bella, influenza, diphtheria–tetanus) are administered routinely to all military recruits; others are administered for deployment to specific geographic or high-risk areas (e.g., typhoid, plague, cholera); and other vaccinations are specific to the occupational setting (e.g., hepatitis B vaccination for health care workers; rabies vaccination for animal control officers). During the first 2 weeks of military training, recruits may receive as many as 17 different antigens (Takafuji and Russell, 1990). Other vaccines may be given later in the training cycle or prior to deployment. The Armed Forces Epidemiologic Board, a group of civilian medical consultants, has been advising DoD since World War II on establishing and implementing DoD’s preventive medicine guidelines. These guidelines are similar to civilian guidelines developed by the CDC and the Advisory Committee on Immunization Practices (IOM, 1996).

Combining several vaccines into a single injection or administering multiple vaccinations at the same clinical visit decreases the number of injections re-