Senate Committees Hold Hearings
on Smallpox Vaccinations
January 31, 2003 - The Senate Labor, Health and Human
Services, and Education Appropriations Subcommittee and the
Senate Health, Education Labor, and Pensions Committee held
hearings Jan. 29 and Jan. 30, respectively, on the federal
smallpox vaccination plan. The Centers for Disease Control
and Prevention (CDC) Director Julie L. Gerberding, M.D., M.P.H.,
and National Institute on Allergy and Infectious Diseases
(NIAID) Director Anthony S. Fauci, M.D., testified at both
hearings on the progress and the future of the program. Witnesses
representing a variety of health care interests expressed
concerns on a number of issues related to implementation of
the smallpox vaccination plan: liability protections for providers,
institutions and manufacturers; compensation for workers for
time lost due to side effects from the vaccine; cost of administering
and monitoring the vaccine; seriousness of the adverse effects;
and the impact on the overall public health system.
Dr. Gerberding announced that 20 states have requested doses
of the vaccine, and the CDC delivered kits the week of Jan.
20 to Connecticut, Nebraska, Vermont and Los Angeles County.
She emphasized that the initial doses are for health care
workers who will be part of the Smallpox Response Teams that
will provide critical services in case of an attack. She also
stressed that the federal government is not recommending that
members of the general public be vaccinated at this time.
Responding to questions from Senate Labor-HHS Appropriations
Subcommittee Chairman Arlen Specter (R-Pa.), Dr. Gerberding
described the ongoing training for providers and monitoring
of the adverse events by the Data Safety Monitoring Board.
Other witnesses' testimony focused on the need to bolster
compensation plans for workers, as state and private workers'
compensation plans are not sufficient to cover health care
expenses or lost wages if the vaccination has serious side
effects. Senate HELP Committee Chairman Judd Gregg (R-N.H.)
vowed to introduce legislation with Ranking Member Edward
Kennedy (D-Mass.) and Senate Majority Leader Bill Frist (R-Tenn.)
addressing the compensation issue. Sen. Gregg stated his belief
that Section 304 of legislation establishing the Department
of Homeland Security (P.L.
107-296) provided all health care providers and vaccine
manufacturers with liability protections, but he agreed to
examine the issue further.
Public health representatives expressed concern that the
cost of the vaccination plan would drain resources from other
public health functions. Dr. Gerberding estimated vaccinations
(including administering the injection and monitoring the
patient) to cost $13 per person, while National Association
of City and County Health Officials (NACCHO) Executive Director
Patrick Libbey projected the cost to be at least $100 per
person, and more expensive in rural areas. Dr. Gerberding
conceded that the $918 million awarded to states in June 2002
for bioterrorism preparedness and another $918 million to
be released in August 2003 may not fill all the gaps in funding.
Senator Jack Reed (D-R.I.) and others called for additional
aid for states as they struggle to fulfill the federal smallpox
plan.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Office of Governmental Relations
efroyd@aamc.org
(202) 828-0525
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