms from the elbow down went numb,and I felt so dizzy and lightheaded that I could barely walk around without feeling like I wasgoing to pass out. I Felt like I might pass out at any moment. I called my spouse to tell her tocome home as quickly as possible. Frightened, my wife had our neighbor rush over to our houseto take care of our scared children, and then rushed me to the hospital with symptoms of severe,
stabbing headache, severe dizziness, nausea, numbness down both arms and legs, and a highheart rate.
5. I was rushed into the emergency room, where they administered IV antihistamines, pain
killers, anti-nausea meds and fluids. They did a chest x-ray and ran blood labs. After an hour,
the symptoms reduced slightly to a severe headache, moderate dizziness, and numbness. I was2discharged with a diagnosis of “Adverse effect of Covid-19 Vaccine, Paresthesia andDizziness”. I combated these severe symptoms for nearly 28 days, to include a headache that
did not subside with medication of any sort. I had several episodes of scary, uncontrollable
shakiness. I have never experienced symptoms like this before in my life. Since the initialdiagnosis, I have had three full blood lab panels, three EKG’s, an MRI, and an emergency CT
Scan. I am currently waiting on a follow-up appointment with Neurology for full diagnosis.
6. I have returned to work on a limited office only duty status doing additional duties but am
currently grounded from flight duties. I will remain grounded from flight status pending a full
diagnosis and waiver process that could take months, or even years. I am also currently
pursuing a Line of Duty determination to document this adverse reaction. My family is under
an increased burden of stress as they take care of me and rotate regularly to observe me due tofears of possible sudden stroke, blood clot, or need of emergency care. This is no way to live.
7. I implore members of Congress to consider the effect this policy is having on our nation’s
service member’s. We are being forced to take a vaccine that is still under EUA to meetdeadlines outlined by our service departments. The immediate impact on our readiness andhealth is unknown, but I know I am not alone. I demand congress to put an immediate end to
the DoD vaccine mandate. Congress is likely unaware of injuries like mine because ourleadership is hiding them from you. Therefore, I felt compelled to speak out.

Maj, USAFR
T-6 Instructor Pilot,

Attachments:
1.Medical Record
2.VAERS Report
3.Order to vaccinate

USMC Infantry Captain, 28y/o Male- Single dose of COVID-19 vaccine, chest pains within 24 hours, sent to ER four days after- Diagnosed with likely pericarditis or pleurisy by cardiologist- Still unable to exercise or exert himself- Cardiologist recommended against further vaccination, however, military medical ignored
recommendation despite never seeing the patient- Has first person contact with other vaccine injured DoD members

Subj:

STATEMENT OF VACCINE INJURY
patient nor ever contacted my cardiologist. When I received his denial,
I called his contact information and spoke to him on the phone forapproximately 20 minutes. When I asked the medical officer about his
adjudication, he incorrectly described my symptoms as occurring fourdays after the shot and told me that evidence of pericarditis would
have occurred within 24 hours of the shot – which is precisely what
happened to me. This was well documented for his adjudication. He thentold me it was his responsibility from the Secretary of Navy andSecretary of Defense that everyone should be vaccinated unless therarest of circumstances.

6. My immediate chain of command was surprised by this decision anddecided to re-route the exemption straight to Quantico. Although wewere told we would hear back on 16 November 2021, I have not received
an official decision. My executive officer was told to expect a denial.
7. I joined the Marines Corps in the summer of 2016 out of deep pride andpatriotism for my country. I have given it my all every day I put on
the uniform. Unfortunately, it seems inevitable that I will be forcedout of the Marine Corps with my name and character stigmatized with ageneral discharge. They will ensure I pay back tens of thousands ofdollars of schooling, revoke my GI bill, take away my family’s healthinsurance, and leave me with unresolved heart problems. I do not write
this for sympathy or pity. It is not about me. I am a blessed man. I
write this as a warning of what is happening to the military. There arethousands of military members that will be forced out because theyrefuse to violate their conscience. Further, we know some that get thevaccine will be injured like I was. We do not know the long-term
consequences. Two of my best friends, one a green beret and the other amarine infantry officer, have been to the ER for chest pain for the
first time in their life a few months after their second dose of thevaccine.

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Subj:

STATEMENT OF VACCINE INJURY- I am recommending against receiving a second dose of the Pfizer vaccine related to these
symptoms.
-----------------------------------------------------------------------------------------------------Diagnostic studies:
Echocardiograpy:
Echo 10/2021
Normal chamber sizes with normal right and left ventricular systolic function. Estimatedejection fraction 60%.
No significant valvular abnormalities.
No prior study for comparison---------------------------------Stress testing:None available---------------------------------ECGs:
09/24/2021: Normal sinus rhythm. Normal ECG. Reviewed the tracing personally anddirectly with the patient--------------------------------Coronary angiography:
None available-------------------------------CT imaging:
None available------------------------------X-ray imaging:
Chest x-ray on 9/24/2021: Normal. Reviewed images personally and directly with thepatient.
-----------------------------Vascular imaging:
Normal-----------------------------Patient Active Problem List
Diagnosis• Atypical chest pain
No current outpatient medications on file prior to visit.
No Known Allergies
History reviewed. No pertinent surgical history.
No current facility-administered medications on file prior to visit.
Family History
Problem Relation Age of Onset• No Known Problems Mother• No Known Problems Father• No Known Problems Brotherirregular heart beat4

Subj:

STATEMENT OF VACCINE INJURY• Heart murmur Son
Social History
Socioeconomic History• Marital status: Married
Spouse name: Not on file
• Number of children: Not on file
• Years of education: Not on file• Highest education level: Not on file
Occupational History• Not on file
Tobacco Use• Smoking status: Never Smoker• Smokeless tobacco: Never Used
Substance and Sexual Activity• Alcohol use: Not on file
• Drug use: Not on file
• Sexual activity: Not on file
Other Topics Concern• Not on file
Social History Narrative• Not on file
Social Determinants of Health
Financial Resource Strain:• Difficulty of Paying Living Expenses:
Food Insecurity:• Worried About Running Out of Food in the Last Year:• Ran Out of Food in the Last Year:
Transportation Needs:• Lack of Transportation (Medical):• Lack of Transportation (Non-Medical):Review of Systems: All systems were reviewed and are negative or non-contributory except
for those findings mentioned in the HPI.
O:
Visit Vitals
Laboratory Data: See EMR. I have reviewed the pertinent laboratory data and cardiac
imaging.
Physical Activity:• Days of Exercise per Week:• Minutes of Exercise per Session:
Stress:• Feeling of Stress :Social Connections:• Frequency of Communication with Friends and Family:• Frequency of Social Gatherings with Friends and Family:

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Subj:

STATEMENT OF VACCINE INJURY• Attends Religious Services:• Active Member of Clubs or Organizations:• Attends Club or Organization Meetings:• Marital Status:
Intimate Partner Violence:• Fear of Current or Ex-Partner:• Emotionally Abused:• Physically Abused:• Sexually Abused:
Smoking Status Never Smoker
Lab Results
Component Value Date
WBC 6.80 09/24/2021
HGB 13.3 (L) 09/24/2021
HCT 38.9 (L) 09/24/2021
MCV 85.8 09/24/2021
PLT 216 09/24/2021
Total Protein
Date Value Ref Range Status
09/24/2021 7.7 6.3 - 8.2 g/dL Final
SodiumDate Value Ref Range Status
09/24/2021 137 135 - 146 mmol/L Final
Potassium
Date Value Ref Range Status
09/24/2021 3.9 3.5 - 5.1 mmol/L Final
GlucoseDate Value Ref Range Status
09/24/2021 94 70 - 99 mg/dL Final
Creatinine
Date Value Ref Range Status
09/24/2021 1.00 0.66 - 1.25 mg/dL Final
CO2
Date Value Ref Range Status
09/24/2021 31 22 - 32 mmol/L Final
Chloride
Date Value Ref Range Status
09/24/2021 98 98 - 107 mmol/L Final
Calcium
Date Value Ref Range Status
09/24/2021 9.9 8.4 - 10.2 mg/dL Final
BUN
Date Value Ref Range Status
09/24/2021 16 6 - 20 mg/dL Final

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Subj:

STATEMENT OF VACCINE INJURY

Total Bilirubin
Date Value Ref Range Status
09/24/2021 0.4 0.2 - 1.3 mg/dL Final
AST
Date Value Ref Range Status
09/24/2021 28 15 - 59 U/L Final
ALT (SGPT)
Date Value Ref Range Status
09/24/2021 20 <=50 U/L Final
Alkaline Phosphatase
Date Value Ref Range Status
09/24/2021 62 38 - 126 U/L FinalAlbumin
Date Value Ref Range Status
09/24/2021 4.8 3.5 - 5.0 g/dL Final
A/G Ratio
Date Value Ref Range Status
09/24/2021 1.7 1.0 - 2.0 (CALC) Final
No results found for: CHOL
No results found for: HDL
No results found for: LDLCALC
No results found for: TRIG
No results found for: CHOLHDLNo results found for: TSH
My personal interpretation of the lab values: The CBC was normal indicating no active
infection based on normal WBC count and no anemia contributing symptoms based on
normal hemoglobin. The platelet count was normal indicating no significant risk forbleeding.
The BMP was normal indicating no significant electrolyte abnormality or renal dysfunction
contributing to the patient's symptoms.
Troponin was negative indicating no myocardial necrosis/infarction contributing to thesymptoms reported.
I have reviewed notes from the patient's recent visit with ER.
“I connected withon 10/19/2021 atorTelephone Visit: telephone call and verified that I am speaking with the correct person using
two patient identifiers.
I discussed the limitations of the evaluation and management by telemedicine and thecurrent circumstances of the pandemic.
The patient expressed understanding and agreed to proceed.
I discussed the assessment and treatment plan with the patient. The patient was provided an
opportunity to ask questions and all were answered. The patient agreed with the plan anddemonstrated an understanding of the instructions.
I provided 22 minutes during this telehealth encounter.
Thank you for allowing me to participate in the care of. Please call7USAF Staff Sergeant, 29y/o Male
- Sponsored athlete who received two doses of Moderna- Experienced extreme distress and apprehension 5 minutes after receiving the second dose
- Chronic fatigue, faintness when sitting, difficulty driving, brain fog, and memory loss
- Diagnosed with “Long Hauler’s Syndrome” which is an emerging disease related to complications
from the Vaccine- Over a year later, still unable to exercise, think clearly or perform his job properly13 February 2022
COVID-19 Vaccine Injury

shot. Having this understanding about myself I was worried about what was justinjected into my body and what it was doing to me from the inside.
SYMPTOMS: As weeks go by, I start to notice weird things happening tome that trace back to the sensations and experience I had with my first episode.
Along with the Chronic Fatigue and the lack of stamina and strength that stemmed
from the first shot, I started to notice a lot of physiological symptoms. One of themost notable things that would happen to me was that every time I would sit down
for more than about 10-15 minutes, I would get that extreme faintness feeling like I
did with my first episode. These episodes would occur while doing the most menial
tasks to include driving, getting my hair cut, sitting in on briefs and just merely
sitting at my desk trying to do my work. The sensation would be so great that I
would have to make excuses to get out of the hair cutting chair or I would have towalk out on briefs to “use the bathroom.” The scariest times though would occur
when I was driving and even happened a few times while I was conducting airfield
checks, doing my job. I would have to pull over, get out and gather myself in orderjust to make it back to base. These episodes would occur for about 3-4 months.
The other symptoms that were extreme in their condition were my memory
loss issues and brain fog. First, Ill expound on my experience with brain fog. Just
to give some context on how bad my brain fog was, it was affecting/impairing my
physical vision. I wouldn’t be able to see clearly, and I would literally try to rub myeyes or attempt to refocus my eyes by looking at different things at different
distances. It felt like a shade had been pulled over my eyes and I was looking
through a constant haze. My brain fog would force me to constantly lose focus on
simple/mindless tasks. It forced me to really think long and hard about things thatused to just be second nature. I would also have to think about the words I would
say before I would say them because it was difficult for me to communicate mythoughts to people. My wife still advocates to this day that she noticed that I would
lose focus and it was difficult for me to speak in fluid sentences.
The brain fog may have been causing my memory issues but to this day I am
not sure if it was the culprit. My memory would be extremely spotty. It was as if I
was a hard drive in a computer and I would download the data to retain theinformation and then every other day, someone would delete that downloaded
information. Again, it may have been the extreme brain fog that caused the lack ofretention of information, or it could have been something else. All these symptoms
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13 February 2022
COVID-19 Vaccine Injury

the blood thinner that I was prescribed to take for 6 months post operation. This
was also an interesting thing to note. This was the first medication that I have everbeen allergic to. Was this another side affect from the vaccine? I am still not sure to
this day. I was switched over to a different blood thinner, of which I had to stay on
until 10 Jan 2022, to prevent blood clots from forming while the healing process
was taking place in my heart. During this 6-month time frame I was still not
feeling “normal”. Even with the allergic reaction gone from the first blood thinner,
I was still feeling off kilter and had all my initial symptoms but not as severe.
CURRENT STATUS: Considering my allergic reaction to the original blood
thinner, I wanted to wait the full term of the postop (6 months) before I keep
pursuing help with my symptoms. I wanted to make sure that I was not having any
subtle allergic reactions from the second blood thinner. I recently got in touch with
the VA and further complained to them about my symptoms. They were able toschedule me with an over the phone appointment with an infectious disease doctorthat took place on 4 February 2022. After I explained to the doctor my symptoms
and the duration of which I have had them, they explained to me that I have “Long
Haulers Syndrome”. She relayed to me that it is extremely rare for someone to still
be feeling these symptoms well over a year after their shots. She also explained tome that unfortunately this can’t be reversed, only the symptoms can be somewhat
treated. She suggested for me to see a psychiatrist regarding the Chronic fatigue aswell as the brain fog. She also said that there is a plan to develop “COVID Clinics”
for people like me to help treat/manage the lasting affects from the vaccine. At thispoint and time though, this is only a concept and has not been put into motion yet.
As it stands, I still have most of the symptoms that I started with just over a year
ago. I don’t have the faintness when I’m sitting down anymore but I do have
moments where I get a strong sensation of it. I still suffer from chronic fatigue anda lack of strength and stamina. I still have brain fog but its not as severe as it used
to be. I still catch myself losing focus and I sometimes still have a hard time being
locked into a thought or even a conversation. I can no longer go to the gym, nor do
I have the drive for it anymore. I can’t do anything of which would require me toexert myself because of the faintness feeling that I get. I can barely walk up an
incline without feeling weak and tired and I become out of breath quickly. As I
have said before, I used to be a sponsored athlete, training in the gym routinely andI have never failed any PT test whether it was in the Army or the Air Force. In my
current state, I feel as if I have suffered a loss, a loss of myself. My old self has
413 February 2022
COVID-19 Vaccine Injury

died, and I cannot get him back. I have complained to so many people, of whichhave told me that, “it was in my head” or “the shot is designed a certain way and it
shouldn’t be causing me to have these symptoms.” I am tired of being scoffed and I
am tired of people telling me what I should be feeling based on “the science”.
What would be the ulterior motive with making something like this up? I was
selected to become a fighter pilot, and I elected to pull myself from continuing
forward due to the severe nature of these symptoms. I knew that I would not beable to handle the physical rigors that pilots face because I can’t event walk up an
incline without being fatigued. This was my dream. That dream was taken fromme. In addition, I am going to be a father in May. I am now scared that I won’t beable to do the physical and playful things that I should be able to do at 29 years ofage with my daughter. I still feel as if I am bound by chains with these lingering
symptoms. I am still fighting for ways, though, to help my symptoms. As I
continue to share my story, there other stories that are being shared back to me, andthese stories are just like mine. What I am going through is real. What others aregoing through is real.

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USMC Aviation Safety Officer, Captain- Discovered a disturbing trend in increased medical events following the release of the COVID-19
vaccine- Clinic at this member’s base admits noticing large influx of heart related issues- These heart related issues following vaccination have not been tracked or reported in VAERS in any
wayRELEASE DATE: 21 OCT 2021 1740(Z)
CLASSIFICATION: Unclassified
FROM: MARINE AIRCRAFT GROUP-31 (MAG-31 2D MAW)

SUBJECT: Final: On-Duty, 04 OCT 2021, Ground, Sports, Recreation, andIndividual Fitness, Event Report # 786410

1. GENERAL INFORMATIONAFSAS Report Number: 786410
Unit Control Number: 165
One Liner: Morning PT; Started feeling chest pains; Chest Pains; Rushed to the hospital
Convening Authority: MARINE AIRCRAFT GROUP-31
Echelon I: United States Marine Corps Forces Command
Echelon II: II MARINE EXPEDITIONARY FORCE
Echelon III: 2D MARINE AIRCRAFT WING
Echelon IV: MARINE WING SUPPORT GROUP-27
Echelon V: MARINE WING SUPPORT DETACHMENT-31
Event Duty Status: On-Duty
Event Type:
Tier 1: Sports & Recreation
Event Method of Initiation: Medical Log/Record

2. EVENT DATE/TIME
Event Date, Local: 04 OCT 2021
Event Time, Local: 0715

3. EVENT LOCATION
Location Description: -Event Country: United States (USA)US State: South Carolina
On Base: YesNearest Base: MCAS Beaufort SC (Multi-Sites)
Latitude: 32 25.894 N
Longitude: 080 40.189 W

4. NARRATIVE
4.1. SEQUENCE OF EVENT
SNM woke up at 4 a.m. with pains in his chest. He thought it was just stomach pains regular stomach
pains from dinner that night. He went to PT becasue he thought the pain would pass. They did acircuit course at PT which consisted of pushups, ball slams, rope lunges, and weighted squats. The PT
session lasted for 30 minutes and when PT was over SNM stated he thinks he needs to go to medical
because he was having chest pains. He went to the medical facility on MCAS Beaufort. From there he
was referrred to Beaufort Memorial Hospital. SNM stayed at the hospital over night for observationand then was discharged the next day at 11:00.

4.2. INVESTIGATION CONCLUSIONS
After SNM was discharged from Beaufort Memorial Hospital he was diagnosed with having anadverse reaction to the COVID Vaccine shot he recieved on Friday.

4.3. BACKGROUND INFORMATION
4.3.1. Person Background Information
None, None
SNM was at morning PT and he began to have chest pains. He informed his NCO and then he went tomedical. From there he was instructed to go to Beaufort Memorial Hospital.
72-Hour / 7-Day History is unremarkable
4.3.2. General Background Information--

4.4. FACTORS--

5. PRIMARY FINDINGSFINDING 1: (CAUSAL)
SNM wsa diagnosed at the hospital for having an adverse reaction to the COVID dhot he had gotten
on friday.

6. PRIMARY RECOMMENDATIONSRECOMMENDATION 1 (317740):
Related Findings: 1
Hazard/Deficiency:
Recommendation 1: No recommendations can be madeAF Form 847: -AFTO Form 22: -Work Order Number: -Control Number: -Project Number: -Function: --Condition: -Unit Control Number: -OPR: null/
OCRs: -RAC: --7. OTHER FINDINGS OF SIGNIFICANCE
8. OTHER RECOMMENDATION OF SIGNIFICANCE
ORS 1 (317738):
Related Findings: -Hazard/Deficiency:
1: No recommendation can be made.
AF Form 847: -AFTO Form 22: -Work Order Number: -Control Number: -Project Number: -Function: -Condition: -Unit Control Number: -OPR: null/
OCRs: -RAC: 5

9. GLOSSARY OF ACRONYMS--

10. REFERENCED AFSAS REPORTS--

11. EVENT COST
Total Event Cost (Excluding Injury Cost): -DoDI Injury Cost: $0.00
Total Event Cost with Injuries: $0.00

12. PERSONNEL INFORMATIONPERSON NUMBER: 1
Gender: MaleAge: 22
Grade: E3
Employment Status:
Tier 1: US Marines
Tier 2: RegularDuty Status:
Tier 1: On
Tier 2: No Further Status
AFSC/Job Series: -Assigned Organization: MARINE WING SUPPORT SQUADRON 273
Activity:
Tier 1: Sports/Recreation/Fitness Activities
Tier 2: Other Sports/Recreation/Fitness Activities
Injury Severity: First Aid Case
Injuries:
Injury: 1
Injured Body Part:
Tier 1: Internal Organs
Tier 2:Heart
Injury Type: -Injury Mechanism:
Tier 1: Overexertion
Tier 2: Repetitive Movements
Person Associated with Object(s):--13. PERSON LEVEL HUMAN FACTORS--

14. EVENT LEVEL DOD HUMAN FACTORS--

15. OBJECTS INFORMATION
There are no Objects entered for this event.

16. SAFETY INVESTIGATION BOARD PERSONNELPOSITION: SINGLE INVESTIGATING OFFICER

TIER 2 REPORTS
Captured Conversations with Injured Service MembersTIER 3 REPORTS
Detailed, Anecdotal Stories of Injured Service MembersTIER 4 REPORTS
Anecdotal Stories of Injured Service Members