I
107TH CONGRESS
2D SESSION
H. R. 5282
To amend the Public Health Service Act to improve immunization rates
by increasing the distribution of vaccines and improving and clarifying
the vaccine injury compensation program, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JULY 26, 2002
Mr. GREENWOOD (for himself and Mr. TOWNS) introduced the following bill;
which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to improve immuni-
zation rates by increasing the distribution of vaccines
and improving and clarifying the vaccine injury com-
pensation program, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Improved Vaccine Affordability and Availability Act’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—STATE VACCINE GRANTS
Sec. 101. Availability of influenza vaccine.
Sec. 102. Program for increasing immunization rates for adults and adoles-
cents; collection of additional immunization data.
Sec. 103. Immunization awareness.
Sec. 104. Supply of vaccines.
TITLE II—VACCINE INJURY COMPENSATION PROGRAM
Sec. 201. Administrative revision of vaccine injury table.
Sec. 202. Equitable relief.
Sec. 203. Parent petitions for compensation.
Sec. 204. Jurisdiction to dismiss actions improperly brought.
Sec. 205. Clarification of when injury is caused by factor unrelated to adminis-
tration of vaccine.
Sec. 206. Basis for calculating projected lost earnings.
Sec. 207. Allowing compensation for family counseling expenses and expenses
of establishing guardianship.
Sec. 208. Allowing payment of interim costs.
Sec. 209. Procedure for paying attorneys’ fees.
Sec. 210. Extension of statute of limitations.
Sec. 211. Advisory commission on childhood vaccines.
Sec. 212. Clarification of standards of responsibility.
Sec. 213. Clarification of definition of manufacturer.
Sec. 214. Clarification of definition of vaccine-related injury or death.
Sec. 215. Clarification of definition of vaccine.
Sec. 216. Ongoing review of childhood vaccine data.
Sec. 217. Pending actions.
Sec. 218. Report.
TITLE I—STATE VACCINE
GRANTS
SEC. 101. AVAILABILITY OF INFLUENZA VACCINE.
Section 317(j) of the Public Health Service Act (42
U.S.C. 247b(j)) is amended by adding at the end the fol-
lowing:
‘‘(3)(A) For the purpose of carrying out activities re-
lating to influenza vaccine under the immunization pro-
gram under this subsection, there are authorized to be ap-
propriated such sums as may be necessary for each of fis-
cal years 2003 and 2004. Such authorization shall be in
addition to amounts available under paragraphs (1) and
(2) for such purpose.
‘‘(B) The authorization of appropriations established
in subparagraph (A) shall not be effective for a fiscal year
unless the total amount appropriated under paragraphs
(1) and (2) for the fiscal year is not less than such total
for fiscal year 2000.
‘‘(C) The purposes for which amounts appropriated
under subparagraph (A) are available to the Secretary in-
clude providing for improved State and local infrastruc-
ture for influenza immunizations under this subsection in
accordance with the following:
‘‘(i) Increasing influenza immunization rates in
populations considered by the Secretary to be at
high risk for influenza-related complications and in
their contacts.
‘‘(ii) Recommending that health care providers
actively target influenza vaccine that is available in
September, October, and November to individuals
who are at increased risk for influenza-related com-
plications and to their contacts.
‘‘(iii) Providing for the continued availability of
influenza immunizations through December of such
year, and for additional periods to the extent that
influenza vaccine remains available.
‘‘(iv) Encouraging States, as appropriate, to de-
velop contingency plans (including plans for public
and professional educational activities) for maxi-
mizing influenza immunizations for high-risk popu-
lations in the event of a delay or shortage of influ-
enza vaccine.
‘‘(D) The Secretary shall submit to the Committee
on Energy and Commerce of the House of Representa-
tives, and the Committee on Health, Education, Labor,
and Pensions of the Senate, periodic reports describing the
activities of the Secretary under this subsection regarding
influenza vaccine. The first such report shall be submitted
not later than June 6, 2003, the second report shall be
submitted not later than June 6, 2004, and subsequent
reports shall be submitted biennially thereafter.’’.
SEC. 102. PROGRAM FOR INCREASING IMMUNIZATION
RATES FOR ADULTS AND ADOLESCENTS; COL-
LECTION 
OF 
ADDITIONAL 
IMMUNIZATION
DATA.
(a) ACTIVITIES OF CENTERS FOR DISEASE CONTROL
AND PREVENTION.—Section 317(j) of the Public Health
Service Act (42 U.S.C. 247b(j)), as amended by section
101, is further amended by adding at the end the fol-
lowing:
‘‘(4)(A) For the purpose of carrying out activities to
increase immunization rates for adults and adolescents
through the immunization program under this subsection,
and for the purpose of carrying out subsection (k)(2),
there are authorized to be appropriated $50,000,000 for
fiscal year 2003, and such sums as may be necessary for
each of the fiscal years 2004 through 2006. Such author-
ization is in addition to amounts available under para-
graphs (1), (2), and (3) for such purposes.
‘‘(B) In expending amounts appropriated under sub-
paragraph (A), the Secretary shall give priority to adults
and adolescents who are medically underserved and are
at risk for vaccine-preventable diseases, including as ap-
propriate populations identified through projects under
subsection (k)(2)(E).
‘‘(C) The purposes for which amounts appropriated
under subparagraph (A) are available include (with re-
spect to immunizations for adults and adolescents) the
payment of the costs of storing vaccines, outreach activi-
ties to inform individuals of the availability of the immuni-
zations, and other program expenses necessary for the es-
tablishment or operation of immunization programs car-
ried out or supported by States or other public entities
pursuant to this subsection.
‘‘(5) The Secretary shall annually submit to Congress
a report that—
‘‘(A) evaluates the extent to which the immuni-
zation system in the United States has been effective
in providing for adequate immunization rates for
adults and adolescents, taking into account the ap-
plicable year 2010 health objectives established by
the Secretary regarding the health status of the peo-
ple of the United States; and
‘‘(B) describes any issues identified by the Sec-
retary that may affect such rates.
‘‘(6) In carrying out this subsection and paragraphs
(1) and (2) of subsection (k), the Secretary shall consider
recommendations regarding immunizations that are made
in reports issued by the Institute of Medicine.’’.
(b) RESEARCH, DEMONSTRATIONS, 
AND
EDU-
CATION.—Section 317(k) of the Public Health Service Act
(42 U.S.C. 247b(k)) is amended—
(1) by redesignating paragraphs (2) through
(4) as paragraphs (3) through (5), respectively; and
(2) by inserting after paragraph (1) the fol-
lowing:
‘‘(2) The Secretary, directly and through grants
under paragraph (1), shall provide for a program of re-
search, demonstration projects, and education in accord-
ance with the following:
‘‘(A) The Secretary shall coordinate with public
and private entities (including nonprofit private enti-
ties), and develop and disseminate guidelines, toward
the goal of ensuring that immunizations are rou-
tinely offered to adults and adolescents by public
and private health care providers.
‘‘(B) The Secretary shall cooperate with public
and private entities to obtain information for the an-
nual evaluations required in subsection (j)(5)(A).
‘‘(C) The Secretary shall (relative to fiscal year
2001) increase the extent to which the Secretary col-
lects data on the incidence, prevalence, and cir-
cumstances of diseases and adverse events that are
experienced by adults and adolescents and may be
associated with immunizations, including collecting
data in cooperation with commercial laboratories.
‘‘(D) The Secretary shall ensure that the enti-
ties with which the Secretary cooperates for pur-
poses of subparagraphs (A) through (C) include
managed care organizations, community-based orga-
nizations that provide health services, and other
health care providers.
‘‘(E) The Secretary shall provide for projects to
identify racial and ethnic minority groups and other
health disparity populations for which immunization
rates for adults and adolescents are below such rates
for the general population, and to determine the fac-
tors underlying such disparities.’’.
SEC. 103. IMMUNIZATION AWARENESS.
(a) DEVELOPMENT OF INFORMATION CONCERNING
MENINGITIS.—
(1) IN GENERAL.—The Secretary of Health and
Human Services, in consultation with the Director of
the Centers for Disease Control and Prevention,
shall develop and make available to entities de-
scribed in paragraph (2) information concerning
bacterial meningitis and the availability and effec-
tiveness of vaccinations for populations targeted by
the Advisory Committee of Immunization Practices
(an advisory committee established by the Secretary
of Health and Human Services, acting through the
Centers for Disease Control and Prevention).
(2) ENTITIES.—An entity is described in this
paragraph if the entity—
(A) is—
(i) a college or university; or
(ii) a prison or other detention facil-
ity; and
(B) is determined appropriate by the Sec-
retary of Health and Human Services.
(b) DEVELOPMENT OF INFORMATION CONCERNING
HEPATITIS.—
(1) IN GENERAL.—The Secretary of Health and
Human Services, in consultation with the Director of
the Centers for Disease Control and Prevention,
shall develop and make available to entities de-
scribed in paragraph (2) information concerning
hepatitis A and B and the availability and effective-
ness of vaccinations with respect to such diseases.
(2) ENTITIES.—An entity is described in this
paragraph if the entity—
(A) is—
(i) a health care clinic that serves in-
dividuals diagnosed as being infected with
HIV or as having other sexually trans-
mitted diseases;
(ii) an organization or business that
counsels individuals about international
travel or who arranges for such travel;
(iii) a police, fire or emergency med-
ical services organization that responds to
natural or man-made disasters or emer-
gencies;
(iv) a prison or other detention facil-
ity;
(v) a college or university; or
(vi) a public health authority or chil-
dren’s health service provider in areas of
intermediate or high endemnicity for hepa-
titis A as defined by the Centers for Dis-
ease Control and Prevention; and
(B) is determined appropriate by the Sec-
retary of Health and Human Services.
SEC. 104. SUPPLY OF VACCINES.
(a) IN GENERAL.—The Secretary of Health and
Human Services, acting through the Director of the Cen-
ters for Disease Control and Prevention, shall prioritize,
acquire, and maintain a supply of such prioritized vaccines
sufficient to provide vaccinations throughout a 6-month
period.
(b) PROCEEDS.—Any proceeds received by the Sec-
retary of Health and Human Services from the sale of vac-
cines contained in the supply described in subsection (a),
shall be available to the Secretary for the purpose of pur-
chasing additional vaccines for the supply. Such proceeds
shall remain available until expended.
(c) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated for the purpose of car-
rying out subsection (a) such sums as may be necessary
for each of fiscal years 2003 through 2008.
TITLE II—VACCINE INJURY
COMPENSATION PROGRAM
SEC. 201. ADMINISTRATIVE REVISION OF VACCINE INJURY
TABLE.
Section 2114 of the Public Health Service Act (42
U.S.C. 300aa–14) is amended—
(1) in subsection (c), by striking paragraph (1)
and inserting the following:
‘‘(1) In promulgating such regulations, the Sec-
retary shall provide for notice and for at least 9060
days opportunity for public comment.’’; and
(2) in subsection (d), by striking ‘‘90 days’’ and
inserting ‘‘60 days’’.
SEC. 202. EQUITABLE RELIEF.
Section 2111(a)(2)(A) of the Public Health Service
Act (42 U.S.C. 300aa–11(a)(2)(A)) is amended by strik-
ing ‘‘No person’’ and all that follows through ‘‘and—’’ and
inserting the following: ‘‘No person may bring or maintain
a civil action against a vaccine administrator or manufac-
turer in a State or Federal court for damages arising
from, or equitable relief relating to, a vaccine-related in-
jury or death associated with the administration of a vac-
cine after October 1, 1988 and no such court may award
damages or equitable relief for any such vaccine-related
injury or death, unless the person proves past or present
physical injury and a timely petition has been filed, in ac-
cordance with section 2116 for compensation under the
Program for such injury or death and—’’.
SEC. 203. PARENT PETITIONS FOR COMPENSATION.
(a) CIVIL ACTIONS.—Section 2111(a)(2) of the Pub-
lic Health Service Act (42 U.S.C. 300aa–(a)(2)) is
amended—
(1) in subparagraph (B), by inserting ‘‘or (B)’’
after ‘‘subparagraph (A)’’;
(2) by redesignating subparagraph (B) as sub-
paragraph (C); and
(3) by inserting after subparagraph (A) the fol-
lowing:
‘‘(B) No parent or other third party may bring
or maintain a civil action against a vaccine adminis-
trator or manufacturer in a State or Federal court
for damages or equitable relief relating to a vaccine-
related injury or death, including but not limited to
damages for loss of consortium, society, companion-
ship or services, loss of earnings, medical or other
expenses, and emotional distress, and no court may
award damages or equitable relief in such an action
unless—
‘‘(i) the person who sustained the under-
lying vaccine-related injury or death upon which
such parent or third party’s claim is premised
has, in accordance with section 2112, been
awarded compensation in a final judgment of
the United States Court of Federal Claims and
such judgment is subject to no further appeal
or review,
‘‘(ii) such parent or other third party is
the parent, legal guardian or spouse of the per-
son who sustained the underlying vaccine-re-
lated injury and such parent, legal guardian or
spouse timely filed a derivative petition, in ac-
cordance with section 2116, and
‘‘(iii)(I) the United States Court of Fed-
eral Claims has issued judgment under section
2112 on the derivative petition, and such par-
ent, legal guardian or spouse elects under sec-
tion 2121(a) to file a civil action, or
‘‘(II) such parent, legal guardian or spouse
elects to withdraw such derivative petition
under section 2121(b) or such petition is con-
sidered withdrawn under such section.