I 

111TH CONGRESS 

1ST SESSION H. R. 2596 

To authorize the Secretary of Health and Human Services to carry out 

a demonstration program to test the feasibility of using the Nation’s 

elementary and secondary schools as influenza vaccination centers. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 21, 2009 

Mr. GENE GREEN of Texas (for himself and Mr. TIM MURPHY of Pennsylvania) introduced the following bill; which was referred to the Committee 

on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To authorize the Secretary of Health and Human Services 

to carry out a demonstration program to test the feasibility of using the Nation’s elementary and secondary 

schools as influenza vaccination centers. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘No Child Left 

5 Unimmunized Against Influenza Act of 2009’’. 


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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) The influenza is a contagious respiratory ill4 ness caused by influenza viruses. The best way to 

5 prevent the influenza is by getting a influenza vac6 cination each year. 

7 (2) Every year in the United States, on aver8 age, more than 200,000 people are hospitalized from 

9 influenza-related complications, and about 36,000 

10 people die from influenza-related causes. 

11 (3) The Centers for Disease Control and Pre12 vention (CDC) Advisory Committee on Immuniza13 tion Practices recommends routine influenza vac14 cination for all children aged 6 months through 18 

15 years with influenza vaccine, effective July 1, 2008. 

16 (4) Children 2 to 17 years of age are twice as 

17 likely to get influenza as adults, including the elder18 ly. 

19 (5) School-aged children are the population 

20 group most responsible for transmission of con21 tagious respiratory viruses, including influenza. 

22 (6) The elderly and young children are the most 

23 vulnerable population to severe illness from influenza 

24 due to weaker immune response to vaccination. Ex25 perts have recognized that the best way to protect 


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1 the elderly from influenza may be to vaccinate chil2 dren. 

3 (7) School-based vaccination programs are ef4 fective and cost-saving ways to vaccinate children 

5 while reducing transmission and infection rates to 

6 the larger community and at the same time reducing 

7 rates of school absenteeism due to influenza. 

8 (8) Increased focus on providing influenza vac9 cine to children targeted for immunization will also 

10 help efforts to build a sound foundation for future 

11 vaccination efforts. 

12 (9) School-based vaccination programs also po13 tentially represent the most feasible mechanism for 

14 community-based pandemic vaccination. 

15 (10) Increased participation in annual influenza 

16 vaccination programs builds the infrastructure nec17 essary for pandemic vaccination. 

18 (11) School-based programs will investigate the 

19 feasibility of conducting mass immunization clinics 

20 and build partnerships with local public health 

21 teams, in the event of a public health emergency. 


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1 SEC. 3. DEMONSTRATION PROGRAM USING ELEMENTARY 

2 AND SECONDARY SCHOOLS AS INFLUENZA 

3 VACCINATION CENTERS. 

4 (a) IN GENERAL.—The Secretary of Health and 

5 Human Services, in consultation with the Secretary of 

6 Education and the Secretary of Labor, shall carry out a 

7 multistate demonstration program designed to test the 

8 feasibility of using the Nation’s elementary schools and 

9 secondary schools as influenza vaccination centers in co10 ordination with school nurses, school health care pro11 grams, local health departments, community health care 

12 providers, State insurance agencies, and private insurers. 

13 (b) PROGRAM DESCRIPTION.— 

14 (1) VACCINATION.— 

15 (A) CHILDREN COVERED BY OTHER FED16 ERAL PROGRAMS.—For children who are eligible 

17 under other federally funded programs for pay18 ment of the costs of purchasing and admin19 istering the influenza vaccine, the Secretary 

20 shall not use the demonstration program under 

21 this section to supplant payment of such costs. 

22 (B) CHILDREN COVERED BY PRIVATE

23 HEALTH INSURANCE.—For children who have 

24 private insurance, the Secretary shall work with 

25 the Secretary of Labor, State insurance agen26 cies, and private insurers to ensure that such 


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1 children have coverage for all reasonable and 

2 customary expenses, including the costs of pur3 chasing and administering the vaccine, incurred 

4 when influenza vaccine is administered outside 

5 of the physician’s office in a school or other re6 lated setting. 

7 (C) OTHER CHILDREN.—To the extent to 

8 which payment of the costs of purchasing and 

9 administering the influenza vaccine for children 

10 is not covered through other federally funded 

11 programs or through private insurance, the Sec12 retary may pay such costs through the dem13 onstration program under this section. 

14 (2) ACIP RECOMMENDATIONS.—The dem15 onstration program shall be designed to administer 

16 vaccines consistent with the recommendations of the 

17 Advisory Committee on Immunization Practices for 

18 the annual vaccination of all children aged 5 years 

19 through 19 years. 

20 (3) LOCATIONS.— 

21 (A) SELECTION.—The Secretary, in con22 sultation with the Secretary of Education, shall 

23 select the elementary schools and secondary 

24 schools to participate in the demonstration pro25 gram. 


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1 (B) SELECTION CRITERIA.—The schools 

2 selected under subparagraph (A) shall include 

3 elementary schools and secondary schools— 

4 (i) located in at least 10 metropolitan 

5 regions in at least 10 States and serving 

6 primarily low-income public school student 

7 populations; and 

8 (ii) located in at least 5 major areas 

9 in at least 5 States served by rural school 

10 districts. 

11 (4) VOLUNTARY PARTICIPATION.—Participation 

12 in the demonstration program by a school or an in13 dividual shall be voluntary. 

14 (5) DURATION.—The demonstration program 

15 shall be conducted for the 2010–2011 and 2011– 

16 2012 influenza seasons. 

17 (6) CHOICE OF VACCINE.—The demonstration 

18 program shall not restrict the discretion of a health 

19 care provider to administer any influenza vaccine ap20 proved by the Food and Drug Administration for 

21 use in pediatric populations. 

22 (c) REPORT.—Not later than 90 days following the 

23 completion of the demonstration program under this sec24 tion, the Secretary shall submit to the Committees on 

25 Education and Labor, Energy and Commerce, and ApproVerDate Nov 24 2008 20:16 May 24, 2009 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2596.IH H2596

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1 priations of the House of Representatives and to the Com2 mittees on Health, Education, Labor, and Pensions and 

3 Appropriations of the Senate a report on the results of 

4 the program. The report shall include— 

5 (1) an assessment of the influenza vaccination 

6 rates of school-aged children in localities where the 

7 demonstration program is implemented, compared to 

8 the national average influenza vaccination rates for 

9 school-aged children, including whether school-based 

10 vaccination assists in achieving the recommendations 

11 of the Advisory Committee on Immunization Prac12 tices for annual influenza vaccination of all children 

13 aged 6 months to 18 years; 

14 (2) an assessment of the utility of employing el15 ementary schools and secondary schools as a part of 

16 a multi-state, community-based pandemic response 

17 program that is consistent with existing Federal and 

18 State pandemic response plans; 

19 (3) an assessment of the feasibility of using ex20 isting Federal and private insurance funding in es21 tablishing a multi-state, school-based vaccination 

22 program for seasonal influenza vaccination; 

23 (4) an assessment of the number of education 

24 days gained by students as a result of seasonal vac25 cinations based on absenteeism rates; 


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1 (5) a determination of whether the demonstra2 tion program under this section— 

3 (A) was successful; and 

4 (B) was implemented for sufficient time 

5 for gathering enough valid data; and 

6 (6) a recommendation on whether the dem7 onstration program under this section should be con8 tinued, expanded, or terminated. 

9 (d) DEFINITIONS.—In this section: 

10 (1) The terms ‘‘elementary school’’ and ‘‘sec11 ondary school’’ have the meanings given such terms 

12 in section 9101 of the Elementary and Secondary 

13 Education Act of 1965 (20 U.S.C. 7801). 

14 (2) The term ‘‘low-income’’ means at or below 

15 200 percent of the income level specified in the most 

16 recent applicable version of the Department of 

17 Health and Human Services Poverty Guidelines per 

18 person in a family unit. 

19 (3) Except as otherwise specified, the term 

20 ‘‘Secretary’’ means the Secretary of Health and 

21 Human Services. 

22 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

23 out this section, there is authorized to be appropriated 

24 $5,000,000 for each of fiscal years 2010 through 2012. 

Æ 


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