 2003 AJN Table of Contents
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Washington Watch
American Journal of Nursing -
April, 2003 - Volume 103, Issue 4
Smallpox Legislation Introduced
Bill’s sponsors hope to ease fears of vaccination.
As President Bush’s smallpox inoculation program gets under
way—without the momentum expected when it was launched January
24—health officials and lawmakers have been taxed by the
vaccine’s uncertainties. One month after the program began, slightly
more than 4,000 of the 500,000 people targeted nationwide, or less than 1%,
have been inoculated, according to the Washington
Post. By March 5, the number was slightly more
than 12,600, according to the Centers for Disease Control and Prevention
(CDC).
To alleviate the concerns of those facing the prospect
of a smallpox vaccine, Representative Henry Waxman (D-CA) has introduced HR
865, Smallpox Vaccine Compensation and Safety Act of 2003, which would
establish a program to compensate those who may suffer adverse effects from
the vaccine. “My goal is the same as that of the president: to
enhance the ability of the United States to defend itself against a
bioterrorist attack,” Waxman said.
Few have chosen vaccination because of possible mild
to serious adverse effects, including death. Experts estimate that 1,000 in
1 million who receive the vaccine will experience serious adverse
effects—about 40 of those will be life threatening—and one or
two will die.
Also on March 5, the Department of Health and
Human Services (DHHS) released a proposal that would address compensation
for health care workers who suffer serious temporary or permanent adverse
effects or who die from the vaccine (or those who accidentally contract the
virus from another).
Coverage for permanent disability or death would be
capped at $262,100. Temporary or partial disability benefits would be paid
at two-thirds of lost wages only after losing five days of work. Claims
would be capped at $50,000. Congress must still approve the legislation.
ANA president Barbara A. Blakeney, MS, APRN,BC, ANP,
believes this legislation falls short in addressing the ANA’s
concerns.
“This compensation plan is solely focused on
worst-case scenarios and does nothing to address the more common scenarios
where individuals experience side effects that would cause them to lose
less than five days of work,” Blakeney said. “We, like many
other health care organizations, cannot fully support the vaccination
program at this time.”
Administration officials previously suggested that
existing workers’ compensation programs could cover those who may
suffer adverse effects from the vaccine. However, many critics agree this
is inadequate. An Association of State and Territorial Health Officials
(ASTHO) survey showed states differ on how to compensate workers who may
experience an adverse reaction to the vaccination. Some state programs
don’t cover vaccine adverse effects, others provide insufficient
compensation, and none cover those who become ill from contact with someone
who has been vaccinated.
Some of the major points of Waxman’s bill are:
grants to states
to help them meet the costs of the smallpox vaccination program.
“I am concerned that the $262,000 won’t
adequately compensate a family who loses its sole breadwinner either
because he or she died or has been completely disabled,” Waxman said.
The ANA has called Waxman’s bill one of the most
comprehensive approaches to addressing the shortcomings of the vaccination
program and will continue to work with Waxman and the DHHS to ensure that
the most effective measures are taken to minimize the risk of the
vaccine’s effects on nurses and others.
safer needles.
States would be required to provide FDA-approved sheathed, bifurcated needles.
the National Smallpox Vaccine Injury
Compensation Program.
For those who suffer adverse effects or who may become infected by someone who has been
vaccinated.
protection from discrimination
against a worker who declines the vaccination.
medical leave for certain vaccine recipients.
Waxman vows to continue his efforts to find a
bipartisan solution that the administration will support, but he has some
reservations about the new program.
Chris Donnellan is an associate director in the ANA’s Department of Government Affairs.
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