Comment on FR Doc # 2010-22745

The proposed rule affecting the National Vaccine Injury Compensation Program is of interest to me for several reasons: first, I am the parent of four children; secondly, I am an employee of a local public health department that encourages childhood vaccination; lastly, I am a public administration doctoral student participating in public comment of a proposed rule for the first time. As a parent, I have taken advantage of childhood vaccine programs without incident. I have always been grateful that medical science has taken such strides to improve the overall life of vast numbers of people. I have also seen friends who have experienced a dramatic change in the health of their children shortly after receiving vaccinations; while I realize there is not a definite scientific or medical link between the two events, the seeming connection has caused concern for a great many parents. As an employee of a LHD, I am always interested in vaccine news and public service programs providing assistance to our community. An integral part of the VICP program that I have a direct connection to is the Vaccine Information Sheet (VIS), which we distribute with each vaccine we administer here. We make a concerted effort to regularly review each VIS to ensure we are providing up-to-date information regarding potential side effects – an effort the public appreciates. As a student, I find the policy process fascinating and am grateful we have an opportunity, as concerned American residents, to comment on proposed rules. In this particular instance, the revision that the proposed rule will bring to the current Vaccine Injury Table will allow a new level of clarity for those injured and enhance the compensation process through transparency. As I researched the topic, I discovered that claims for hepatitis A, trivalent influenza vaccines, and meningococcal (conjugate and polysaccharide) and human papillomavirus (HPV) vaccines total less than 5% of the overall claims since the VICP program began. Since its inception, there have been 13,512 claims filed through the VICP; of these claims, 2,529 have been awarded for a total outlay of $2,057,619,039.90 including injury compensation and attorney fees. Of these claims, 27 hepatitis A, 82 HPV, 505 trivalent influenza vaccines, and 15 meningococcal vaccine injuries and deaths are included; thus, the collective number of claims for these four distinct vaccines represents a mere five percent of the total number of claims. More research is required to determine if this relatively low incidence is due to the lack of clarity in the Vaccine Injury Table. With the revision allowed by the proposed rule, it is possible that the number of these claims will rise. Some may argue that this is an additional burden for the taxpayers, noting an increase in compensation; however, noting that the Vaccine Injury Compensation Trust Fund is funded by an excise tax on each dose of vaccine purchased, it becomes apparent that the program is self-sustaining. Further research indicates that in August 2001 the fund had an ending balance of $1,691,991,806.13; in comparison, August 2010 has an ending balance of $3,244,617,487.92 (Public Debt). Although more than $2B has been paid in claims and attorneys’ fees over the past twenty-two years, the fund continues to maintain a healthy balance and can accommodate the potential increase in claims for hepatitis A, trivalent influenza vaccines, and meningococcal (conjugate and polysaccharide) and human papillomavirus (HPV) vaccines, should these see an increase. The VICP has provided a measure of relief to those that file a claim and qualify for compensation within the set guidelines. The proposed rule will augment the claim and compensation process by providing clearer information. It is also of note that the revision will not increase costs to any of the involved entities. As a public administrator in California, facing budget issues for the past few years, I am keenly aware of increasing costs. At times, unfunded mandates can just about eliminate a program due to the burden of increased costs. This revision, though, will increase public benefit without affecting small entities or State, local, and tribal government. Additionally, families will not be negatively affected. Each of these facts serves to reinforce the positive effect of this revision.