[Congressional Record Volume 149, Number 59 (Friday, April 11, 2003)]
[Senate]
[Pages S5388-S5390]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          SMALLPOX EMERGENCY PERSONNEL PROTECTION ACT OF 2003

  Mr. SUNUNU. Madam President, I ask unanimous consent that the Senate 
immediately proceed to H.R. 1770, which is being held at the desk.
  The PRESIDING OFFICER. The clerk will state the bill by title.
  The assistant legislative clerk read as follows:

       A bill (H.R. 1770) to provide benefits and other 
     compensation for certain individuals with injuries resulting 
     from administration of smallpox countermeasures, and for 
     other purposes.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. FRIST. Madam President, I rise today in strong support of the 
Smallpox Compensation Act of 2003.
  I applaud the leadership of Senator Judd Gregg, the distinguished 
Chairman of the Health, Education, Labor, and Pensions Committee. He 
has done a tremendous benefit for the Nation through this critical 
legislation when there is such great need to improve our public health 
preparedness.
  I commend Senator Edward Kennedy for his efforts to achieve 
bipartisan consensus on the smallpox legislation we are considering 
today. I also thank all of the members of the Senate Health, Education, 
Labor, and Pensions Committee, and for the work of Representatives 
Billy Tauzin and John Dingell for their efforts to develop and pass 
this legislation.
  Finally, the President of the United States deserves great credit for 
working to ensure that America is prepared against the threat of 
bioterrorism, and that the Nation's healthcare workers, first 
responders, and their families are protected from adverse affects that 
may result from smallpox vaccinations. Without President Bush's 
commitment, we could not have reached this critical agreement.
  We know the grave danger that a smallpox attack poses. Smallpox is 
one of the deadliest diseases known to man. Health experts, the Federal 
Government, and State and local health entities continue to address the 
smallpox threat, including the development of a long-term immunization 
plan.
  The administration has taken great steps to meet this threat by 
setting forth an immunization plan for our Nation's healthcare workers 
and first responders.
  However, too many healthcare workers have been deterred from 
receiving the smallpox vaccine--in part because of uncertainties about 
what would happen, and how they would provide for themselves, if they 
suffered a serious adverse reaction to the vaccine.
  This legislation helps to respond to that fear. It makes clear that 
adequate compensation will be available if an individual becomes ill or 
dies as a result of receiving the smallpox vaccine.
  Passing this legislation will help strengthen President Bush's plan 
to vaccinate healthcare workers, public health officials and first 
responders--a vaccination strategy that is vital to our national 
security.
  This legislation is part of a long-term strategy. We must continue to 
work to ensure appropriate liability and compensation measures for 
future countermeasures, as well as strong communications, surveillance, 
capacity-building and research efforts to strengthen our overall public 
health infrastructure to respond to emerging public health threats.
  Indeed, this is not purely a public health issue; it is also an issue 
of national security. We must ensure that an adequate number of 
healthcare workers and first responders are vaccinated in order to 
protect the American people should smallpox be used as an offensive 
weapon. Dr. Anthony Fauci of the National Institutes of Health, NIH, 
has noted, in fact, that we would have perhaps only 2-3 days to 
vaccinate exposed individuals and prevent death in the event of an 
outbreak. This task would be nearly impossible without having an 
adequate number of individuals vaccinated prior to an outbreak.
  While the risk of a smallpox attack is not necessarily high, the risk 
is real.

[[Page S5389]]

And the results could be devastating. They would surely be even more 
devastating without having enough people vaccinated before an outbreak. 
So we need to act here, and we need to act quickly.
  In addition, we also must act in the coming weeks to pass the 
President's Project Bioshield Act of 2003 and legislation to improve 
our overall vaccine liability system. These are also critical longer 
term steps in rebuilding our defenses against infectious disease 
outbreaks, whether naturally-occurring or as a result of the use of 
offensive use of weapons of mass destruction.
  Again, I commend the President, Chairman Gregg, Senator Kennedy, and 
all of my colleagues, who have worked to craft this bipartisan 
legislation. I am very pleased to support this legislation.
  Mr. GREGG. Madam President, with a mortality rate of over 30 percent, 
smallpox was one of the world's most feared diseases until a 
collaborative global vaccination program eradicated the disease in the 
1970s. Smallpox no longer occurs naturally, and today can only be found 
in laboratories in the United States and Russia. Or so we believe. With 
the fall of the Soviet Union, some in the intelligence community are 
concerned that samples of the virus may have found its way to other 
countries, including Iraq. This is of grave concern to our Nation and 
the entire global community. Highly contagious and easily dispersed in 
the air, smallpox virus can be a deadly weapon in terrorist hands.
  Congress and the administration have responded to this potential 
threat by authorizing the purchase of approximately 300 million doses 
of smallpox vaccine, enough for every man, woman, and child in America. 
Equally important, the administration developed a plan to respond in 
the event of an outbreak of the disease. Since the administration 
launched its smallpox vaccination plan on January 24, 2003, over 30,000 
health care workers have been inoculated. To adequately prepare our 
Nation for the possibility of such an attack, however, more health care 
providers must be immunized. Additionally, it is critical that we begin 
vaccinating other emergency personnel, such as law enforcement 
officers, firefighters, and paramedics.
  However, confusion as to the threat posed by the smallpox virus and 
concerns about the safety and potential side-effects of the vaccine, as 
well as the availability of compensation for any vaccine-related 
injuries, have impeded the program's progress. Although severe adverse 
reactions to the smallpox vaccine are very rare, we must ensure that 
health care and emergency workers who suffer such reactions receive 
appropriate medical care and compensation. Moreover, since the smallpox 
vaccine is made up of a live virus, we must also provide protection to 
any family members, patients, and others who are accidentally infected 
by these inoculated workers.
  That is why I introduced the Smallpox Emergency Personnel Protection 
Act of 2003 (S. 313), which I chair. The bill before us reflects the 
bipartisan agreement that was reached after many weeks of hard work and 
long discussions with Republicans, Democrats, and the White House on 
this legislation.
  The Smallpox Emergency Personnel Protection Act would create a ``no 
fault'' system to compensate vaccinated health care and emergency 
workers injured by the smallpox vaccine and other smallpox 
countermeasures, including any persons who accidentally contract 
smallpox from the vaccine. All persons experiencing any adverse events 
from the smallpox vaccine would be reimbursed for all reasonable 
necessary medical expenses and be compensated for lost wages.
  In the rare event of death, the victim's family would receive a 
$262,100 lump-sum benefit payment. If there are any surviving children, 
then the family would have the option of receiving either the lump-sum 
or a $50,000 annual death benefit payment until the children become 18 
years of age.
  Those who become permanently and totally disabled as a result of the 
vaccine could receive up to $50,000 annually in lost wages. Those who 
are temporarily disabled could receive up to $50,000 annually in lost 
wages, up to a lifetime total of $262,100. No such lifetime limit would 
apply in the case of permanent and total disability.
  While those harmed by the smallpox vaccine retain the right to sue 
the federal government for negligence, all vaccine related claims must 
first go through the compensation program. Finally, the legislation 
includes some clarifications of section 304 of the Homeland Security 
Act, to ensure that providers, such as hospitals, doctors, nurses, and 
public healthcare workers, are protected from personal liability in the 
administration of the smallpox vaccine and in caring for infected 
persons.
  The Smallpox Emergency Personnel Protection Act is an important 
element of our national smallpox vaccination program that will help 
ensure its timely implementation. I do hope that the Secretary of 
Health and Human Services will carry out the smallpox vaccination 
program in a manner that appropriately monitors and evaluates newly 
proposed technologies, devices, and other elements of the program, in 
order to assure the safest route of administration. To this end, I 
anticipate that the Secretary will review periodically for possible 
inclusion under the program new and modified technologies, tasks, and 
procedures that may reduce the risks and increase the safety of the 
program and its administration. I understand that the Secretary will 
continue to engage in dialogue with the affected parties and to ensure 
the safe and effective administration of the smallpox vaccine.
  Our Nation's healthcare and emergency workers will be on the front 
line in responding to any smallpox attack. Now, more than ever, we need 
to provide piece-of-mind and security to healthcare and emergency 
workers who volunteer to be vaccinated. This compensation package will 
give these workers the confidence they need to proceed with 
vaccinations. It is imperative that Congress pass the Smallpox 
Emergency Personnel Protection Act as swiftly as possible, so that we 
can ensure that our healthcare and emergency workers and their families 
are protected and that this country is prepared to respond in the event 
of an attack.
  Mr. KENNEDY. Madam President, America faces a crisis because of our 
lack of preparedness for a bioterrorist attack. For months, we've 
worked to develop a fair, reasonable package to end this crisis. Today, 
we can finally say that we have an agreement, and I commend Senator 
Gregg, Senator Frist, Senator Mikulski and all our colleagues on the 
Health Committee for all they've done.
  I also thank the many representatives of nurses and other health 
providers, police officers and fire fighters for working with all of us 
to create a fair compensation program. We have come a long way and 
we're grateful for their intense commitment to this urgent challenge.
  Smallpox is one of the cruelest, most contagious, and deadliest 
diseases ever known. Modern medicine has eradicated this disease in 
nature, but unfortunately is has been preserved as a weapon of war. The 
former Soviet Union weaponized the deadly virus--and control over these 
dangerous biological materials is often weak. Other nations probably 
have stocks of the virus--and none of us can be sure that the virus 
won't find its way into the hands of a terrorist.
  If we remain unprepared, an attack with smallpox could kill vast 
numbers of Americans. Smallpox is deadlier than tanks, or bombs. It is 
more lethal than machine guns or rocket-propelled grenades. It 
threatens the security of every American. We can and must protect our 
country against the use of smallpox as a weapon.
  Vaccination provides almost complete protection against the disease--
but the protection can come at a high price in some cases. For an 
unfortunate few, it can cause serious side effects such as 
encephalitis, blindness or severe infections. Recent deaths after the 
vaccination of civilian and military personnel have raised concern that 
the vaccine may cause heart attacks. The number of people who 
experience these devastating effects is small, so the cost of meeting 
their needs will not be great. But the failure to meet their needs can 
be devastating for them, and devastating for the overall preparedness 
effort.
  At long last, after many negotiations, we can now say that the 
nation's first responders will have an effective compensation program. 
They deserve it and our nation's security demands it.

[[Page S5390]]

  The agreement we have reached ensures that those who participate in 
the vaccination program will receive fair compensation if they suffer 
side effects from the vaccine. The compensation package is 
significantly more generous than the original proposal. Workers who are 
permanently and totally disabled will receive two thirds of their lost 
wages--three quarters if they have dependents--up to $50,000 a year, 
with no lifetime cap on those benefits. Workers who are temporarily or 
partially disabled will receive the same benefit, but with a lifetime 
cap of $262,100--the same cap as for firefighters and police officers. 
The children of anyone who dies as a result of vaccination will be 
eligible for the same benefits as those with permanent and total 
disability until they reach 18 years of age.
  The intent of the bill is that these benefits should be exempt from 
taxation, as in other worker compensation programs, including the 
Public Safety Officers Benefit program. The intent is also that these 
benefits be indexed for inflation.
  The benefits in this plan will go further than in the original plan 
in improving the health of those who are injured. Instead of limiting 
benefits to medical services and items needed only for immediate 
treatment of injury, the plan covers a wider range of medical needs 
including rehabilitative care and palliative care.
  Our agreement also takes the important step of extending eligibility 
for compensation to all workers called upon to receive the vaccine. 
There are no deadlines to coerce persons into signing up for the 
program.
  Thanks to the effective work of Senator Mikulski, the bill now 
includes strong provisions to make sure that the public has adequate 
information about the risks of vaccination, the voluntary nature of the 
program, and the availability of potential benefits and compensation. 
the bill also ensures voluntary screening for potential participants to 
identify health conditions that could put them at risk. Medical follow-
ups will evaluate adverse health effects, and effective screening and 
counselling will reduce them.
  So far, the vaccination plan is faltering. Only a small fraction of 
those who we rely on to protect us--the men and women in our hospitals 
and fire departments and police departments--have been willing to have 
smallpox vaccinations. They know the risks, and they worry that if they 
are injured or killed by the vaccine, they and their families will not 
be compensated adequately.
  That is why it is so important to guarantee help for persons no 
longer able to work as a result of reactions to the smallpox vaccine, 
and to guarantee that their children have financial security as well.
  Under certain circumstances, those who have been vaccinated can 
spread the virus used in the vaccine to others and cause them to become 
ill. Recently, concerns about the safety of the vaccine were raised by 
two heart attack deaths among the 31,000 civilians who have been 
vaccinated, and one heart attack death among the 300,000 military 
personnel who have been vaccinated. Five other civilians suffered heart 
attacks that were not fatal. No one knows whether the heart attacks 
were the result of the vaccine--but they have added new concern about 
the vaccination.
  This agreement is a major step forward. We still have far more to do 
to be fully prepared for bioterrorist attacks, but this agreement is a 
major step forward against what could well be the worst of all 
terrorist attacks, and I urge the Senate to approve it.
  Mr. SUNUNU. Madam President, I ask unanimous consent that the bill be 
read the third time and passed, the motion to reconsider be laid upon 
the table, and that any statements relating to the bill be printed in 
the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill (H.R. 1770) was read the third time and passed.
  Mr. SUNUNU. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. SUNUNU. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Ms. Murkowski). Without objection, it is so 
ordered.

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