Information

R-25 SS-102R-25 SS-102 - History


R-25 SS-102

R-25

(Submarine No. 102: dp. 495 (surf.), 576 (subm.); 1. 175'b. 16'8"; dr. 13'11" (mean), s. 14 k. (surf.), 11 k. (subm.)cpl. 29; a. 1 3", 4 21" tt.; cl. R-21)

R-25(Submarine No. 102) was laid down 26 April 1917 by the Lake Torpedo Boat Co., Bridgeport, Conn.; launched 15 May 1919; sponsored by Mrs. Richard H. M. Robinson; and commissioned 23 October 1919, Lt. Comdr. Charles A. Loekwood, Jr., in command.

At the end of November, R-25 got underway for her homeport, Coco Solo, C.Z. Arriving 11 January 1920, she was designated SS-102 in July and, except for overhaul periods at Balboa and on the east coast, operated in the waters off the Canal Zone until the fall of 1923. In November of that year she arrived at Philadelphia; underwent inactivation overhaul and on 21 June 1924 was decommissioned and laid UD at League Island. She was struck from the Navy list 9 May 1930 and sold for scrap the following July.


R-25 SS-102R-25 SS-102 - History

Top submarine leader in the war against Japan, Vice Admiral Charles Andrews Lockwood, Jr., will forever be known in submarine history as the legendary Commander Submarine Force Pacific Fleet (COMSUBPAC) who led the silent service to victory during World War II in the Pacific.

Born in Midland, Virginia, on 6 May 1890, Charles Andrews Lockwood, Jr., graduated from the U.S. Naval Academy in 1912. He first served in the Atlantic aboard the battleships MISSISSIPPI (BB-23) and ARKANSAS (BB-33) (1912-1913). Following these brief cruises in battleships, and a short tour as instructor in the Naval Training Station, Great Lakes, in September 1914, he reported to the tender MOHICAN (SP-117) for indoctrination in submarines. In December 1914, Lockwood, at Cavite, Philippines, was assigned command of the submarine A-2 (SS-3) (1914-1917) as well as the B-1 (SS-10) (1916-1917).

America's entry into World War I found him in command of First Submarine Division, Asiatic Fleet, flagship the monitor MONADNOCK, which he also commanded from September 1917 until detached the following April.

After commanding the G-1 (SS-19) at New London, Connecticut, and the N-5 (SS-57) at New York (1918-1919) and took command of the captured German minelaying submarine UC-97 from March 1919 to August 1919. The ex-German submarine UC-97 was used to evaluate the capabilities of German submarine equipment. Lieutenant Commander Lockwood outfitted, commissioned, and commanded two new submarines: the R-25 (SS-102) in the Atlantic and Caribbean (1919-1920) and the S-14 (SS-119), before serving on the Yangtze Patrol aboard the gunboat QUIROS (PG-40) (1922-1923) and ISABEL (PY-10), on the latter as flag lieutenant to Patrol commander Admiral William W. Phelps (1923), for the ensuing year on that station successively as commanding officer of the ELCANO (PG-38), executive officer of the destroyer PERRY (DD-226), and commander of the SMITH THOMPSON (DD-212) before assuming command of Submarine Division 13, on the Eastern Pacific (1925-1928). Here he took command of the submarine V-3 (SS-163) from May 1926 to December 1928. He was then assigned as an advisor to the Brazilian Navy on submarines (1929-1931). In 1931 he served as first lieutenant aboard the battleship CALIFORNIA (BB-44) in the Pacific (1931-1932) and as navigator and executive officer of the cruiser CONCORD (CL-10) (1932-1933).

In 1935, following an assignment to the Naval Academy as a teacher of seamanship (1933-1935), Lockwood returned to submarines, assuming command of Submarine Division 13, flagship CUTTLEFISH (SS-171), on the West coast (1935-1937). In 1937 he was assigned to the Office of the Chief of Naval Operations (1937-1939) where he worked on submarine matters before being assigned as chief of staff to U.S. Fleet Submarine Commander Admiral Wilhelm L. Friedell, flagship RICHMOND (CL-9), in the Pacific (1939-1941).

During World War II, Rear Admiral Lockwood served in the thick of action, as U.S. Naval Attache to Great Britain from February 1941 to March 1942 and in May 1942, the month after he became Commander Submarines, Southwest Pacific, from April 1942 until February 1943, he was promoted to the rank of rear admiral. Following the death of Rear Admiral Robert H. English in December 1942, Lockwood shifted his flag to Pearl Harbor, replacing temporary ComSubPac Captain John H. Brown in February 1943.

The following is quoted directly from the Navy Office of Information concerning Lockwood's Distinguished Service Medal:

"For exceptionally meritorious service as Commander Submarine Forces, Pacific Fleet, from February 1943 to September 1945. A forceful leader, professionally skilled in the performance of a vital assignment, vice Admiral Lockwood was responsible for the strategic planning and tactical execution of submarine operations which culminated in the sinking by the forces under his command of over one thousand hostile ships, including one battleship, seven aircraft carriers and five cruisers, and in the damaging of more than five hundred additional ships. Rendering distinguished service in support of vital amphibious operations in the forward areas of the Pacific, Vice Admiral Lockwood also contributed to the development and effective employment of new weapons of extreme advantage to the Allied cause."

During his tour as Commander Submarine Force Pacific, Rear Admiral Lockwood improvised tactics to make the most effective use of submarines and pushed the Navy's Bureaus of Ships and Ordnance to provide his men with the most effective submarines and torpedoes possible. He oversaw the tests that proved early U.S. torpedo unreliability and prompted the improvements that made them the highly effective weapons they became in 1944 and 1945. U.S. submarines sank more than 5.6 million tons of enemy shipping including more than 1,100 merchant ships and over 200 warships. U.S. submarine attacks on enemy shipping accounted for more than fifty percent of enemy ships lost during the war. Of the 15,400 U.S. submariners in the war, 375 officers and 3,131 enlisted men on fifty-two submarines were lost.

Lockwood was awarded a Gold Star in lieu of Second Distinguished Service Medal:

". as Commander Submarine Force, Pacific Fleet, from January to September 1945. (He) readily foresaw the possibilities and advantages of invading and ravaging the Sea of Japan during the closing months of the war and, through his sound judgment and professional skill in laying the groundwork and developing the plans for this extensive operation, was in large measure responsible for the successful penetration of his submarines through the minefields of Tsushima Straits and into Japanese home waters where over 50 ships and many smaller vessels were sunk along the last lifeline to the Asiatic Mainland. he brought his gallant command to the peak of combat efficiency in support of the Allied offensives against Iwo Jima and Okinawa. (and) contributed materially to the success of our sustained drive to force the capitulation of the Japanese Empire. "

On September 1, 1945, Rear Admiral Lockwood was present with Fleet Admiral Chester W. Nimitz, USN, on board the USS MISSOURI in Tokyo Bay for the formal signing of the Japanese surrender. Lockwood's strong leadership and devotion to his troops won him the nickname "Uncle Charlie."

In October 1943, Lockwood was promoted to Vice Admiral, moving Pacific Fleet headquarters to Guam early in 1945 until he was relieved on December 18, 1945 and ordered to duty as Naval Inspector General, Office of the Chief of Naval Operations, Navy Department, Washington, D. C. On June 30, 1947, he was relieved of all active duty pending retirement, and was transferred to the Retired List, effective September 1, 1947.

Upon his retirement, he returned home to Los Gatos, California, were he wrote his wartime memoirs "Sink ‘Em All" (1951) and autobiography "Down to the Sea in Subs" (1967), as well as co-authoring a number of submarine and war histories including "Hell Cats of the Sea" (1955) and "Hell at 50 Fathoms" (1962), the movie "Hell Cats of the Navy", staring Ronald Reagan and Nancy Davis, was based on his 1955 book.

As for the men who served under his command Lockwood wrote in his book, Sink ‘Em All:

"They were no supermen, nor were they endowed with any supernatural qualities of heroism. They were merely top-notch American lads, well trained, well treated, well armed and provided with superb ships. May God grant there will be no World War III but, if there is, whether it be fought with the weapons we know or with weapons at whose type we can only guess, submarines and submariners will be in the thick of the combat, fighting with skill, determination and matchless daring for all of us and for our United States of America."

Vice Admiral Charles A. Lockwood died on June 6, 1967. He is buried at the Golden Gate National Cemetery, San Bruno, California.

A Curious Compact Among Four Friends
By Colonel Norman S. Marshall California Center for Military History


Four close friends, each being colleagues and co-workers before, during and after World War II, and each being a fellow Californian, rest together in the nearby Golden Gate National Cemetery at San Bruno, California.

The Golden Gate National Cemetery at San Bruno is located about two miles west of the San Francisco International Airport, and according to Admiral Richard Kelly Turner's biographer (1), Fleet Admiral Chester W. Nimitz arranged for this final resting place well before his death in 1966.

This is how Fleet Admiral Nimitz related how it came about that Kelly Turner is buried in the Golden Gate National Cemetery:

As you well know, BUPERS buries people. When I was CHBUNAV, Helen Hess, who handled all the Bureau's arrangement of funerals, said to me:

Why don't people plan ahead in connection with their burial?"

When I came to retire in the 12th Naval District, I remembered her remark and looked around. I found the Presidio Burial Grounds filled. I went out to the golden Gate Cemetery at San Bruno, and the caretaker there said, ‘I have just the place for you, a high spot in the center of the cemetery.' I wrote to Admirals Spruance and Turner and asked them if they were interested in being buried at the apex of the war dead in the Golden Gate Cemetery. When Harriet Turner became very ill, Kelly wrote to me and said, ‘Is the offer still good?' I said it was and she was buried there and Kelly soon followed.

On 13 September 1952, Fleet Admiral Chester Nimitz wrote to the Chief of Naval Personnel:

While I fully understand and appreciate the decision of the Quartermaster General to make no grave site reservations in the Golden Gate National Cemetery for other officers, I earnestly request that Admiral Raymond A. Spruance, USN (Retired), and Admiral R. K. Turner, USN (Retired) upon their deaths be given grave sites adjoining those which have been reserved for Mrs. Nimitz and me. This request is made because I firmly believe that our success in the Pacific during World War II was due in a very large measure to the splendid service rendered the Nation by these two officers, and it is fitting that they enjoy the same privilege granted to me in choosing their final resting place close to the Service personnel who died in the Pacific."

Fleet Admiral Chester W. Nimitz (U.S. Naval Academy, 1905) had long worked with Admiral Raymond Spruance (U.S. Naval Academy, 1906) and made him the air boss at Midway. He was the pre-eminent carrier strategist of the Pacific. Turner (U.S. Naval Academy, 1906) won Nimitz' admiration for leading amphibious groups throughout the Pacific during the war and Charles Lockwood (U.S. Naval Academy, 1908) was a submariner, like Nimitz, and became Commander Submarine Force, Pacific (COMSUBPAC) in February 1943 which force crushed the Japanese Merchant Fleet.

Nimitz had enormous respect and appreciation for each of these men and wanted them all to be together. They had been friends and shipmates for forty years. Their wives had been supportive and friends also.

Thus, their grave sites perfectly aligned in the first row along the street bearing Nimitz's name –Nimitz Drive. This is a unique tribute to each of these Californians.


Laststandonzombieisland

Here at LSOZI, we are going to take off every Wednesday for a look at the old steam/diesel navies of the 1859-1946 period and will profile a different ship each week. These ships have a life, a tale all their own, which sometimes takes them to the strangest places.- Christopher Eger

Warship Wednesday, Aug 2, 2017: Uncle’s submersible aircraft carrier

Official U.S. Navy Photograph, from the collections of the Naval History and Heritage Command. Catalog #: NH 99774

Here we see the S-class “pigboat” the early direct-drive diesel-electric submarine USS S-1 (SS-105) with her after deck awash, preparing to take a tiny Martin MS-1 seaplane on board during tests in October 1923. Note the tube-shaped sealed hangar behind the tower. The image was probably taken at Hampton Roads, Virginia.

As you can tell, S-1 was the U.S. entry into the oddball inter-war submarine aircraft carrier race.

The Germans first used the concept of a submarine that could support aircraft when SM U-12 helped support a pair of Friedrichshafen FF.29 reconnaissance seaplanes at Zeebrugge in 1915. Though the FF.29s were not housed on the primitive 188-foot U-boat, they did experiment with carrying on the deck of the surfaced submarine in a takeoff position, then launching an aircraft by partially submerging, allowing the seaplane to float off and fly away to strike its target– thus extending their range.

SM U-12 with a seaplane aboard in trials 1915. Note the lollygag under the deck gun.

In the only German sub-air attack of the war, an FF.29 took off on 6 January 1916, motored around the Kent coast, and returned to Zeebrugge without accomplishing much.

The Brits later experimented with E-class submarines in the Great War and by the 1920s, the RN was joined by Italy (Ettore Fieramosca), France (the Surcouf as detailed in an earlier Warship Wednesday), and later Germany (the Type IX D 2-“Monsun”) and Japan (the I-15 Series and later the huge I-400 series, another WW past favorite) in crafting undersea aircraft carriers.

The S-class submarines, derided as “pig boats” or “sugar boats” were designed in World War I, but none were finished in time for the conflict.

Some 51 examples of these 1,200-ton diesel-electrics were built in several sub-variants by 1925 and they made up the backbone of the U.S. submarine fleet before the larger “fleet” type boats of the 1930s came online. At 219-feet oal, these boats could dive to 200 feet and travel at a blistering 14kts on the surface on their twin NELSECO 8-cylinder 4-stroke direct-drive diesel engines. Armament was a quartet of 21-inch bow tubes with a dozen fish and a retractable 3″/23cal popgun on deck for those special moments. Crew? Just 38 officers and men.

The hero of our tale, SS-1, has an inauspicious name and was a “Holland” type boat laid down at Fore River Shipyard, Quincy, Massachusetts on a subcontract by the Electric Boat Co. Launched on 26 October 1918, she was sponsored by none other than Mrs. Emory S. Land, just two weeks before the Great War ended.

The USS S-1 slides down the ways at the Fore River Ship Builders on October 26, 1918. Via Pigboats.com

USS S-1 (Submarine # 105) Off Provincetown, Massachusetts, on 17 April 1920, while running trials. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 41988

She was commissioned on 5 June 1920 and was attached to Submarine Division (SubDiv) 2 out of sometimes-chilly New London.

(SS-105) Covered with ice while underway in Long Island Sound, January 1922. Note the retractable 3/23 deck gun at right. Courtesy of the Naval Historical Foundation. Collection of Lieutenant O.E. Wightman. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 80576

On 2 January 1923, she shifted to SubDiv Zero, for “experimental work” involving a dozen all metal Cox-Klemin XS-1 (BuNo A6508-A6520) and six wood-and-fabric Martin MS-1 (BuNo A6521-A6526) seaplanes.

These small (1,000lb, 18 feet long, 18 foot wingspan) experimental biplanes were envisioned to fly off S-class submarines for over-the-horizon scouting and observation missions.

Martin MS-1 scouting seaplane (Bureau # A-6525) being assembled on the after deck of USS S-1 (SS-105), at Hampton Roads, Virginia, 24 October 1923. Note the entrance to the submarine’s small hangar, at left, booms used to erect the plane’s structure, and the seaplane’s metal floats and three-cylinder engine. Donation of Lieutenant Gustave Freret, USN (Retired), 1970. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 71028

(SS-105) Hangar installed at the after end of the submarine’s fairwater, circa October 1923. This hangar was used during tests with the very small Martin MS-1 scouting floatplane. Donation of Lieutenant Gustave Freret, USN (Retired), 1972. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 76124

The seaplanes were to be knocked down, sealed in a hangar attached to the deck behind the conning tower, then after surfacing in a calm area, the little doodlebug could be rolled out and assembled. Like SM-12, they would be launched by ballasting the sub until the deck was awash and allowed to float off and take air.

(SS-105) With a Martin MS-1 seaplane on her deck, circa the mid-1920s. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 41986

(SS-105) Underway, while fitted with an aircraft hangar aft of her fairwater, circa the mid-1920s. Note the 4″/50 that has replaced her original gun. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 41987

Curtiss HS-2L seaplane operating with and S-1 type submarine, 1924. These big flying boats were bought in quantity in WWI and were the backbone of the USN and Coast Guard until the late 1920s, but it was thought that submarines could refuel them– another experiment by SS-1. Catalog #: NH 60769

(SS-105) Martin MS-1 scouting seaplane (Bureau # A-6525) on her after deck, during the mid-1920s. Among the submarines docked in the background is USS K-7 (SS-38), at left. USS L-8 (SS-48) is at right, with USS L-9 (SS-49) just to her left. Original photo caption gives location as New London, Connecticut. However, the view may have been taken at Norfolk or Hampton Roads, Virginia. Donation of Lieutenant Gustave Freret, USN (Retired), 1970. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 70979

(SS-105) With a Martin MS-1 scouting floatplane (Bureau # A-6525) on her after deck, probably at Norfolk, Virginia, on 24 October 1923. Donation of Lieutenant Gustave Freret, USN (Retired), 1970. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 72793

Control Force submarines and their tenders at Christobal, Panama Canal Zone, circa 1923. Description: The tenders are (from left to right): Savannah (AS-8), Bushnell (AS-2), Beaver (AS-5) and Camden (AS-6). Submarines are mostly R type boats, among them R-23 (SS-100) and R-25 (SS-102), both in the nest alongside Savannah’s port quarter. The larger submarine alongside Savannah’s bow may be S-1 (SS-105), with her large seaplane hangar. Photographed by A.E. Wells. Courtesy of Commander Christopher Noble, USN (Retired), 1967. U.S. Naval History and Heritage Command Photograph. Catalog #: NH 42573

Over the next three years, SS-1 was busy with the project until finally, the “first full cycle of surfacing, assembly, launching, retrieving, disassembly, and submergence took place on 28 July 1926 on the Thames River in New London.”

Deemed unproductive for the outlay in slim peacetime funds, the aircraft experiments were canceled and the tiny seaplanes scrapped.

By July 1927, SS-1, with her hangar removed, was back in regular squadron work. First transferred to SubDiv 4, then SubDiv2, she made regular training cruises in the Caribbean, East Coast, and Canal Zone until 1931 when she was transferred to the Pacific Fleet, operating from Pearl Harbor.

At the same time, many of her classmates were retired and scrapped, replaced by newer and much larger fleet boats. Accordingly, SS-1 was given orders to proceed to Philadelphia where she was decommissioned on 20 October 1937 and mothballed.

With tensions rising at the start of WWII in Europe, the old SS-1 was taken out of storage and brought back to life, though she was in poor shape. Carrying new and would-be bubbleheads, she made two cruises to Bermuda, training submariners, and returned to Philadelphia from the second cruise on the same day the Japanese attacked Pearl Harbor. Ironically, as noted by Capt. Julius Grigore in his work on Surcouf, the two submarine carriers may have crossed paths at this time.

Though several S-boats served the Navy well in both the Atlantic and Pacific, six were transferred to the Royal Navy as Lend-Lease. USS S-1 was in this lot and swapped to the Brits at New London on 20 April 1942, to be struck from the Navy List on 24 June 1942.

In her new career, with Lt. Anthony Robert Danielle, DSC, RN, in command, she was known as HMS P-552.

Just out of New London on 1 May she encountered three survivors from the Norwegian steam ship Taborfjell (1,339GT), which had been claimed by the German submarine U-576 under Hans-Dieter Heineken. Saving Radio Operator Olaf Alfsen, Second Officer Erling Arnesen, and Third Engineer Officer Ole Karlsen Svartangen after a two-hour search about 95 nautical miles east of Cape Cod, P-552 diverted to St. Johns and landed the men ashore 7 May.

The sub arrived in Durban South Africa, via Gibraltar and Freetown, in December 1942 where she was used for training for several months.

She was paid off by the RN 11 August 1944 and given back to the USN while still in Durban two months later. She never left the harbor again and was scrapped in September 1946.

The Navy revisited the possibility of submarine aircraft carriers again during World War II and the early 1950s but nothing came of it. They did experiment with refueling large seaplanes via submarine as well as using them in helicopter landings for special operations into the 1950s, using the abbreviations AOSS — submarine oiler, and SSP–submarine transport.

USS Guavina (AGSS-362), refueling a P5M-1 Marlin flying boat off Norfolk, Virginia (USA), in 1955. Prior to World War II several submarines were fitted to refuel seaplanes. During the war, Germany and Japan used this technique with some success. After the war this technique was experimented with within the US Navy. It was planned to use submarines to refuel the new jet powered P6M Seamaster flying boats. As part of this program Guavina was converted to carry 160,000 gallons of aviation fuel. To do this blisters were added to her sides and two stern torpedo tubes were removed. When the P6M project was canceled, there was no further need for submarine tankers. This concept was never used operationally in the US Navy.

USS Corporal’s emergency helicopter op

And today, there are several programs to put UAVs on subs, for scouting and observation missions–proving that everything old is new again.

Still, SS-1 was the only U.S. Navy submarine to have the capability to submerge with a manned aircraft aboard and then successfully launch it. For that, she will be immortal.


Displacement: Surfaced: 854 t., Submerged: 1062 t.
Length 219′ 3″
Beam 20′ 8″
Draft 15′ 11″(mean)
Speed: surfaced 14.5 kts, submerged 11 kts
Complement 4 Officers, 34 Enlisted
Propulsion: New London Ship & Engine Co (NELSECO) diesel engines, HP 1200, twin propellers
Fuel capacity: 41,921 gal.
Electric: Electro Dynamic Co., electric motors, HP 1500, Battery cells 120, Endurance: 20 hours @ 5 kn submerged
Armament: 4 21″ torpedo tubes, 12 torpedoes, one 3″/23 retractable deck gun–later fixed 4″/50
Aircraft: 1 tiny seaplane

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CJA Scheme re admissibility

 Is it evidence of bad character? (s. 98) If not admit if relevant.  Is it evidence of bad character but to do with the alleged offence (s 98(a)) or investigation (98(b)? if so – admit it on the test of relevance  Is a relevant gateway open? (s.101)

s.101: The Seven Gateways

s. 101(1)(a) : Parties agreed?

s. 101(1)(b) : Intentionally given / elicited by D?

s. 101(1)(c) : Important explanatory evidence?

s.101(1)(d): Important matter in issue between defendant and prosecution?

s. 101(1)(e) : Substantial probative value in relation to an important matter in issue between D1 and D2? (NB: only applies between co-defendants, cannot be used by prosecution).

s. 101(1)(f) : Correcting a false impression given by the defendant?

(s. 101(1)(g)) D has made attack on another person's character?

 Is the requirement to exclude relevant? (s. 101(3)) (only to gateways (d) and (g)).  Check details of relevant supplementary provision. (ss. 102 – 106)

ii) Brian has two previous convictions for actual bodily harm and one for grievous bodily harm, all committed during the last ten years. The prosecution wishes to know whether it may adduce evidence of these previous convictions.

iii) Cheryl has a previous conviction for possession of an unlawful weapon in 2009. In examination in chief Cheryl denies any involvement in the attack and testifies as to her involvement with a pacifist group called “AGAINST” (Against Guns and Iniquitous Nasty Sharp Things). What would be the likely evidential implications arising from Cheryl’s testimony?

iv) David has a previous conviction for indent assault upon a child in 2003. He does not give evidence, but in a police interview, which is admitted as part of the prosecution’s case at trial, he admitted involvement in the attack upon Flora but claimed that he had been acting in self-defence as Flora had tried to attack him with a machete. What would be the likely evidential implications arising from the admission into evidence of this interview with the police?

Comment critically (where appropriate) upon the law you have applied in formulating your advice.

READING:

Doak, McGourley & Thomas, chapter 11.. Please refer to the lecture handout for indicative alternative reading from textbooks

( NB there is no need to read the sections on good character or bad character in civil cases for this tutorial)


R-25 SS-102R-25 SS-102 - History

Numbering: Most submarines are numbered in a single series, designated "SS", with variations including SSN, SSBN, AGSS, etc. Some specialized types were numbered in separate SSK (hunter-killer), SST (training), SC (cruiser), SF (fleet) and SM (minelaying) series. Some of these specialist types were later renumbered in the standard SS series.

Note: This series has not been completed. The remaining ships will be added in due time.

DANFS Online: Submarines
SSK 1 BARRACUDA
SSK 2 BASS
SSK 3 BONITA
SST 1 MACKEREL
SST 2 T-2/MARLIN
SF 4 V-1
SF 5 V-2
SF 6 V-3
SF 7/SM 1 V-4
SM 1 ARGONAUT
SS 1 HOLLAND
SS 2 PLUNGER/A-1
SS 3 ADDER/A-2
SS 4 GRAMPUS/A-3
SS 5 MOCCASIN/A-4
SS 6 PIKE/A-5
SS 7 PORPOISE/A-6
SS 8 SHARK/A-7
SS 9 OCTOPUS/C-1
SS 10 VIPER/B-1
SS 11 CUTTLEFISH/B-2
SS 12 TARANTULA/B-3
SS 13 STINGRAY/C-2
SS 14 TARPON/C-3
SS 15 BONITA/C-4
SS 16 SNAPPER/C-5
SS 17 NARWHAL
SS 18 GRAYLING
SS 19 SALMON
SS 19 1/2 G-1
SS 20 F-1
SS 21 F-2
SS 22 F-3
SS 23 F-4
SS 24 E-1
SS 25 E-2
SS 26 G-4
SS 27 G-2
SS 28 H-1
SS 29 H-2
SS 30 H-3
SS 31 G-3
SS 32 K-1
SS 33 K-2
SS 34 K-3
SS 35 K-4
SS 36 K-5
SS 37 K-6
SS 38 K-7
SS 39 K-8
SS 40 L-1
SS 41 L-2
SS 42 L-3
SS 43 L-4
SS 44 L-5
SS 45 L-6
SS 46 L-7
SS 47 M-1
SS 48 L-8
SS 49 L-9
SS 50 L-10
SS 51 L-11
SS 52 AA-1
SS 53 N-1
SS 54 N-2
SS 55 N-3
SS 56 N-4
SS 57 N-5
SS 58 N-6
SS 59 N-7
SS 60 AA-2
SS 61 AA-3
SS 62 O-1
SS 63 O-2
SS 64 O-3
SS 65 O-4
SS 66 O-5
SS 67 O-6
SS 68 O-7
SS 69 O-8
SS 70 O-9
SS 71 O-10
SS 72 O-11
SS 73 O-12
SS 74 O-13
SS 75 O-14
SS 76 O-15
SS 77 O-16
SS 78 R-1
SS 79 R-2
SS 80 R-3
SS 81 R-4
SS 82 R-5
SS 83 R-6
SS 84 R-7
SS 85 R-8
SS 86 R-9
SS 87 R-10
SS 88 R-11
SS 89 R-12
SS 90 R-13
SS 91 R-14
SS 92 R-15
SS 93 R-16
SS 94 R-17
SS 95 R-18
SS 96 R-19
SS 97 R-20
SS 98 R-21
SS 99 R-22
SS 100 R-23
SS 101 R-24
SS 102 R-25
SS 103 R-26
SS 104 R-27
SS 105 S-1
SS 106 S-2
SS 107 S-3
SS 109 S-4
SS 110 S-5
SS 111 S-6
SS 112 S-7
SS 113 S-8
SS 114 S-9
SS 115 S-10
SS 116 S-11
SS 117 S-12
SS 118 S-13
SS 119 S-14
SS 120 S-15
SS 121 S-16
SS 122 S-17
SS 123 S-18
SS 124 S-19
SS 125 S-20
SS 126 S-21
SS 127 S-22
SS 128 S-23
SS 129 S-24
SS 130 S-25
SS 131 S-26
SS 132 S-27
SS 133 S-28
SS 134 S-29
SS 135 S-30
SS 136 S-31
SS 137 S-32
SS 138 S-33
SS 139 S-34
SS 140 S-35
SS 141 S-36
SS 142 S-37
SS 143 S-38
SS 144 S-39
SS 145 S-40
SS 146 S-41
SS 147 H-4
SS 148 H-5
SS 149 H-6
SS 150 H-7
SS 151 H-8
SS 152 H-9
SS 153 S-42
SS 154 S-43
SS 155 S-44
SS 156 S-45
SS 157 S-46
SS 158 S-47
SS 159 S-48
SS 160 S-49
SS 161 S-50
SS 162 S-51
SS 163 BARRACUDA
SS 164 BASS
SS 165 BONITA
SS 167 NARWHAL
SS 168 NAUTILUS
SS 169 DOLPHIN
SS 170 CACHALOT
SS 171 CUTTLEFISH
SS 172 PORPOISE
SS 173 PIKE
SS 174 SHARK
SS 175 TARPON
SS 176 PERCH
SS 177 PICKEREL
SS 178 PERMIT
SS 179 PLUNGER
SS 180 POLLACK
SS 181 POMPANO
SS 182 SALMON
SS 183 SEAL
SS 184 SKIPJACK
SS 185 SNAPPER
SS 186 STINGRAY
SS 187 STURGEON
SS 188 SARGO
SS 189 SAURY
SS 190 SPEARFISH
SS 191 SCULPIN
SS 192 SQUALUS/SAILFISH
SS 193 SWORDFISH
SS 194 SEADRAGON
SS 195 SEALION
SS 196 SEARAVEN
SS 197 SEAWOLF
SS 198 TAMBOR
SS 199 TAUTOG
SS 200 THRESHER
SS 201 TRITON
SS 202 TROUT
SS 203 TUNA
SS 204 MACKEREL
SS 205 MARLIN
SS 206 GAR
SS 207 GRAMPUS
SS 208 GRAYBACK
SS 209 GRAYLING
SS 210 GRENADIER
SS 211 GUDGEON
SS 212 GATO
SS 213 GREENLING
SS 214 GROUPER
SS 215 GROWLER
SS 216 GRUNION
SS 217 GUARDFISH
SS 218 ALBACORE
SS 219 AMBERJACK
SS 220 BARB
SS 221 BLACKFISH
SS 222 BLUEFISH
SS 223 BONEFISH
SS 224 COD
SS 225 CERO
SS 226 CORVINA
SS 227 DARTER
SS 228 DRUM
SS 229 FLYING FISH
SS 230 FINBACK
SS 231 HADDOCK
SS 232 HALIBUT
SS 233 HERRING
SS 234 KINGFISH
SS 235 SHAD
SS 236 SILVERSIDES
SS 237 TRIGGER
SS 238 WAHOO
SS 239 WHALE
SS 240 ANGLER
SS 241 BASHAW
SS 242 BLUEGILL
SS 243 BREAM
SS 244 CAVALLA
SS 245 COBIA
SS 246 CROAKER
SS 247 DACE
SS 248 DORADO
SS 249 FLASHER
SS 250 FLIER
SS 251 FLOUNDER
SS 252 GABILAN
SS 253 GUNNEL
SS 254 GURNARD
SS 255 HADDO
SS 256 HAKE
SS 257 HARDER
SS 258 HOE
SS 259 JACK
SS 260 LAPON
SS 261 MINGO
SS 262 MUSKALLUNGE
SS 263 PADDLE
SS 264 PARGO
SS 265 PETO
SS 266 POGY
SS 267 POMPON
SS 268 PUFFER
SS 269 RASHER
SS 270 RATON
SS 271 RAY
SS 272 REDFIN
SS 273 ROBALO
SS 274 ROCK
SS 275 RUNNER
SS 276 SAWFISH
SS 277 SCAMP
SS 278 SCORPION
SS 279 SNOOK
SS 280 STEELHEAD
SS 281 SUNFISH
SS 282 TUNNY
SS 283 TINOSA
SS 284 TULLIBEE
SS 285 BALAO
SS 286 BILLFISH
SS 287 BOWFIN
SS 288 CABRILLA
SS 289 CAPELIN
SS 290 CISCO
SS 291 CREVALLE
SS 292 DEVILFISH
SS 293 DRAGONET
SS 294 ESCOLAR
SS 295 HACKLEBACK
SS 296 LANCETFISH
SS 297 LING
SS 298 LIONFISH
SS 299 MANTA
SS 300 MORAY
SS 301 RONCADOR
SS 302 SABALO
SS 303 SABLEFISH
SS 304 SEAHORSE
SS 305 SKATE
SS 306 TANG
SS 307 TILEFISH
SS 308 APOGON
SS 309 ASPRO
SS 310 BATFISH
SS 311 ARCHERFISH
SS 312 BURRFISH
SS 313 PERCH
SS 314 SHARK
SS 315 SEA LION
SS 316 BARBEL
SS 317 BARBERO
SS 318 BAYA
SS 319 BECUNA
SS 320 BERGALL
SS 321 BESUGO
SS 322 BLACKFIN
SS 323 CAIMAN
SS 324 BLENNY
SS 325 BLOWER
SS 326 BLUEBACK
SS 327 BOARFISH
SS 328 CHARR
SS 329 CHUB
SS 330 BRILL
SS 331 BUGARA
SS 332 BULLHEAD
SS 333 BUMPER
SS 334 CABEZON
SS 335 DENTUDA
SS 336 CAPITAINE
SS 337 CARBONERO
SS 338 CARP
SS 339 CATFISH
SS 340 ENTEMEDOR
SS 341 CHIVO
SS 342 CHOPPER
SS 343 CLAMAGORE
SS 344 COBBLER
SS 345 COCHINO
SS 346 CORPORAL
SS 347 CUBERA
SS 348 CUSK
SS 349 DIODON
SS 350 DOGFISH
SS 351 GREENFISH
SS 352 HALFBACK
SS 353 DUGONG
SS 354 EEL
SS 355 ESPADA
SS 356 JAWFISH
SS 358 GARLOPA
SS 359 GARRUPA
SS 360 GOLDRING
SS 361 GOLET
SS 362 GUAVINA
SS 363 GUITARRO
SS 364 HAMMERHEAD
SS 365 HARDHEAD
SS 366 HAWKBILL
SS 367 ICEFISH
SS 368 JALLAO
SS 369 KETE
SS 370 KRAKEN
SS 371 LARGARTO
SS 372 LAMPREY
SS 373 LIZARDFISH
SS 374 LOGGERHEAD
SS 375 MACABI
SS 376 MAPIRO
SS 377 MENHADEN
SS 378 MERO
SS 381 SAND LANCE
SS 382 PICUDA
SS 383 PAMPANITO
SS 384 PARCHE
SS 385 BANG
SS 386 PILOTFISH
SS 387 PINTADO
SS 388 PIPEFISH
SS 389 PIRANHA
SS 391 POMFRET
SS 392 STERLET
SS 393 QUEENFISH
SS 394 RAZORBACK
SS 395 REDFISH
SS 396 RONQUIL
SS 397 SCABBARDFISH
SS 398 SEGUNDO
SS 399 SEA CAT
SS 400 SEA DEVIL
SS 401 SEA DOG
SS 402 SEA FOX
SS 403 ATULE
SS 404 SPIKEFISH
SS 405 SEA OWL
SS 406 SEA POACHER
SS 407 SEA ROBIN
SS 408 SENNET
SS 409 PIPER
SS 410 THREADFIN
SS 411 SPADEFISH
SS 412 TREPANG
SS 413 SPOT
SS 414 SPRINGER
SS 415 STICKLEBACK
SS 416 TIRU
SS 417 TENCH
SS 418 THORNBACK
SS 419 TIGRONE
SS 420 TIRANTE
SS 422 TORO
SS 423 TORSK
SS 424 QUILLBACK
SS 425 TRUMPETFISH
SS 426 TUSK
SS 427 TURBOT
SS 428 ULNA
SS 429 UNICORN
SS 432 WHITEFISH
SS 435 CORSAIR
SS 436 UNICORN
SS 475 ARGONAUT
SS 476 RUNNER
SS 477 CONGER
SS 478 CUTLASS
SS 479 DIABLO
SS 480 MEDREGAL
SS 481 REQUIN
SS 482 IREX
SS 483 SEA LEOPARD
SS 484 ODAX
SS 485 SIRAGO
SS 486 POMODON
SS 487 REMORA
SS 488 SARDA
SS 489 SPINAX
SS 490 VOLADOR
SS 522 AMBERJACK
SS 523 GRAMPUS
SS 524 PICKEREL
SS 525 GRENADIER
SS 526 DORADO
SS 563 TANG
SS 564 TRIGGER
SS 565 WAHOO
SS 566 TROUT
SS 567 GUDGEON
SS 568 HARDER
AGSS 569 ALBACORE
SSN 571 NAUTILUS
SSR 572 SAILFISH
SSR 573 SALMON
SSG 574 GRAYBACK
SSN 575 SEAWOLF
SS 576 DARTER
SSG 577 GROWLER
SSN 578 SKATE
SSN 579 SWORDFISH
SS 581 BLUEBACK
SS 582 BONEFISH
SSN 583 SARGO
SSN 584 SEADRAGON
SSN 585 SKIPJACK
SSRN 586 TRITON
SSGN 587 HALIBUT
SSN 588 SCAMP
SSN 589 SCORPION
SSN 590 SCULPIN
SSN 591 SHARK
SSN 592 SNOOK
SSN 593 THRESHER
SSN 594 PERMIT
SSN 595 PLUNGER
SSN 597 TULLIBEE
SSBN 598 GEORGE WASHINGTON
SSBN 599 PATRICK HENRY
SSBN 600 THEODORE ROOSEVELT
SSBN 601 ROBERT E. LEE
SSN 603 POLLACK
SSN 604 HADDO
SSN 605 JACK
SSN 606 TINOSA
SSBN 608 ETHAN ALLEN
SSBN 609 SAM HOUSTON
SSBN 610 THOMAS A. EDISON
SSBN 611 JOHN MARSHALL
SSN 612 GUARDFISH
SSN 614 GREENLING
SSN 615 GATO
SSBN 616 LAFAYETTE
SSBN 617 ALEXANDER HAMILTON
SSBN 618 THOMAS JEFFERSON
SSBN 620 JOHN ADAMS
SSN 621 HADDOCK
SSBN 622 JAMES MONROE
SSBN 623 NATHAN HALE
SSBN 624 WOODROW WILSON
SSBN 625 HENRY CLAY
SSBN 627 JAMES MADISON
SSBN 628 TECUMSEH
SSBN 630 JOHN C. CALHOUN
SSBN 631 ULYSSES S. GRANT
SSBN 632 VON STUEBEN
SSBN 634 STONEWALL JACKSON
SSBN 635 SAM RAYBURN
SSBN 636 NATHANAEL GREENE
SSN 637 STURGEON
SSN 638 WHALE
SSN 639 TAUTOG
SSBN 641 SIMON BOLIVAR
SSBN 643 GEORGE BANCROFT
SSBN 644 LEWIS AND CLARK
SSBN 645 JAMES K. POLK
SSN 646 GRAYLING
SSN 647 POGY
SSN 649 SUNFISH
SSN 650 PARGO
SSN 651 QUEENFISH
SSN 652 PUFFER
SSN 653 RAY
SSBN 654 GEORGE C. MARSHALL
SSBN 655 HENRY L. STIMSON
SSBN 656 GEORGE WASHINGTON CARVER
SSBN 658 MARIANO G. VALLEJO
SSBN 659 WILL ROGERS
SSN 660 SAND LANCE
SSN 661 LAPON
SSN 662 GURNARD
SSN 663 HAMMERHEAD
SSN 664 SEA DEVIL
SSN 666 HAWKBILL
SSN 668 SPADEFISH
SSN 669 SEAHORSE
SSN 671 NARWHAL
SSN 672 PINTADO
SSN 674 TREPANG
SSN 678 ARCHERFISH
SSN 679 SILVERSIDES
SSN 680 WILLIAM H. BATES
SSN 682 TUNNY
SSN 687 RICHARD B. RUSSELL
U-111
U-117
U-140
U-2513
U-3008
UB-148
UB-88
UC-97

These histories are taken from Dictionary of American Naval Fighting Ships (US Naval Historical Center, 1959-1991). The histories may not reflect the most recent information concerning the ships' status and operations.

This section of the HG&UW site coordinated and maintained by Andrew Toppan.
Copyright © 1996-2003, Andrew Toppan. All Rights Reserved.
Reproduction, reuse, or distribution without permission is prohibited.


Discussion

NHIS data indicate that many adults in the United States remained unprotected against vaccine-preventable diseases in 2018. Adult vaccination coverage remained similar to that in 2017 for most vaccines, with modest increases observed only for hepatitis B vaccination and HPV vaccination (males aged 19&ndash26 years and Hispanic females aged 19&ndash26 years). Having health insurance coverage, having a usual place for health care, and having &ge1 physician contact during the preceding year were associated with higher vaccination coverage. Vaccination coverage estimates for three of the four vaccines in this report that are included in Healthy People 2020 (influenza, pneumococcal, and hepatitis B [for HCP] vaccines) were below the respective target levels, even among insured adults and adults with multiple health care visits during the preceding year (10). Herpes zoster vaccination coverage in 2018 was 4.5 percentage points above the Healthy People 2020 target of 30% (10). Racial and ethnic differences in vaccination coverage persisted for all vaccinations with lower coverage generally for most vaccinations among non-White and Hispanics compared with non-Hispanic White adults. Depending on the vaccine, 20.1%&ndash87.5% reported not having received vaccinations among adults who had health insurance and &ge10 physician contacts during the preceding year, indicating multiple missed opportunities for vaccination and the need to increase routine assessment of adult vaccination needs and vaccination with recommended vaccines.

Composite Adult Vaccination Quality Measure

Coverage for the age-appropriate composite measures was low in all age groups. The composite adult vaccination quality measure presented in this report was adopted by the Indian Health Service and added to the Healthcare Effectiveness Data and Information Set (HEDIS) by the National Committee for Quality Assurance (NCQA) for first-year reporting beginning in 2018 (18). HEDIS is a set of national performance measures used to compare health plans and drive improvement in important facets of health care delivery. NCQA added the Adult Immunization Status measure to the HEDIS Health Plan Set to assess routine vaccination for select vaccines. The measure includes four rates assessing receipt of influenza, Td/Tdap, herpes zoster, and pneumococcal vaccination for adults aged &ge19 years and a composite rate to provide a summary of performance across these different vaccines. The composite rate assessed the total number of vaccines that were received across a health plan&rsquos member population per clinical guidelines (i.e., the sum of the individual vaccines administered divided by the sum of the individual vaccines required). The measure was specified for the HEDIS Electronic Clinical Data Systems reporting method. Data sources included administrative claims, electronic medical records, registries, case management systems, and health information exchanges.

The vaccination coverage estimates for the composite adult vaccination quality measure presented in this report derived from self-report of vaccination status will differ from those generated by the NCQA, which are based on vaccination records from electronic clinical data systems for members enrolled in participating health plans. In addition, CDC and NCQA use different approaches for calculating coverage estimates. The CDC analytic approach uses persons as the unit of analysis, where estimates for each age group represent the proportion of adults who reported receipt of all the vaccines routinely recommended for that age group. The composite numerator for CDC estimates includes only those persons who reported receiving all the recommended vaccines (a unit of person) the composite denominator for estimates includes all the persons with indications for vaccination on the basis of the recommended vaccines for that specific age group (a unit of person, each person counted once) (Supplementary Table, https://stacks.cdc.gov/view/cdc/105325). The NCQA analytic approach (19) uses recommended vaccines as the unit of analysis specifically, the number of vaccinations administered or contraindicated (numerator) out of the possible number of vaccinations needed by plan members according to ACIP recommendations for the age group (denominator) (i.e., the percentage of the total recommended number of vaccinations, per the guidelines for that age, that were administered as indicated [i.e., the sum of the individual vaccines administered divided by the sum of the individual vaccines required]). Also, in contrast to the CDC approach, NCQA uses actual vaccination data from the participating health plans (commercial, Medicare, and Medicaid) to generate estimates, different exclusion criteria for analyses than CDC, different measurement periods for ascertaining influenza and Td/Tdap vaccination status, and different criteria for herpes zoster vaccination (e.g., the criteria are vaccine-type specific with the recombinant zoster vaccine criterium requiring series completion to be counted). In addition, the NCQA criterion for pneumococcal vaccination of plan members aged &ge66 years at the start of the measurement period was based on the previous &ldquoseries completion&rdquo ACIP recommendations in effect during 2018 (i.e., receipt of both PCV13 and PPSV23 in series with the recommended interval based on whether the recipient was pneumococcal vaccine-naïve or had previously received PPSV23) (Supplementary Table, https://stacks.cdc.gov/view/cdc/105325) (20). For the comparison estimates in this report, recommended vaccines were adapted as the unit of analysis. The composite numerator of the adapted NCQA approach indicates whether the vaccination was administered (a unit of recommended vaccinations received). The composite denominator indicates the number of recommended vaccinations for persons based on their age (a unit of recommended vaccinations). For the adapted NCQA approach, influenza vaccination was measured as receipt during the preceding 12 months, Tdap was measured as receipt during the preceding 10 years, and herpes zoster vaccines and pneumococcal vaccine were measured as having ever received these vaccinations. For actual NCQA estimates: 1) influenza vaccination was measured as receipt on or between July 1 of the year before the measurement period and June 30 of the measurement period 2) Td/Tdap vaccination was measured as receipt of at least one Td or Tdap vaccine between 9 years before the start of the measurement period and the end of the measurement period 3) persons received at least 1 dose of the herpes zoster live vaccine or 2 doses of the herpes zoster recombinant vaccine (at least 28 days apart) anytime on or after the person&rsquos 50th birthday and 4) persons were administered both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine at least 12 months apart, with the first occurrence after the age of 60 years.

NCQA revisited the usefulness of the composite rate during a re-evaluation of the measure in 2020. Stakeholder feedback included concerns about the usability of the composite rate as constructed, particularly with combining vaccines recommended for younger versus older adults into a composite. Thus, NCQA removed the composite rate from the Adult Immunization Status measure in 2020. The four individual vaccine rates for influenza, Td/Tdap, herpes zoster, and pneumococcal vaccination will continue to be reported.

Composite performance measures, which combine multiple individual (&ldquocomponent&rdquo) quality measures, provide a useful way to examine overall health system performance in implementing standards of care as well as a reminder and an incentive for implementing these standards by providers (11). The U.S. Department of Health and Human Services has proposed a developmental Healthy People 2030 (HP2030) composite adult vaccination quality measure as a new objective to assess overall adult vaccination performance (21). This developmental measure targets increasing the proportion of adults age &ge19 years who receive recommended age-appropriate vaccines. This objective is a high-priority public health issue with evidence-based interventions however, reliable baseline data are required before it can become a core HP2030 objective. The composite adult vaccination quality measure estimates in this report indicate that, despite variable coverage with individual recommended vaccines, few adults in any age group were fully vaccinated according to ACIP recommendations. Presenting both composite and component measures allows assessment of overall performance and targeted interventions for improvement.

Influenza Vaccination

Since the 2010&ndash11 influenza season, ACIP has recommended annual influenza vaccination for all persons aged &ge6 months (22). By the 2017&ndash18 season (seven seasons after annual influenza vaccination was recommended for all adults), vaccination coverage among adults aged &ge19 years was 46.1%, with an average annual 1.1 percentage point increase from the 2009&ndash10 through the 2017&ndash18 seasons. However, by the 2017&ndash18 season, approximately 50% of adults had not received influenza vaccine, and coverage was well below the Healthy People 2020 target of 70% (10). In addition, coverage among adults aged &ge19 years with high-risk conditions remained low (61.0% in the 2017&ndash18 season). Even after its universal influenza vaccination recommendation, ACIP continued to emphasize that persons with high-risk conditions should be a focus of vaccination efforts (22). Persons with underlying health conditions might not consider themselves as high risk, limiting the effectiveness of targeted messages. Many persons with high-risk conditions see subspecialists, who are less likely to recommend influenza vaccination than general practitioners (23).

Vaccination of HCP is an important component of influenza prevention programs in the United States (24). Vaccination of HCP could reduce transmission of influenza in health care settings, staff illness and absenteeism, and influenza-related morbidity and mortality (24). Despite the availability of safe and effective influenza vaccines (25,26), influenza vaccination coverage among HCP remains suboptimal (4,15,27&ndash30). By the 2017&ndash18 season, vaccination coverage among HCP overall (71.8%) and among HCP with and without direct patient care (72.6% and 70.5%, respectively) remained far below the Healthy People 2020 target for HCP of 90% (10).

Previous studies of influenza illnesses and hospitalizations that could be averted by vaccination have indicated that higher vaccination rates could prevent a substantial number of influenza cases and hospitalizations (31). For example, one study indicated that a 5% influenza vaccination coverage increase would result in 785,000 fewer illnesses (56% among those aged 18&ndash64 years) and 11,000 fewer hospitalizations (31). More effort is needed to reach the Healthy People 2020 and 2030 targets to benefit fully from influenza vaccination (10,32). Ensuring that all persons who visit a health care provider during the influenza season receive a vaccination recommendation and offer from their provider and use of immunization information systems could increase influenza vaccination rates (33,34). Employers and health care administrators also should implement evidence-based interventions to increase influenza vaccination coverage among HCP, including on-site vaccination at no or low cost to HCP (30).

Pneumococcal Vaccination

The overall pneumococcal vaccination estimates in this report include respondents who received PCV13, PPSV23, or both. Respondents indicating receipt of &ge2 doses of pneumococcal vaccine include adults who are recommended to receive 1 dose of PPSV23 only, or a dose of PCV13 and up to 2 doses of PPSV23 (17,35). Since 1997, ACIP has recommended PPSV23 vaccination of all adults aged &ge65 years and younger adults with chronic or immunocompromising medical conditions (35). In 2012, ACIP recommended PCV13 to adults aged 19&ndash64 years at increased risk and, in 2014, ACIP recommended routine use of PCV13 in series with PPSV23 for all adults aged &ge65 years (17,36). At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). On June 26, 2019, after having reviewed the evidence accrued during the preceding 3 years (37), ACIP voted to remove the recommendation for routine PCV13 use among adults aged &ge65 years and to recommend administration of PCV13 based on shared clinical decision-making for adults aged &ge65 years who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant, and who have not previously received PCV13. All adults aged &ge65 years should continue to receive 1 dose of PPSV23 (36). Recommendations and guidance and implementation considerations for recommendations on shared clinical decision-making are available (37,38).

Pneumococcal vaccination of persons aged 19&ndash64 years at increased risk increased during 2010&ndash2018 but remains well below the Healthy People 2020 target of 60% (10). Millions of adults in the United States have conditions placing them at increased risk for complications of pneumococcal disease or other vaccine-preventable infections (39,40). Adults with certain chronic and immunocompromising health conditions are at substantially increased risk for IPD compared with adults without these conditions, with disease rates up to 33 times higher in some immunocompromised adults (41). In this report, only one fourth of adults aged 19&ndash64 years at increased risk reported ever receiving a dose of pneumococcal vaccine, leaving approximately 70% of adults at increased risk unprotected. Pneumococcal vaccination of adults aged &ge65 years increased during 2010&ndash2018 however, coverage remains well below the Healthy People 2020 target of 90% (10). Achieving higher pneumococcal vaccination levels can reduce morbidity and mortality related to pneumococcal disease.

Herpes Zoster Vaccination

Overall, in 2018, herpes zoster vaccination coverage among adults aged 50&ndash59 years was 5.8%, similar to the estimate for 2017. ZVL was licensed by the U.S. Food and Drug Administration (FDA) for adults aged &ge50 years, but not recommended by ACIP for adults aged 50&ndash59 years. The ACIP recommendation was driven by concerns about waning immunity of ZVL in vaccine recipients aged 50&ndash59 years combined with increasing risk for herpes zoster with age and cost-effectiveness analyses (42). In October 2017, ACIP recommended the recent FDA-approved RZV for use in immunocompetent adults aged &ge50 years, revaccination of those who previously received ZVL, and preferential use of RZV over ZVL because of its higher and more long-lasting efficacy (43). The differences between FDA&rsquos ZVL licensing and ACIP recommendations for ZVL use likely influenced the usage patterns of ZVL before widespread distribution of RZV. The limited use of ZVL in persons aged 50&ndash59 years likely reflects use of an FDA-approved vaccine among some vaccination providers and individual clinical decision-making with their patients, illustrating the strong influence of ACIP recommendations on national vaccination practices.

ZVL coverage among adults aged &ge60 years was 34.9% in 2017 (9) and 28% among the same age group in 2018. Even if no ZVL had been administered in 2018, that might be insufficient to explain the decreased coverage compared with 2017. This observed decrease in coverage might reflect the effect of the change in herpes zoster vaccination recommendations in October 2017 and the questions asked in the 2018 NHIS to ascertain type of herpes zoster vaccine received. In 2017, respondents were asked if they had ever received a shingles vaccine. The 2018 NHIS included questions to ascertain herpes zoster vaccination by type of vaccine (ZVL versus RZV), number of vaccine doses received, and timing of vaccine receipt (13).

Results from this study indicated that recently recommended RZV coverage (&ge1 dose) was 2.4% among adults aged &ge50 years. ACIP recommended 2 doses of RZV to adults aged &ge50 years (43). This study showed that in 2018, RZV coverage (&ge2 dose) was 0.6% among adults aged &ge50 years. More RZV doses were distributed in the third and fourth quarters (64%) in 2018 compared with the first two quarters (36%) (CDC unpublished data, 2018), and uneven distribution of this new vaccine could have had an impact on vaccine receipt, estimation of vaccination coverage, and series completion. The results from this study provides first-year RZV coverage following the 2017 ACIP recommendation and a baseline for assessing changes in herpes zoster vaccination coverage following introduction of RZV. Monitoring RZV vaccine use is important for developing strategies to improve coverage for this newly recommended vaccine.

Overall, herpes zoster vaccination coverage for adults aged &ge60 years was 34.5% in 2018, similar to the 2017 estimate and 4.5 percentage points above the Healthy People 2020 target of 30% (10). Although the Healthy People 2020 target was achieved, approximately 65% of adults recommended to receive this vaccine remain unprotected. Barriers that might have constrained overall herpes zoster vaccination uptake include shortages of herpes zoster vaccines (e.g., there was a ZVL shortage in 2011 and a RZV shortage in 2018) as well as financial and logistic challenges (44,45). The high cost for providers to purchase a supply and high out-of-pocket costs for patients are well-documented barriers (46,47). For ZVL, challenges existed to stocking the vaccine (which requires freezer storage), and for ZVL and RZV, variation in out-of-pocket payments for some Medicare Part D beneficiaries existed depending on their specific plan (46,47). RZV must be stored in a refrigerator (but should not be frozen) and administered immediately after reconstitution or stored in a refrigerator and used within 6 hours. Studies showed that provider recommendation was a strong predictor for vaccination (48,49). Health care providers should routinely assess patients&rsquo vaccination status and strongly recommend needed vaccines to adults (48,49).

Tetanus Toxoid&ndashContaining Vaccination

ACIP updated the adult Tdap vaccination recommendation to include all adults aged &ge19 years who have not yet received a dose of Tdap, including those aged &ge65 years, in 2012 (50). Tdap should be administered regardless of interval since the last Td shot. A single dose of Tdap is particularly important for adults who have or who anticipate having close contact with an infant aged <1 year (e.g., parents, grandparents, childcare providers, and HCP) to reduce risk for transmitting pertussis to infants too young to be vaccinated, who are at the greatest risk for severe pertussis including hospitalization and death. Overall, Tdap coverage has remained low for all age groups and among adults living with an infant aged <1 year. In 2018, although there was no increase compared with the 2017 estimate, the trend test found that Tdap coverage increased significantly from 2010 to 2018. Health care providers should not miss an opportunity to vaccinate adults aged &ge19 years who have not received Tdap previously.

Vaccination also offers the best protection against pertussis infection in HCP (51&ndash53). In 2006, ACIP recommended that HCP aged 19&ndash64 years receive a single dose of Tdap to reduce the risk for transmission of pertussis in health care settings (52). In 2010, ACIP updated HCP recommendations indicating that all HCP, regardless of age, should receive a single dose of Tdap as soon as feasible if they had not previously received Tdap (24). Vaccinating HCP with Tdap can be a cost-effective strategy to prevent outbreaks in health care settings (51&ndash53). However, as of 2018, Tdap vaccination coverage among HCP is suboptimal (55.8%).

Tdap vaccination coverage among HCP was lower compared with influenza and hepatitis B vaccination coverage among HCP. Influenza and hepatitis B vaccines are two other vaccines recommended for HCP in the United States (24,54). Influenza (2017&ndash18 season) and hepatitis B (2018) vaccination coverage among HCP was 71.8% and 67.2%, respectively. Coverage among HCP with direct patient care was 72.6% and 75.3%, respectively. However, influenza and hepatitis B vaccination have been recommended for HCP since 1984 and 1982, respectively, compared with Tdap, which has been recommended for HCP only since 2006 (52,54,55). Other factors, such as perceived risk, employer requirements, and targeted vaccination campaigns, also might contribute to higher influenza and hepatitis B vaccination among HCP (54&ndash57). Since Tdap vaccination coverage was first assessed in the United States in 2008 (52), Tdap coverage among HCP has increased from 15.9% in 2008 (58) to 55.8% in 2018. Continued monitoring of Tdap vaccination among HCP is useful for evaluating vaccination campaigns and planning and to control pertussis among HCP and their contacts.

Hepatitis A Vaccination

Hepatitis A is an acute infection that can result in mild illness or be severe enough to result in hospitalization or, rarely, in death. Incidence rates decreased by approximately 95% from 1995 to 2011, then increased by 140% from 2011 to 2017 (59). Incidence rates in the United States have been influenced by occasional outbreaks, often linked to imported food, and among nonimmune persons experiencing homelessness (60). Although the average number of annual hepatitis A virus (HAV) infections reported to CDC in recent years has declined substantially compared with 2000, fluctuations have occurred during the preceding 20 years because of large outbreaks. After a long downward trend, the first increase between 2012 and 2013 (1,562 and 1,781 reported cases, respectively) was because of a large multistate outbreak associated with pomegranate arils imported from Turkey (61). From 2015 to 2016, reported cases again increased by 44.4% from 1,390 to 2,007 cases. The 2016 increase was caused by two hepatitis A outbreaks, each of which was linked to imported foods. Increases might be expected because of ongoing outbreaks reported to CDC among persons who use drugs, persons experiencing homelessness (62), and men who have sex with men (63). Men who have sex with men should be vaccinated against hepatitis A and hepatitis B and tested for hepatitis B. Optimal use of vaccination can substantially reduce the hepatitis A disease burden (64). One study found that among U.S.-born adults aged &ge20 years, HAV susceptibility prevalence (total antibody to HAV negative) was 74.1% during 2007&ndash2016, indicating that HAV immunity levels among adults was low (65). In 1995, the first hepatitis A vaccine became available in the United States. ACIP recommended hepatitis A vaccination of international travelers, men who have sex with men, persons who use injection and noninjection drugs (i.e., all those who use illegal drugs), persons who have occupational risk for exposure, persons who anticipate close personal contact with an international adoptee, persons experiencing homelessness, persons infected with HIV, persons with chronic liver disease, persons living in group settings for those with developmental disabilities, persons who are incarcerated, pregnant women who are identified to be at risk for HAV infection during pregnancy, and adults aged >40 years (66).

Information on hepatitis A vaccination was available for the adult general population and selected populations for whom hepatitis A vaccination specifically is indicated (only for those with foreign travel to areas of high or intermediate endemicity and those with chronic liver disease). Although hepatitis A vaccination of adult travelers was higher during 2010&ndash2018 than among adult nontravelers, overall hepatitis A vaccination among travelers aged &ge19 years and adults aged &ge19 years with chronic liver disease has remained low (as of 2018, 18.9% and 15.8%, respectively). HCP are encouraged to assess the needs of their patients for hepatitis A vaccine and offer it when appropriate. To further improve hepatitis A vaccination coverage and reduce the burden of hepatitis A infection in the United States, HCP are encouraged to adopt strategies to identify candidates for hepatitis A vaccination (e.g., implementing standing orders in electronic medical records, collocating vaccination at homeless shelters and syringe service programs, and offering vaccine to residents and staff of long-term care centers), and to ensure that traveling adults and all adults at increased risk for hepatitis A infection or seeking protection from hepatitis A infection are offered hepatitis A vaccine (33,34,64,66&ndash68). Travelers, especially healthy travelers with no physician visit, should see their doctor to discuss their travel-related vaccinations and other preventive care services. CDC recommends that international travelers should schedule a visit to a primary doctor or a travel medicine provider 4&ndash6 weeks before their trip (67&ndash69).

Hepatitis B Vaccination

ACIP has recommended a 3-dose hepatitis B vaccine series since 1982 for HCP (70,71), since 1991 for travelers to or persons working in countries with high or intermediate hepatitis B endemicity (72), and since 2011 for unvaccinated adults with diabetes aged 19&ndash59 years. In addition, vaccine can be administered to unvaccinated adults with diabetes aged &ge60 years at the discretion of their HCP (73,74). Despite these longstanding recommendations for hepatitis B vaccination, coverage remained low in 2018. Furthermore, overall hepatitis B vaccination among travelers and adults with chronic liver disease has remained low, although hepatitis B vaccination among travelers was higher in 2018 and preceding years than among nontravelers.

Several factors might contribute to low hepatitis B vaccination among travelers to countries where hepatitis B virus is endemic. Many travelers to international destinations might omit seeking travel health advice because of lack of awareness of the risk for travel-associated infection and travel-related vaccination recommendations (75&ndash77). Some travelers (e.g., business travelers, journalists, and relief workers) might be notified of travel on short notice and have little time for vaccination before departure, even though these travelers should be vaccinated in expectation of travel to hepatitis B virus&ndashendemic areas to protect themselves (75&ndash77). Travelers might believe that travel of short duration, to resorts or on tours, will pose little risk for travel-related diseases (78&ndash81). HCP are encouraged to adopt strategies to identify candidates for hepatitis B vaccination and to ensure that traveling adults, all adults at increased risk for hepatitis B infection, or those seeking protection from hepatitis B infection are offered hepatitis B vaccine (75&ndash81). Travelers to a country of high or intermediate hepatitis B endemicity are encouraged to schedule a visit with their doctor or a travel medicine provider 4&ndash6 weeks before travel to discuss the need for travel-related vaccinations (75&ndash77).

In addition, during 2010&ndash2018, estimates of hepatitis B vaccination among HCP did not improve, ranging from 61% to 67%, well below the Healthy People 2020 target of 90% (10). Hepatitis B vaccination coverage among HCP with direct patient care was higher (75%), although still below the Healthy People 2020 target (10). Before hepatitis B vaccination was widely implemented, hepatitis B virus (HBV) infection was recognized as a common occupational risk among HCP (82,83). Routine hepatitis B vaccination of HCP and the use of standard precautions have resulted in a 98% decline in HBV infections among HCP from 1983 through 2010 (84). The Occupational Safety and Health Administration mandates that employers offer hepatitis B vaccination to all personnel who have occupational risk and that postexposure prophylaxis be available following an exposure (74,84,85). Continued efforts are needed to increase hepatitis B vaccination coverage among unvaccinated HCP to protect workers and patients (86).

HPV Vaccination

HPV is the most common sexually transmitted infection in men and women in the United States (87&ndash91). Vaccination can prevent HPV infection and associated diseases including genital warts, precancerous lesions, anogenital cancers, and oropharynx cancer (87). In 2006, quadrivalent HPV vaccine was recommended by ACIP for use in females aged 11 or 12 years and for those aged 13&ndash26 years who had not been vaccinated previously or who had not completed the 3-dose series (87). In 2009, ACIP provided guidance that the quadrivalent vaccine could be given to males aged 9&ndash26 years (a permissive recommendation) (92,93). In 2011, ACIP recommended routine use of HPV vaccine among males aged 11 or 12 years and for those aged 13&ndash21 years who had not been vaccinated previously or who had not completed the 3-dose series and a permissive recommendation for males aged 22&ndash26 years (91,94). In 2015, after 9-valent HPV vaccine was licensed, ACIP recommended any of the three licensed HPV vaccines (quadrivalent, bivalent, or 9-valent) for females and quadrivalent or 9-valent vaccine for males among the same age groups previously recommended (95). In 2016, ACIP recommended a 2-dose schedule for HPV vaccination of females and males initiating their vaccination before age 15 years (96). In 2019, ACIP updated recommendations on HPV catch-up vaccination for U.S. adults to include all persons through age 26 years (97). For adults aged 27&ndash45 years, shared clinical decision-making about HPV vaccination is recommended because certain persons who are not adequately vaccinated might benefit (97).

Although receipt of at least 1 dose of HPV vaccine increased from 20.7% in 2010 to 52.8% in 2018 for females aged 19&ndash26 years, and from 2.1% in 2011 to 26.3% in 2018 among males aged 19&ndash26 years, as of 2018, coverage has remained low, and many young adult females (47.2%) and males (73.7%) remain unvaccinated and vulnerable to cancers that safe, effective HPV vaccines can prevent. Findings on age at first dose of HPV vaccination of adults indicated that most female and male respondents in the 2018 NHIS reported receiving the first dose of HPV vaccine at age &ge13 years. In 2018, approximately 12% of females and 15% of males aged 19&ndash26 years not vaccinated at age &le18 years reported receiving the first dose of HPV vaccine as a catch-up dose at age 19&ndash26 years. Since HPV vaccine licensure, multiple cohorts of unvaccinated adolescents and young adults have accumulated. For example, in the 2018 National Immunization Survey&ndashTeen (98), provider-reported vaccination histories indicated that 23.7% of females and 35.5% of males aged 17 years were unvaccinated (having not received at least one HPV vaccine dose) (98). These estimates reflect the current pool of females and males who could benefit from catch-up vaccination and the number of unprotected older adolescents adding to that pool annually, indicating the importance of catch-up vaccination among young adults.

HCP recommendations for vaccination are strongly associated with a patient&rsquos receipt of vaccines (34,99&ndash103). Findings from one report indicate that among male adolescents with a HCP recommendation, HPV coverage was approximately two times higher than that among those without a provider recommendation (68.8% versus 35.4%) (48). The same report found that provider recommendation was associated with higher HPV vaccination coverage in most states (48). Another study found that HPV vaccination coverage among female adolescents (&ge1 dose) was 58.3% among those with a provider recommendation compared with only 20.7% among those without a provider recommendation (104). Other research has indicated that recommendations from providers increase parental acceptance of vaccination of their children and that parents change their minds about delaying and refusing vaccines because of information or assurances from HCP (105,106). HCP conversations with parents can be an important pathway to achieving higher HPV vaccination coverage of female adolescents, including talking to parents about the HPV vaccine, giving parents time to discuss the vaccine, and making a strong recommendation for HPV vaccination (107). However, in 2016, up to 35% of parents of adolescents reported not receiving a provider recommendation for the vaccine (48). Increasing HPV vaccination could lead to greater decreases in HPV-attributable diseases in the United States. Continued efforts are needed to improve coverage among members of the primary target group for HPV vaccine (girls and boys aged 11&ndash12 years) and among all racial and ethnic groups. As more adolescents are vaccinated at the target age group and age into the adult population monitored in NHIS, vaccine coverage estimates are expected to increase. To reduce the amount of time needed to achieve population-level impacts of vaccination, such as reduction in HPV-associated cancer incidence, efforts are also needed to improve catch-up vaccination through age 26 years among those who have not started or completed their vaccination (4,97). Providers should assess vaccination status at clinical encounters, educate persons about the diseases that can be prevented by vaccines, and strongly recommend indicated vaccines (34,99,108).

Trends in Adult Vaccination Coverage

Although the point estimates for each year varied by only a few percentage points, linear trend tests indicated that during 2010&ndash2018, vaccination coverage increased for influenza (among adults aged &ge19 years overall and those with high-risk conditions), pneumococcal (among those aged 19&ndash64 years at increased risk and adults aged &ge65 years), herpes zoster (among adults aged &ge60 years), Tdap (among adults aged &ge19 years), hepatitis A (among adults aged &ge19 years and travelers or nontravelers aged &ge19 years), hepatitis B (among adults aged &ge19 years), and HPV (among women aged 19&ndash26 years) vaccines, and during 2011&ndash2018 for HPV vaccine (among men aged 19&ndash26 years). Although these increases were small, collectively they might have resulted in meaningful reductions in disease among adults (31). Hepatitis B vaccination coverage plateaued among adults aged &ge19 years with chronic liver conditions and travelers or nontravelers aged &ge19 years.

Racial and Ethnic Differences in Vaccination

In 2018, racial/ethnic differences in vaccination coverage persisted for all seven vaccines assessed in this report. Generally, higher coverage was observed for White adults compared with most other groups. Black, Hispanic, and Asian adults had lower vaccination coverage than Whites for all vaccines routinely recommended for adults, with a few exceptions. Among HCP, there were differences for influenza, Tdap, and hepatitis B vaccination, with White HCP generally having higher vaccination coverage compared with Black and Hispanic HCP.

The findings provided in this report are consistent with previous studies (4,109). Although studies indicate that racial and ethnic disparities in childhood vaccination have been reduced substantially or not observed for certain vaccinations (98,110,111), racial and ethnic disparities in adult vaccination persist (4,28,29,111&ndash118). School entry vaccination requirements and the Vaccines for Children program, which provides vaccines to children who might otherwise be unable to afford them, might contribute to reduced racial and ethnic disparities in vaccination coverage for children (119&ndash121). Multiple factors contribute to racial and ethnic differences in adult vaccination, including differences in attitudes toward vaccination and preventive care, propensity to seek and accept vaccination, variations in the likelihood that providers recommend vaccination, differences in quality of care received by racial and ethnic populations, and differences in concerns about vaccination including vaccine safety (111&ndash118). In addition, non-Hispanic Black and Hispanic adults are more likely to be uninsured (122). Lack of medical insurance has been an important predictor of low adult vaccination uptake (4,117,123). Another factor that might contribute to coverage disparities is differential awareness of vaccines. Studies have shown that awareness of Tdap, herpes zoster, and HPV vaccines was significantly lower among racial and ethnic minorities compared with non-Hispanic Whites (57,102,123,124). Older Black adults report more negative attitudes toward influenza vaccination than White adults (113) however, studies of standardized offering of influenza and pneumococcal vaccines have demonstrated reductions in racial and ethnic coverage disparities (125,126). Using a combination of patient tracking, vaccination reminders for providers and patients, and patient outreach and assistance also reduces racial/ethnic vaccination differences (103). Incorporating standards for adult vaccination practices, which include routinely assessing vaccination needs during all clinical encounters, providing a strong recommendation for vaccination to patients with indications, and then offering vaccination at the visit (34) or referring patients for vaccination elsewhere, can reduce vaccination disparities.

Access-to-Care Characteristics and Adult Vaccination Coverage

Consistent with a previous report (127), in this study having health insurance was generally associated with a greater likelihood of having received recommended vaccinations, even after controlling for demographic and access-to-care variables. For many of the vaccines, coverage was greater among adults with private health insurance compared with those reporting public health insurance, but this finding was not consistent for all vaccines and age groups. The factors contributing to vaccination levels by type of health insurance are not well understood. Health insurance coverage, although beneficial in improving access to health care services, might not be sufficient in itself to achieve optimal adult vaccination. In this report, even among adults who had health insurance and &ge10 physician contacts during the preceding year, up to 87.5% reported not receiving one or more recommended vaccines. Provider attitudes toward adult vaccination, practice patterns that do not routinely incorporate assessments for vaccines for adults, and other barriers to vaccination might determine whether patients are offered and receive vaccines (127&ndash133).

Generally, persons with a usual place for health care were more likely to report having received recommended vaccinations than those who did not have a usual place for health care, regardless of whether they had health insurance, and vaccination coverage generally increased as the number of physician contacts increased. Having a usual place for health care and routine physician contact can provide important opportunities for providers to educate their patients about vaccine-preventable diseases and to recommend and offer vaccination (102,109,117,134). However, a recent study showed that overall, among adults with a doctor visit, only 57.0% received a provider recommendation for influenza vaccination (49). Patients usually trust the opinions of HCP regarding vaccination more so than opinions from others (34,135). However, only 32% of family physicians and 29% of internists assess their adult patients&rsquo vaccination status at every visit (135).

Adult Vaccination Coverage by Nativity, Years Living in the United States, and Citizenship

Results from this study indicated that adult vaccination coverage was generally lower among foreign-born compared with U.S.-born persons. Vaccination coverage for foreign-born persons differed by time lived in the United States. A previous study showed that vaccination was also associated with language used for interview, race/ethnicity, and birth country/region (136). Among foreign-born persons, vaccination coverage was generally lower among those who were not U.S. citizens, those interviewed in a language other than English, and non-Hispanic Blacks or Hispanics. Hispanic foreign-born adults had the lowest coverage for several vaccines. This finding is particularly relevant because foreign-born persons from Latin America account for more than half of all foreign-born adults in the United States (137&ndash139). Vaccination coverage and immunization schedules are different in many countries compared with the United States and vary by country and even by regions within countries (136,140,141). Although immigrant visa applicants and refugees destined for permanent resettlement in the United States are subject to ACIP-recommended vaccination requirements, the differences between the United States and other countries in the schedules of routine vaccinations among adults might contribute to differences in the coverage levels of the vaccines studied. Public policymakers, vaccination programs, and HCP should consider foreign-born populations in their public health assessment, evaluation, and outreach programs that target disadvantaged groups (142).

Improving Adult Vaccination Coverage

Studies indicate that a strong HCP recommendation is closely associated with patient vaccination (48,49,128). Standards for Adult Immunization (the Standards) was published for implementing ACIP recommendations and outlining approaches for improving adult vaccination coverage (33,34). Wider adoption of the Standards (i.e., assessing vaccination status at each adult patient visit, issuing strong recommendations for indicated vaccines, offering vaccines or referring patients to other providers for vaccination, and recording vaccinations received in the Immunization Information System [IIS]) (33,34) will help improve vaccine coverage. Research suggests medical specialists are less likely than primary care clinicians to assess for, recommend, stock, or refer patients for needed vaccines (143). Because patients with conditions placing them at increased risk for infection are likely to receive care from specialists, these encounters might represent missed opportunities for vaccination and could be addressed by consistent implementation of the Standards by these providers. Among the challenges clinicians face in assessing the need for vaccination is availability of a complete and accurate vaccination history along with access at the point of care to the most current vaccination recommendations. Enhancing provider access to IIS could help improve vaccination coverage because IIS can provide consolidated immunization histories for use by a vaccination provider in determining appropriate client vaccinations (144). Nationwide adoption of electronic health records, many of which have the capacity for patient-centered clinical decision support, also offer opportunities for improving adult vaccination coverage (4).

Standardized offering of vaccines reduces but does not eliminate racial/ethnic differences in coverage (15). Although programmatic initiatives designed to improve adult vaccine coverage overall might have a positive effect on these disparities (125), their persistence in the face of years of such intervention suggests that novel and systematic approaches are required. More information on contributors to such disparities will be necessary to inform the design of meaningful interventions to further improve vaccination among adult populations.


Contents

The Group 1 boats were decommissioned in 1931, but were recommissioned in 1940 to serve as training boats at Submarine Base New London, Connecticut. Three (R-3, R-17, and R-19) were transferred to the United Kingdom's Royal Navy as HMS P.511, HMS P.512, and HMS P.514 in 1941-1942. P.514 was lost on 21 June 1942 in a collision with the Canadian minesweeper HMCS Georgian due to being mistaken for a U-boat. R-12 was lost on 12 June 1943 in an accident off Key West, Florida.

At some point between the wars the US R-class were modified for improved rescue ability in the event of sinking. A motor room hatch was added, the motor room being the aftermost compartment. The tapered after casing became a step as a result of this modification. [4]

At least one R-class submarine can be seen briefly in the 1943 movie Crash Dive, filmed at the New London submarine base.

Electric Boat built four "R Class" boats for the Peruvian Navy (R-1 to R-4). Built after World War I using materials assembled from cancelled S-class submarines, they were refitted in 1935–36 and 1955–56, and renamed Islay, Casma, Pacocha, and Arica in 1957. They were discarded in 1960.


یواس‌اس آر-۲۵ (اس‌اس-۱۰۲)

یواس‌اس آر-۲۵ (اس‌اس-۱۰۲) (به انگلیسی: USS R-25 (SS-102) ) یک زیردریایی بود که طول آن ۱۷۵ فوت (۵۳ متر) بود. این زیردریایی در سال ۱۹۱۹ ساخته شد.

یواس‌اس آر-۲۵ (اس‌اس-۱۰۲)
پیشینه
مالک
سفارش ساخت: ۲۹ اوت ۱۹۱۶
آب‌اندازی: ۲۶ آوریل ۱۹۱۷
آغاز کار: ۱۵ مه ۱۹۱۹
اعزام: ۲۳ اکتبر ۱۹۱۹
مشخصات اصلی
وزن: ۴۹۵ long ton (۵۰۳ تن)
درازا: ۱۷۵ فوت (۵۳ متر)
پهنا: ۱۶ فوت ۸ اینچ (۵٫۰۸ متر)
آبخور: ۱۳ فوت ۱۱ اینچ (۴٫۲۴ متر)
سرعت: ۱۴ گره (۲۶ کیلومتر بر ساعت؛ ۱۶ مایل بر ساعت)

این یک مقالهٔ خرد کشتی یا قایق است. می‌توانید با گسترش آن به ویکی‌پدیا کمک کنید.


List of Waffen-SS foreign volunteers and conscripts

The Waffen-SS ("Armed SS") was created as the armed wing of the Nazi Party's Schutzstaffel ("Protective Squadron" SS). Ώ] It grew from three regiments to over 38 divisions during World War II, and served alongside the Heer (regular army) but was never formally part of it. ΐ] By 1945, the Waffen-SS had developed into a multi-ethnic and multi-national military force of Nazi Germany, its divisions manned by volunteers and conscripts from across Europe. Α]

When Adolf Hitler and his Nazi Party came to power in 1933, a number of paramilitary organizations already existed, namely the Sturmabteilung ("Storm Detachment" SA) and Schutzstaffel ("Protection Squad" SS). Β] Together, these two groups numbered more than three million men, a fact which deeply troubled the traditional officer corps of the German Army. Γ] Β] In 1933, a group of 120 loyal SS men were chosen to form the Leibstandarte SS Adolf Hitler. Δ] A year later, Hitler approved the formation of the SS-Verfügungstruppe, which, together with the Leibstandarte SS Adolf Hitler, made up the early elements of what would eventually became the Waffen-SS. Δ] It was Hitler's wish that unit should never be integrated into the army nor the state police, but remain an independent force of military-trained men at the disposal of the Führer in times of both war and peace. Ε] Ζ] It was commanded by Heinrich Himmler in his capacity as Reichsführer-SS. Η]

The Waffen-SS was initially given the lowest priority for recruits and its members were regarded as "amateur soldiers" by the regular army. ⎖] The Germanic Waffen-SS divisions had extremely tough entry requirements out of every 100 applicants, only 7 were accepted. Γ] Josef Dietrich, a high ranking SS general, insisted that all men of the Waffen-SS would have to be mature, a minimum height of 180 cm, between the ages of 23 to 35, in superb physical condition, and have a perfect ancestry record, with no hint of Jewish blood. Γ] ⎖]

Initially, only Germans that belonged to the Aryan race were allowed to join the Waffen-SS, but due to shortage of manpower when events turned against the Axis powers the Nazis dropped their racial restrictions and allowed foreign volunteers and conscripts to form Waffen-SS divisions. ⎗] ⎘] The Nazis instructed all members of the Waffen-SS to fight against "Bolshevik subhumans". ⎙]

For all its expenditure and training, the Waffen-SS did not see actual combat until Germany invaded Poland, effectively starting World War II in Europe. It was then only about 10,000 men strong. Α] When Germany next turned West to conquer France and the Low Countries in 1940, the Waffen-SS had expanded to 100,000. Γ] That same year, Himmler opened up membership for people he regarded as being of "related stock", which resulted in a number of right wing Scandinavians signing up to fight in the Waffen-SS. When the Germans turned East and invaded the Soviet Union in the biggest military operation in history, further volunteers from France, Spain, Belgium, the Netherlands, Czechoslovakia, and the Balkans signed up to fight for the Nazi cause. Γ] After 1942 when the war turned decisively against the Nazi Germany, further recruitment from the occupied territories signed up to fight for the Nazis. Γ] Eventually units consisting of Russians, Indians, Arabs and even Britons were created. Γ] At its peak, the Waffen-SS numbered almost a million men (38 divisions) from across Europe. Ζ] After the war, the unit was banned and declared a criminal organization for its heavy involvement in war crimes. ⎚]


R-25 SS-102R-25 SS-102 - History

As the work on the canal neared completion - and the investment grew considerably - eventually to some 352 million dollars - an investment the United States needed to protect from any posible hostile action. At this time - Submarines were considered primarily a coastal defense force - not useful for much else - so like the forces sent to the Asiatic Station to "show the flag" - in 1913 five C Boats (Octopus, Stingray, Tarpon, Bonita, and Snapper) were deployed to Coco Solo - of course with tenders.

As we are all aware - DANFS contains error and omissions. With regard to this deployment by so many ships - DANFS is nearly silent - in fact is silent in several respects.

-from the DANFS entry for SNAPPER C-5: "On that date [7 December 1913] C-5 and her sisters of the redesignated First Division, escorted by four surface ships, sailed for Cristobal, C.Z. Five days later the ships completed the 700 mile passage, at that time the longest cruise made by United States submarines under their own power."

C-3's and C-4's entries are similar. Worse two of the ships known to be part of the four surface ships accompanying the C boats have no mention at all - we have to rely on other sources such as this one:

-from the Panama American, August 15, 1939:

That also leaves a question: what was that fourth ship? We know Potomac wasn't yet a submarine tender (that didn't happen until a couple years later) and there is no mention of this "transit" in her DANFS entry at all Tallahassee was indeed in service as a submarine tender - however her DANFS entry is also silent on this period - so no help there either. Severn's entry does at least acknowledge arriving "in the Zone" on December 12 - but no details - including how she got there (under tow from Potomac). An extensive serach of DANFS (and other sources) turns up only two ships as even being in the region - USS Ozark - though DANFS indicates she is on special duty around Mexico by early 1914 and USS Castine - though DANFS indicates she is around Norfolk. As noted - neither Potomac nor Tallahassee's DANFS's entries have any mention of accompanying First Division to the Canal Zone - so an ommision from either Ozark's nor Castine's entries are conclusive. What is noted in C-5's entry (but not Castine's) is that Castine was one of the ships that towed the C boats to Guantanamo Bay earlier in the year (May the other ship was USS MARS which was decommissioned in July).

So until we can get the deck logs from one of the ships invloved (and hopefully they - as in modern log keeping list all of the ships "in company, anchorage, etc.") the identity of that fouth ship will remain a mystery.

As important to shipping as the Canal itself - access to the canal was made an equal priority - with defensive assets cruising around the sea lanes to and from the Canal. The Virgin Islands, Bermuda, Cuba, even the Azores were regular hosts to tenders and their fleets of submarines.


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