[House Report 117-179]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 117-179
======================================================================
MATERNAL VACCINATION ACT
_______
November 30, 2021.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 951]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 951) to direct the Secretary of Health and Human
Services to carry out a national campaign to increase awareness
of the importance of maternal vaccinations for the health of
pregnant and postpartum individuals and their children, and for
other purposes, having considered the same, reports favorably
thereon with an amendment and recommends that the bill as
amended do pass.
CONTENTS
Page
I. Purpose and Summary.............................................2
II. Background and Need for the Legislation.........................2
III. Committee Hearings..............................................3
IV. Committee Consideration.........................................4
V. Committee Votes.................................................4
VI. Oversight Findings..............................................4
VII. New Budget Authority, Entitlement Authority, and Tax Expenditure4
VIII. Congressional Budget Office Estimate............................5
IX. Federal Mandates Statement......................................5
X. Statement of General Performance Goals and Objectives...........6
XI. Duplication of Federal Programs.................................6
XII. Committee Cost Estimate.........................................6
XIII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits.....6
XIV. Advisory Committee Statement....................................6
XV. Applicability to Legislative Branch.............................6
XVI. Section-by-Section Analysis of the Legislation..................6
XVII. Changes in Existing Law Made by the Bill, as Reported...........7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Maternal Vaccination Act''.
SEC. 2. MATERNAL VACCINATION AWARENESS AND EQUITY CAMPAIGN.
(a) Campaign.--Section 313 of the Public Health Service Act (42
U.S.C. 245) is amended--
(1) in subsection (a), by inserting ``and among pregnant and
postpartum individuals,'' after ``low rates of vaccination,'';
(2) in subsection (c)(3), by striking ``prenatal and
pediatric'' and inserting ``prenatal, obstetric, and
pediatric'';
(3) in subsection (d)(4)(B), by inserting ``pregnant and
postpartum individuals and'' after ``including''; and
(4) in subsection (g), by striking the dollar amount and
inserting ``$17,000,000''.
(b) Additional Activities.--Section 317(k)(1)(E) of the Public Health
Service Act (42 U.S.C. 247b(k)(1)(E)) is amended--
(1) in clause (v), by striking ``and'' at the end; and
(2) by adding at the end the following clause:
``(vii) increase vaccination rates of pregnant and
postpartum individuals, including individuals from
racial and ethnic minority groups, and their children;
and''.
I. Purpose and Summary
H.R. 951, the ``Maternal Vaccination Act,'' amends the
Public Health Service Act (PHSA) to require the Secretary of
Health and Human Services (the Secretary) to include outreach
to obstetric care providers and improve efforts to increase
vaccination among pregnant and postpartum individuals in
vaccine public awareness campaigns. The bill also includes
efforts to increase vaccination rates of pregnant and
postpartum individuals as an authorized purpose for preventive
health project grants authorized by the PHSA.
II. Background and Need for Legislation
Vaccinations for individuals during pregnancy can protect
mothers and newborns against infectious diseases.\1\ Antibodies
from vaccines have been shown to protect pregnant women and can
be passed on to newborns, who may be too young to receive
certain vaccines in the first several months of life.\2\ The
Centers for Disease Control and Prevention (CDC) recommend that
pregnant women receive the influenza vaccine and the tetanus
toxoid, reduced diphtheria toxoid, and acellular pertussis
vaccine (Tdap, also known as the whooping cough vaccine). CDC
advises that both vaccines can protect mothers and newborns
from complications of flu and pertussis, illnesses that can
cause serious harm to patients, including early labor and
delivery.\3\ CDC has also extended its recommendation for
vaccination against coronavirus disease of 2019 (COVID-19) to
all pregnant and breastfeeding individuals, citing growing
evidence of the safety and efficacy of COVID-19 vaccination
during pregnancy and the increased risk of severe illness from
COVID-19 for pregnant individuals.\4\
---------------------------------------------------------------------------
\1\U.S. Department of Health and Human Services, Vaccines for
Pregnant Women, (https://www.hhs.gov/immunization/who-and-when/
pregnant/index.html).
\2\Id.
\3\Centers for Disease Control and Prevention, Why Maternal
Vaccines Are Important, (https://www.cdc.gov/vaccines/pregnancy/hcp-
toolkit/important-maternal-vaccines.html).
\4\Centers for Disease Control and Prevention, COVID-19 Vaccines
While Pregnant or Breastfeeding, (https://www.cdc.gov/coronavirus/2019-
ncov/vaccines/recommendations/pregnancy.html).
---------------------------------------------------------------------------
Despite longstanding recommendations for flu and Tdap
vaccination, only 54.5 percent of pregnant individuals reported
receiving a flu vaccine between October 2020 and January 2021,
and 53.5 percent of pregnant individuals reported receiving
Tdap vaccines.\5\ Only 30.7 percent of women with a recent live
birth reported receiving both vaccines.\6\ Among these
individuals, there were significant racial disparities. While
33.3 percent of White women reported receiving both vaccines,
only 17.7 percent of Black women reported receiving both
vaccines.\7\ Other factors correlating with lower flu or Tdap
vaccination rates included living below the federal poverty
level, living in the South, being without prenatal insurance,
and attaining lower levels of education.\8\
---------------------------------------------------------------------------
\5\Centers for Disease Control and Prevention, Flu and Tdap
Vaccination Coverage Among Pregnant Women--United States, April 2021,
(https://www.cdc.gov/flu/fluvaxview/pregnant-women-apr2021.htm).
\6\Id.
\7\Id.
\8\Id.
---------------------------------------------------------------------------
The COVID-19 vaccine also has low uptake among pregnant
individuals. According to recent data from CDC, only 31 percent
of pregnant individuals have been vaccinated against COVID-19.
Rates are lower among Latino pregnant individuals, 25 percent
of whom have been vaccinated against COVID-19, and lower still
among Black pregnant individuals, at only 15.6 percent.\9\
---------------------------------------------------------------------------
\9\Centers for Disease Control and Prevention, CDC Statement on
Pregnancy Health Advisory, (https://www.cdc.gov/media/releases/2021/
s0929-pregnancy-health-advisory.html).
---------------------------------------------------------------------------
Care providers, especially obstetric care providers, have
been shown to play an important role in ensuring pregnant
individuals receive recommended vaccines. According to the
American College of Obstetricians and Gynecologists, when a
recommendation for vaccination comes directly from an obstetric
care provider during pregnancy, the odds of vaccine acceptance
and receipt are five-fold to 50-fold higher.\10\
---------------------------------------------------------------------------
\10\American College of Obstetricians and Gynecologists, Committee
Opinion on Maternal Immunization, (https://www.acog.org/clinical/
clinical-guidance/committee-opinion/articles/2018/06/maternal-
immunization).
---------------------------------------------------------------------------
H.R. 951 aims to improve vaccination among pregnant and
postpartum individuals by incorporating outreach to obstetric
care providers and pregnant and postpartum individuals in
existing federal vaccine awareness campaigns. The bill would
also include efforts to vaccinate pregnant and postpartum
individuals, including individuals from racial and ethnic
minority groups, and their children, as an authorized purpose
for prevention grants authorized by the Public Health Service
Act.
III. Committee Hearings
For the purposes of section 3(c) of rule XIII of the Rules
of the House of Representatives, the following hearing was used
to develop or consider H.R. 951:
The Subcommittee on Health held a legislative hearing on
June 15, 2021, entitled ``Booster Shot: Enhancing Public Health
through Vaccine Legislation.'' The Subcommittee received
testimony from the following witnesses:
Phyllis Arthur, Vice President, Infectious
Diseases and Emerging Science Policy, Biotechnology
Innovation Organization;
Rebecca Coyle, Executive Director, American
Immunization Registry Association;
Yvonne Maldonado, M.D., Chair, Committee on
Infectious Diseases, American Academy of Pediatrics;
and
Lijen (L.J.) Tan, Ph.D., Chief Strategy
Officer, Immunization Action Coalition.
IV. Committee Consideration
H.R. 951, the ``Maternal Vaccination Act,'' was introduced
on February 8, 2021, by Representative Terri Sewell (D-AL)
along with 44 original cosponsors and referred to the Committee
on Energy and Commerce. Subsequently, on February 9, 2021, H.R.
951 was referred to the Subcommittee on Health. A legislative
hearing was held on the bill on June 15, 2021.
On July 15, 2021, the Subcommittee on Health met in open
markup session, pursuant to notice, to consider H.R. 951 and 18
other bills. During consideration of the bill, an amendment in
the nature of a substitute (AINS) offered by Representative
Barragan (D-CA) was agreed to by a voice vote. Upon conclusion
of consideration of the bill, the Subcommittee on Health agreed
to report the bill favorably to the full Committee, amended, by
a voice vote.
On July 21, 2021, the full Committee met in open markup
session, pursuant to notice, to consider H.R. 951 and 23 other
bills. No amendments were offered during consideration of the
bill. Upon conclusion of consideration of the bill, the full
Committee agreed to a motion on final passage offered by
Representative Pallone (D-NJ), Chairman of the Committee, to
order H.R. 951 reported favorably to the House, as amended, by
a voice vote.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
951.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
VIII. Congressional Budget Office Estimate
U.S. Congress,
Congressional Budget Office,
Washington, DC, September 21, 2021.
Hon. Frank Pallone Jr.,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 951, the Maternal
Vaccination Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Sarah
Sajewski.
Sincerely,
Phillip L. Swagel,
Director.
Enclosure.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
H.R. 951 would instruct the Centers for Disease Control and
Prevention to broaden a public awareness campaign on
vaccinations to include pregnant and postpartum individuals and
require the campaign to disseminate vaccine information to
providers and facilities that provide obstetric care. The bill
would also authorize an additional $2 million annually from
2021 through 2025 for the vaccination awareness campaign.
For this estimate, CBO assumes H.R. 951 will be enacted
near the beginning of fiscal year 2022. Based on historical
spending for similar activities, CBO estimates that
implementing H.R. 951 would increase federal spending by $7
million over the 2022-2026 period, subject to the availability
of appropriated funds.
The CBO staff contact for this estimate is Sarah Sajewski.
The estimate was reviewed by Leo Lex, Deputy Director of Budget
Analysis.
IX. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
X. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to support
efforts to increase vaccination rates among pregnant and
postpartum individuals and their children.
XI. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 951 is known to be duplicative of another Federal program,
including any program that was included in a report to Congress
pursuant to section 21 of Public Law 111-139 or the most recent
Catalog of Federal Domestic Assistance.
XII. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XIII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 951 contains no earmarks, limited tax
benefits, or limited tariff benefits.
XIV. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the Act may be cited as the
``Maternal Vaccination Act.''
Sec. 2. Maternal vaccination awareness and equity campaign
Section 2 amends Section 313 of the PHSA, relating to a
public awareness campaign on the importance of vaccinations, to
direct the Secretary to incorporate efforts directed toward
pregnant and postpartum individuals into such campaign.
Section 2 further amends PHSA section 313 by requiring the
Secretary to disseminate information to obstetric care
providers and authorizing the Secretary to directly disseminate
scientific and evidence-based vaccine-related information to
pregnant and postpartum individuals.
Additionally, section 2 amends PHSA section 317(k),
relating to grants for addressing vaccine-preventable diseases,
to include efforts to increase vaccination rates among
postpartum individuals, including individuals from racial and
ethnic minority groups, and their children, as an authorized
purpose of such grants.
To account for increased activities authorized by the
Maternal Vaccination Act, section 2 increases the authorization
for PHSA sections 313, 317(k), and 317(n) related to
vaccination data from $15 million annually to $17 million
annually for each of fiscal years 2021 through 2025.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part B--Federal-State Cooperation
* * * * * * *
SEC. 313. PUBLIC AWARENESS CAMPAIGN ON THE IMPORTANCE OF VACCINATIONS.
(a) In General.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention and in
coordination with other offices and agencies, as appropriate,
shall award competitive grants or contracts to one or more
public or private entities to carry out a national, evidence-
based campaign to increase awareness and knowledge of the
safety and effectiveness of vaccines for the prevention and
control of diseases, combat misinformation about vaccines, and
disseminate scientific and evidence-based vaccine-related
information, with the goal of increasing rates of vaccination
across all ages, as applicable, particularly in communities
with low rates of vaccination, and among pregnant and
postpartum individuals, to reduce and eliminate vaccine-
preventable diseases.
(b) Consultation.--In carrying out the campaign under this
section, the Secretary shall consult with appropriate public
health and medical experts, including the National Academy of
Medicine and medical and public health associations and
nonprofit organizations, in the development, implementation,
and evaluation of the evidence-based public awareness campaign.
(c) Requirements.--The campaign under this section shall--
(1) be a nationwide, evidence-based media and public
engagement initiative;
(2) include the development of resources for
communities with low rates of vaccination, including
culturally and linguistically appropriate resources, as
applicable;
(3) include the dissemination of vaccine information
and communication resources to public health
departments, health care providers, and health care
facilities, including such providers and facilities
that provide [prenatal and pediatric] prenatal,
obstetric, and pediatric care;
(4) be complementary to, and coordinated with, any
other Federal, State, local, or Tribal efforts, as
appropriate; and
(5) assess the effectiveness of communication
strategies to increase rates of vaccination.
(d) Additional Activities.--The campaign under this section
may--
(1) include the use of television, radio, the
internet, and other media and telecommunications
technologies;
(2) include the use of in-person activities;
(3) be focused to address specific needs of
communities and populations with low rates of
vaccination; and
(4) include the dissemination of scientific and
evidence-based vaccine-related information, such as--
(A) advancements in evidence-based research
related to diseases that may be prevented by
vaccines and vaccine development;
(B) information on vaccinations for
individuals and communities, including pregnant
and postpartum individuals and individuals for
whom vaccines are not recommended by the
Advisory Committee for Immunization Practices,
and the effects of low vaccination rates within
a community on such individuals;
(C) information on diseases that may be
prevented by vaccines; and
(D) information on vaccine safety and the
systems in place to monitor vaccine safety.
(e) Evaluation.--The Secretary shall--
(1) establish benchmarks and metrics to
quantitatively measure and evaluate the awareness
campaign under this section;
(2) conduct qualitative assessments regarding the
awareness campaign under this section; and
(3) prepare and submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and
Committee on Energy and Commerce of the House of
Representatives an evaluation of the awareness campaign
under this section.
(f) Supplement Not Supplant.--Funds appropriated under this
section shall be used to supplement and not supplant other
Federal, State, and local public funds provided for activities
described in this section.
(g) Authorization of Appropriations.--There are authorized to
be appropriated to carry out this section and subsections (k)
and (n) of section 317, [$15,000,000] $17,000,000 for each of
fiscal years 2021 through 2025.
* * * * * * *
project grants for preventive health services
Sec. 317. (a) The Secretary may make grants to States, and in
consultation with State health authorities, to political
subdivisions of States and to other public entities to assist
them in meeting the costs of establishing and maintaining
preventive health service programs.
(b) No grant may be made under subsection (a) unless an
application therefor has been submitted to, and approved by,
the Secretary. Such an application shall be in such form and be
submitted in such manner as the Secretary shall by regulation
prescribe and shall provide--
(1) a complete description of the type and extent of
the program for which the applicant is seeking a grant
under subsection (a);
(2) with respect to each such program (A) the amount
of Federal, State, and other funds obligated by the
applicant in its latest annual accounting period for
the provision of such program, (B) a description of the
services provided by the applicant in such program in
such period, (C) the amount of Federal funds needed by
the applicant to continue providing such services in
such program, and (D) if the applicant proposes changes
in the provision of the services in such program, the
priorities of such proposed changes, reasons for such
changes, and the amount of Federal funds needed by the
applicant to make such changes;
(3) assurances satisfactory to the Secretary that the
program which will be provided with funds under a grant
under subsection (a) will be provided in a manner
consistent with the State health plan in effect under
section 1524(c) and in those cases where the applicant
is a State, that such program will be provided, where
appropriate, in a manner consistent with any plans in
effect under an application approved under section 315;
(4) assurances satisfactory to the Secretary that the
applicant will provide for such fiscal control and fund
accounting procedures as the Secretary by regulation
prescribes to assure the proper disbursement of and
accounting for funds received under grants under
subsection (a);
(5) assurances satisfactory to the Secretary that the
applicant will provide for periodic evaluation of its
program or programs;
(6) assurances satisfactory to the Secretary that the
applicant will make such reports (in such form and
containing such information as the Secretary may by
regulation prescribe) as the Secretary may reasonably
require and keep such records and afford such access
thereto as the Secretary may find necessary to assure
the correctness of, and to verify, such reports;
(7) assurances satisfactory to the Secretary that the
applicant will comply with any other conditions imposed
by this section with respect to grants; and
(8) such other information as the Secretary may by
regulation prescribe.
(c)(1) The Secretary shall not approve an application
submitted under subsection (b) for a grant for a program for
which a grant was previously made under subsection (a) unless
the Secretary determines--
(A) the program for which the application was
submitted is operating effectively to achieve its
stated purpose,
(B) the applicant complied with the assurances
provided the Secretary when applying for such previous
grant, and
(C) the applicant will comply with the assurances
provided with the application.
(2) The Secretary shall review annually the activities
undertaken by each recipient of a grant under subsection (a) to
determine if the program assisted by such grant is operating
effectively to achieve its stated purposes and if the recipient
is in compliance with the assurances provided the Secretary
when applying for such grant.
(d) The amount of a grant under subsection (a) shall be
determined by the Secretary. Payments under such grants may be
made in advance on the basis of estimates or by the way of
reimbursement, with necessary adjustments on account of
underpayments or overpayments, and in such installments and on
such terms and conditions as the Secretary finds necessary to
carry out the purposes of such grants.
(e) The Secretary, at the request of a recipient of a grant
under subsection (a), may reduce the amount of such grant by--
(1) the fair market value of any supplies (including
vaccines and other preventive agents) or equipment
furnished the grant recipient, and
(2) the amount of the pay, allowances, and travel
expenses of any officer or employee of the Government
when detailed to the grant recipient and the amount of
any other costs incurred in connection with the detail
of such officer or employee.
When the furnishing of such supplies or equipment or the detail
of such an officer or employee is for the convenience of and at
the request of such grant recipient and for the purpose of
carrying out a program with respect to which the grant under
subsection (a) is made. The amount by which any such grant is
so reduced shall be available for payment by the Secretary of
the costs incurred in furnishing the supplies or equipment, or
in detailing the personnel, on which the reduction of such
grant is based, and such amount shall be deemed as part of the
grant and shall be deemed to have been paid to the grant
recipient.
(f)(1) Each recipient of a grant under subsection (a) shall
keep such records as the Secretary shall by regulation
prescribe, including records which fully disclose the amount
and disposition by such recipient of the proceeds of such
grant, the total cost of the undertaking in connection with
which such grant was made, and the amount of that portion of
the cost of the undertaking supplied by other sources, and such
other records as will facilitate an effective audit.
(2) The Secretary and the Comptroller General of the United
States, or any of their duly authorized representatives, shall
have access for the purpose of audit and examination to any
books, documents, papers, and records of the recipient of
grants under subsection (a) that are pertinent to such grants.
(g)(1) Nothing in this section shall limit or otherwise
restrict the use of funds which are granted to a State or to an
agency or a political subdivision of a State under provisions
of Federal law (other than this section) and which are
available for the conduct of preventive health service programs
from being used on connection with programs assisted through
grants under subsection (a).
(2) Nothing in this section shall be construed to require any
State or any agency or political subdivision of a State to have
a preventive health service program which would require any
person, who objects to any treatment provided under such a
program, to be treated or to have any child or ward treated
under such program.
(h) The Secretary shall include, as part of the report
required by section 1705, a report on the extent of the
problems presented by the diseases and conditions referred to
in subsection (j) on the amount of funds obligated under grants
under subsection (a) in the preceding fiscal year for each of
the programs listed in subsection (j); and on the effectiveness
of the activities assisted under grants under subsection (a) in
controlling such diseases and conditions.
(i) The Secretary may provide technical assistance to States,
State health authorities, and other public entities in
connection with the operation of their preventive health
service programs.
(j)(1) Except for grants for immunization programs the
authorization of appropriations for which are established in
paragraph (2), for grants under subsections (a) and (k)(1) for
preventive health service programs to immunize without charge
children, adolescents, and adults against vaccine-preventable
diseases, there are authorized to be appropriated such sums as
may be necessary. Not more than 10 percent ot the total amount
appropriated under the preceding sentence for any fiscal year
shall be available for grants under subsection (k)(1) for such
fiscal year.
(2) For grants under subsection (a) for preventive health
service programs for the provision without charge of
immunizations with vaccines approved for use, and recommended
for routine use, there are authorized to be appropriated such
sums as may be necessary.
(k)(1) The Secretary may make grants to States, political
subdivisions of States, and other public and nonprofit private
entities for--
(A) research into the prevention and control of
diseases that may be prevented through vaccination;
(B) demonstration projects for the prevention and
control of such diseases;
(C) public information and education programs for the
prevention and control of such diseases;
(D) education, training, and clinical skills
improvement activities in the prevention and control of
such diseases for health professionals (including
allied health personnel);
(E) planning, implementation, and evaluation of
activities to address vaccine-preventable diseases,
including activities to--
(i) identify communities at high risk of
outbreaks related to vaccine-preventable
diseases, including through improved data
collection and analysis;
(ii) pilot innovative approaches to improve
vaccination rates in communities and among
populations with low rates of vaccination;
(iii) reduce barriers to accessing vaccines
and evidence-based information about the health
effects of vaccines;
(iv) partner with community organizations and
health care providers to develop and deliver
evidence-based interventions, including
culturally and linguistically appropriate
interventions, to increase vaccination rates;
(v) improve delivery of evidence-based
vaccine-related information to parents and
others; [and]
(vi) improve the ability of State, local,
Tribal, and territorial public health
departments to engage communities at high risk
for outbreaks related to vaccine-preventable
diseases, including, as appropriate, with local
educational agencies, as defined in section
8101 of the Elementary and Secondary Education
Act of 1965; and
(vii) increase vaccination rates of pregnant
and postpartum individuals, including
individuals from racial and ethnic minority
groups, and their children; and
(F) research related to strategies for improving
awareness of scientific and evidence-based vaccine-
related information, including for communities with low
rates of vaccination, in order to understand barriers
to vaccination, improve vaccination rates, and assess
the public health outcomes of such strategies.
(2) The Secretary may make grants to States, political
subdivisions of States, and other public and nonprofit private
entities for--
(A) research into the prevention and control of
diseases and conditions;
(B) demonstration projects for the prevention and
control of such diseases and conditions;
(C) public information and education programs for the
prevention and control of such diseases and conditions;
and
(D) education, training, and clinical skills
improvement activities in the prevention and control of
such diseases and conditions for health professionals
(including allied health personnel).
(3) No grant may be made under this subsection unless an
application therefor is submitted to the Secretary in such
form, at such time, and containing such information as the
Secretary may by regulation prescribe.
(4) Subsections (d), (e), and (f) shall apply to grants under
this subsection in the same manner as such subsections apply to
grants under subsection (a).
(l) Authority to Purchase Recommended Vaccines for Adults.--
(1) In general.--The Secretary may negotiate and
enter into contracts with manufacturers of vaccines for
the purchase and delivery of vaccines for adults as
provided for under subsection (e).
(2) State purchase.--A State may obtain additional
quantities of such adult vaccines (subject to amounts
specified to the Secretary by the State in advance of
negotiations) through the purchase of vaccines from
manufacturers at the applicable price negotiated by the
Secretary under this subsection.
(m) Demonstration Program To Improve Immunization Coverage.--
(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and
Prevention, shall establish a demonstration program to
award grants to States to improve the provision of
recommended immunizations for children, adolescents,
and adults through the use of evidence-based,
population-based interventions for high-risk
populations.
(2) State plan.--To be eligible for a grant under
paragraph (1), a State shall submit to the Secretary an
application at such time, in such manner, and
containing such information as the Secretary may
require, including a State plan that describes the
interventions to be implemented under the grant and how
such interventions match with local needs and
capabilities, as determined through consultation with
local authorities.
(3) Use of funds.--Funds received under a grant under
this subsection shall be used to implement
interventions that are recommended by the Task Force on
Community Preventive Services (as established by the
Secretary, acting through the Director of the Centers
for Disease Control and Prevention) or other evidence-
based interventions, including--
(A) providing immunization reminders or
recalls for target populations of clients,
patients, and consumers;
(B) educating targeted populations and health
care providers concerning immunizations in
combination with one or more other
interventions;
(C) reducing out-of-pocket costs for families
for vaccines and their administration;
(D) carrying out immunization-promoting
strategies for participants or clients of
public programs, including assessments of
immunization status, referrals to health care
providers, education, provision of on-site
immunizations, or incentives for immunization;
(E) providing for home visits that promote
immunization through education, assessments of
need, referrals, provision of immunizations, or
other services;
(F) providing reminders or recalls for
immunization providers;
(G) conducting assessments of, and providing
feedback to, immunization providers;
(H) any combination of one or more
interventions described in this paragraph; or
(I) immunization information systems to allow
all States to have electronic databases for
immunization records.
(4) Consideration.--In awarding grants under this
subsection, the Secretary shall consider any reviews or
recommendations of the Task Force on Community
Preventive Services.
(5) Evaluation.--Not later than 3 years after the
date on which a State receives a grant under this
subsection, the State shall submit to the Secretary an
evaluation of progress made toward improving
immunization coverage rates among high-risk populations
within the State.
(6) Report to congress.--Not later than 4 years after
the date of enactment of the Affordable Health Choices
Act, the Secretary shall submit to Congress a report
concerning the effectiveness of the demonstration
program established under this subsection together with
recommendations on whether to continue and expand such
program.
(7) Authorization of appropriations.--There is
authorized to be appropriated to carry out this
subsection, such sums as may be necessary for each of
fiscal years 2010 through 2014.
(n) Vaccination Data.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall expand and enhance, and, as appropriate, establish and
improve, programs and conduct activities to collect, monitor,
and analyze vaccination coverage data to assess levels of
protection from vaccine-preventable diseases, including by
assessing factors contributing to underutilization of vaccines
and variations of such factors, and identifying communities at
high risk of outbreaks associated with vaccine-preventable
diseases.
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