[Congressional Record Volume 149, Number 27 (Thursday, February 13, 2003)]
[Extensions of Remarks]
[Page E268]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          SMALLPOX VACCINE COMPENSATION AND SAFETY ACT OF 2003

                                 ______
                                 

                          HON. HENRY A. WAXMAN

                             of california

                    in the house of representatives

                      Thursday, February 13, 2003

  Mr. WAXMAN. Mr. Speaker, today I am introducing legislation to 
enhance the ability of the United States to respond to a terrorist 
attack that uses the lethal smallpox virus. This legislation 
establishes a program to compensate those injured by the smallpox 
vaccine. It also contains provisions to assist state efforts against 
smallpox and to protect health care workers and their employers during 
the vaccination campaign.
  I am introducing this bill today to begin a dialogue that I hope will 
culminate in the quick passage of legislation. This is not a partisan 
issue. I know that all members of the House and Senate are committed to 
protecting the American public from potential bioterrorist threats. I 
look forward to working with members from both the Republican and 
Democratic parties and with the Administration to develop a bipartisan 
solution. I hope that my ideas, as outlined in this legislation, can 
provide a starting place for discussion.
  Three weeks ago, President Bush launched a national program to 
vaccinate millions of healthcare workers against smallpox in order to 
protect the United States in case of a bioterrorist attack. To date, 
the number of those vaccinated is far lower than anticipated. According 
to press accounts, about one thousand health care workers have been 
vaccinated, despite an initial goal of about 500,000 in the first 
month.
  According to public health officials, one reason for this gap is that 
health care workers are concerned about the risks of the smallpox 
vaccine itself. About one out of every million people who receive the 
vaccine will die, and several others will suffer severe medical 
complications, including brain damage, blindness, and significant 
scarring. Serious injury can occur even among people who have never 
been vaccinated, but who come into close contact with someone who has 
recently received the vaccine.
  The homeland security bill passed last fall limited the liability of 
hospitals, doctors, and vaccine manufacturers for injuries caused by 
the smallpox vaccine. However, the legislation did not provide 
compensation to those who are injured.
  I have heard from public health officials and vaccination experts 
that many health care workers are understandably reluctant to accept a 
vaccine to protect the public while being forced to face the 
consequences of an adverse reaction alone. These consequences can 
include large medical bills, lost income, pain and suffering, and 
death. There can be no doubt that a compensation program is urgently 
needed.
  Some have suggested that existing workers compensation programs can 
cover those vaccinated in case of injury. This approach is not 
adequate. It is clear that some state programs do not cover vaccine 
injuries at all, others provide insufficient compensation, and not one 
covers those who fall ill from contact with someone who has received 
the vaccine.
  Health insurance may also fall short. Some insurers have threatened 
not to cover smallpox vaccine injuries. And some volunteers or contacts 
who get injured by the vaccine may not have health insurance at all.
  Aside from the lack of compensation for vaccine injury, there are 
other impediments to the smallpox vaccination effort. States are 
straining under the weight of their usual public health 
responsibilities and need additional funding. Volunteers who need 
immediate medical care because of a smallpox vaccine reaction may not 
be able to afford it, and those volunteers who fall ill for a few days 
with common local reactions to the vaccine may lose wages while 
recovering.
  The legislation I am introducing today addresses these problems. My 
goal is the same as the President's: to enhance the ability of the 
United States to defend against a bioterrorist attack. I believe that 
changes in the law are urgently needed to achieve this goal.
  First, the bill establishes a no-fault compensation program for those 
injured by the smallpox vaccine modeled on the successful program for 
children injured by routine immunizations. This system is fair, 
efficient, and less litigious than the traditional court system. Most 
importantly, a compensation program will provide real security to 
health care workers and their families in case of injury and will 
remove a major impediment to the vaccination effort.
  Second, the bill would provide grants to states to pay for their 
vaccination programs, including education and testing for medical 
conditions that are risk factors for severe reactions to the smallpox 
vaccine.
  Third, the bill would provide states full funding to pay for the 
immediate medical care of any health care worker or first responder 
injured by the vaccine, or anyone injured by coming into contact with 
someone who has been recently vaccinated. Timely medical attention can 
help to prevent the most serious complications of adverse reactions 
from ever developing.
  Fourth, the bill would prohibit discrimination against any worker who 
refuses to be vaccinated.
  Fifth, the bill would permit up to four days of paid leave for health 
care workers who experience transient but significant local reactions. 
Employers can obtain reimbursement for this expense from the 
compensation program.
  Each of these provisions will support our nation's preparations for a 
smallpox attack. In the coming days, I look forward to a productive 
legislative exchange to assure that these issues are quickly addressed.

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