House Rejects Measure to Compensate Sufferers of Smallpox Vaccine Side Effects

The House late March 31 failed to pass a bill (H.R. 1463) that would provide compensation for workers and others who receive the smallpox vaccine and subsequently suffer side effects.

The vote took place under the suspension of the rules procedure, which requires a two-thirds majority. Voting on the bill was 206-184.

The intent of the bill was to get more health care workers and first responders to voluntarily receive the vaccination.

House Republicans now will be forced to go back and negotiate with Democrats on a compensation program that would be more widely acceptable.

So far, only an estimated 20,000 of some 450,000 people whom the Bush administration had hoped would volunteer to be vaccinated have received the vaccination. This tepid response prompted the White House to seek fast enactment of legislation compensating those who suffer side effects from the vaccines.

Both Parties Want Program

Both Republicans and Democrats favor the establishment of a compensation program for workers who volunteer to receive the smallpox vaccine under an antibioterrorism plan initiated by the Bush administration in January 2003. However, the parties have clashed in both the House and Senate on what level of compensation to offer, whether the funding should be mandatory or discretionary, and a number of other issues.

In the Senate, Judd Gregg (R-N.H.), chairman of the Health Education, Labor and Pension Committee introduced (S. 15) March 12, which would amend the Public Health Service Act and create a no-fault system to compensate injured health care workers, emergency responders, or people who contract smallpox through secondary infection (33 OSHR 264 , 3/20/03).

The bill that failed to pass the House, sponsored by Rep. Richard Burr (R-N.C.), was very similar to Gregg's bill and would have set a lifetime cap of lost wages compensation at $262,100, with no compensation for the first five days of missed work. Until the $262,100 cap had been met, the program would have paid 66.6 percent of actual lost wages--75 percent for those with dependents--subject to an annual cap of $50,000. Funding to compensate those injured by the vaccine would have been subject to annual appropriations.

Democrats Sought Alternative

Democrats, led by Rep. Lois Capps (D-Calif.) and Henry Waxman (D-Calif.), had sought to offer on the floor an alternative to the Republican bill. Their substitute would have placed no lifetime cap on wage replacement. Compensation for temporary disability would have included unreimbursed medical costs and 66.6 percent of unreimbursed lost wages. The percentage would have risen to 75 percent for people with dependents. The yearly cap on wage replacement would have been set at $75,000. Funding to compensate injured workers would have been mandatory under the Democrats' plan, a key sticking point in talks between the parties on how to craft a compensation program.

Democrats and first responder groups complained March 31 that the Republican bill provided no grants to states to screen and educate those who potentially would receive the vaccine.

During floor debate, House Energy and Commerce Committee Chairman W.J. (Billy) Tauzin (R-La.) defended the substance of the bill and defended Republicans' decision to bring it up on the House suspension calendar. Tauzin charged that Democrats continued to raise the bar in negotiations, even after Republicans made changes in Burr's bill to address their concerns. He acknowledged that some of the first responder groups wanted higher compensation for the risks associated with the vaccine, but said: "This is not a management-labor union discussion. This is an emergency."

Problems Arise From Smallpox Vaccine

The U.S. Centers for Disease Control and Prevention accepted a recommendation March 31 by the Advisory Committee on Immunization Practices that volunteers be excluded from the smallpox vaccination program if they have known underlying heart disease, with or without symptoms, or if they have three or more known major cardiac risk factors--hypertension, diabetes, high cholesterol, and smoking.

As a result, a handful of states have suspended their smallpox vaccination programs in light of recent reports of deaths among workers who were administered the vaccine.

Arizona, California, Illinois, Maine, Michigan, Nevada, New York and Vermont have suspended their vaccination programs until investigations are completed. In addition, the Wisconsin Federation of Nurses and Health Care Professionals have asked Gov. Jim Doyle (D) to suspend smallpox inoculations there.

On March 25, the Centers for Disease Control and Prevention announced that heart disease is grounds for a medical deferral from receiving the smallpox vaccine. According to CDC, seven health care workers who were inoculated experienced heart-related problems including heart attacks, which have led to two deaths.

Five of the victims were women in their 50s who worked in either a health care facility or within the public health system (33 OSHR 286, 3/27/03).

Federal officials have estimated that for every 1 million people who receive the smallpox vaccination, one to two deaths and an additional 14 to 52 life-threatening events can be expected.

Copyright © 2003 by The Bureau of National Affairs, Inc., Washington D.C.