Smallpox Vaccination Plan

Senate Health, Education, Labor and Pensions Committee

I would like to thank all of our witnesses for taking the time to come here today to discuss the implementation of the Administration's smallpox vaccination plan.

While smallpox no longer occurs naturally, some in the intelligence community are concerned that countries like Iraq and North Korea may possess samples of the virus. Highly contagious and easily dispersed in thesmallpox virus can be a deadly weapon in terrorist hands.

Congress and the Administration have responded to this potential threat by purchasing 300 million doses of smallpox vaccine and by developing a plan to protect the American people against such an attack.

In accordance with this plan, the smallpox vaccine would be offered to 500,000 health care workers, expand to 10 million emergency responders, and extend to the rest of the population as early as 2004.

As a strong advocate for making the smallpox vaccine available to the general public, I think the plan was thoughtful and on the mark. Americans, after consulting with their doctors, should be allowed to make voluntary, informed decisions to receive the vaccine for themselves and their families.

The more people who are vaccinated against smallpox, the lower the rate of transmission of the disease, and the greater likelihood that such an outbreak could be contained. Also, the fewer people who are susceptible to the disease, the less likely an enemy is to use it against us.

Health care worker vaccinations began on Friday, January 24. The National Institute for Allergy and Infectious Diseases, the CDC, and its state and local partners should be commended for planning the pre-event smallpox vaccination program and for helping it become operational so quickly.

As with any comprehensive program rolled out under such exigent circumstances, there are some questions and concerns.
These areas include logistics; provider education and training, including screening for contraindications and treating adverse reactions; and preventing the vaccine's inadvertent transmission.

There has also been no pediatric testing of the smallpox vaccine - only on adults. Most adults don't want the vaccine for themselves, so much as to protect their children. Children are not small adults, and we need to make sure that our stocks of smallpox vaccine are safe and effective for children - notwithstanding recent positive testing in adults.

I am also sympathetic to the concerns of our health care and emergency workers who volunteer to be vaccinated. They will be on the front line in responding to any smallpox attack, and we must ensure that their health and safety is protected, and that persons who suffer serious adverse reactions to the vaccine have appropriate recourse.

While some have called for a new federal "no fault" workers' compensation program to cover smallpox-vaccine related injuries, we need to remember that states already have such systems already in place.

Vaccinated workers are not the only group of people who could be injured; co-workers, family members, patients, and others could become infected inadvertently. These persons could not file a claim under any state workers' compensation program.

I'm looking forward to hearing our witnesses on this issue, and will continue to work with the Administration, my friends across the aisle - and especially our health care and emergency workers - to address this important issue.

We need to ensure that the children and families of these workers are protected.

Finally, we need to know what Congress must do to ensure an adequate supply of smallpox vaccine, the development of a safer smallpox vaccine, and the development of vaccines to address other biological threats.

In light of these issues, some have urged that the smallpox vaccination program be delayed. I strongly disagree. Considering the potential threat to our nation posed by a smallpox attack, we must continue to move forward.

Even the Institute of Medicine (IOM), which was charged by the CDC to provide advice on how best to implement the program, does not recommend that it be delayed. In his testimony before the Labor, HHS Appropriations Subcommittee yesterday, the Chair of the IOM's Committee on Smallpox Vaccination Program Implementation, Dr. Brian Strom, made this point clear:

...by recommending that CDC 'proceed cautiously,' the [IO VI] committee never implied that CDC was proceeding too quickly or without due caution, as has been somewhat misstated in some of the press reports on the committee's recommendations. The committee did not recommend that the vaccination program be delayed or slowed down. The committee only encouraged CDC to facilitate local implementation at the pace that safety would allow. CDC has acknowledged that these are its intentions, and the committee believes that CDC will proceed accordingly.
That is the purpose of today's hearing: To ensure that the smallpox vaccination plan continues to proceed safely and efficiently. I look forward to hearing from our witnesses.