Congress passes smallpox vaccine compensation plan

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Apr 14, 2003 (CIDRAP News) – Congress, acting to remove a major barrier to the government's smallpox vaccination program, has passed a more generous compensation plan for those harmed by the vaccine than the one originally proposed by the Bush administration.

The plan approved Friday, Apr 11, provides the dependent families of people who die as a result of the vaccine with up to $50,000 a year to replace lost wages until the victim's youngest child reaches age 18. People who are permanently and totally disabled will get up to $50,000 a year for lost wages until they are 65.

The administration proposal, announced early in March, would have provided a lump sum of $262,100 to those suffering permanent total disability and to the families of those who die because of the vaccine.

The compensation plan was passed less than a day after Democrats and the Bush administration reached a compromise the evening of Apr 10, according to Associated Press and New York Times reports. The compromise was negotiated by Sen. Edward Kennedy, D-Mass., and White House Chief of Staff Andrew Card, according to the AP.

The plan also provides that those who suffer temporary disability or permanent partial disability could collect lost wages up to $262,100, according to the AP. The original proposal set a ceiling of $50,000 and didn't pay anything for the first 5 days of work missed. Under the approved plan, a person who misses 10 or more days of work will get paid for all the missed days.

Another provision says that if someone with no dependents dies as a result of the vaccine, his or her family will receive a lump sum of $262,100.

The Bush plan would have required people to be vaccinated within 180 days to be eligible for compensation, but the compromise plan dropped that rule.

The American Public Health Association (APHA) praised the compensation package on several counts, while the American Nurses Association (ANA) gave it a lukewarm endorsement.

The APHA said the plan offers "a more appropriate level of compensation" for workers and the families of workers harmed by the vaccine. "Raising the cap on wage replacement compensation from a total of $50,000 to $50,000 per year for those who are permanently disabled is a significant improvement that will go a long way to ensure that the children of vaccinees are protected should a serious adverse event related to the vaccination render the individual unable to work," said Georges P. Benjamin, MD, APHA executive director.

The compromise plan "also recognizes the need to bolster education, screening and referral efforts by authorizing grants to states," Benjamin said. "We are pleased that as a first step, the emergency supplemental appropriations bill includes a down payment on this grant program."

The ANA called the plan a positive step but said it doesn't provide for adequate education and screening to help prevent vaccination complications. ANA President Barbara A. Blakeney said that in the US military vaccination program, troops have "rightly received personalized education and free and confidential prescreening" before getting smallpox shots, a process that "properly screened out one third of the potential recipients. But Congress' final legislative package [for civilians] still does not ensure that nurses and other health care workers will receive similar support."

Blakeney also said that if a nurse were permanently disabled by the vaccine, wage replacement would end at age 65 and she or he would have to rely on Medicare and Social Security from then on.

About 31,000 public health and healthcare workers had been vaccinated in the civilian smallpox preparedness program as of last week. Plans call for vaccinating a total of about 439,000 workers to serve on smallpox resonse teams.

See also:

Text of legislation on the Library of Congress' Thomas site (search H.R. 1770)
http://thomas.loc.gov/

ANA news release
http://www.indiananurses.org/news/smallpox_legislation_print.htm

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