tion and document the extent to which lack of compensation is identified as a barrier, among other possible barriers (e.g., uncertainty surrounding risk of smallpox, fear of transmitting virus to contacts, extent to which local programs are encouraging vaccination).

Notification About Availability of Compensation or Lack of Compensation

CDC implemented the committee’s recommendation from its first letter report (IOM, 2003:13) that “informed consent forms include explicit notification of the availability, or lack thereof, of compensation for adverse reactions.” The January 16, 2003 version of CDC’s revised Vaccine Information Statement (VIS) includes the statement, “Treatment of severe reactions can be very expensive. Workers’ compensation or health insurance may not cover these expenses. There is no federal program to reimburse you for time lost from work, either because of illness due to vaccination or concern about spreading the virus to others. Your employer can tell you if they, or workers compensation, will cover these expenses” (CDC, 2003e).

The committee commends CDC for more clearly describing the compensation situation to potential vaccinees. However, the committee believes that the language used for this statement should be in bold type and should be simpler, so it can be more easily understood by a wider cross-section of potential vaccinees, especially considering the recent expansion of the program to a more diverse pool of vaccinees. The committee believes that it is very important that all vaccinees have a clear understanding of what types of coverage and protection they can or cannot expect from their employer, their state, and the federal government. More readable compensation language could take the form of:

  • “Right now, if you get sick or have to take time off from work, you cannot expect compensation.” or,

  • “Right now, if you get sick or have to take time off from work, the availability of compensation is uncertain.” or,

  • “Although other federal and state compensation proposals are under discussion, they have not yet been approved and you should not assume that you will be compensated for any injuries or illnesses that result from vaccination.”

No matter what specific language CDC decides to use, the committee recommends that the compensation language be easy to read and understandable to a wide range of audiences.

CDC has included the notification about the availability, or lack thereof, of compensation in the VIS. It is expected that potential vaccinees

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