[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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