Texas Public Health Associtation Encourages Vaccination Program for First Responders During Disasters

Texas Public Health Association: Testimony to Senate Health and Human Services Committee
Senate Bill 1328 by Sen. Jane Nelson
March 31, 2009

Presented by: Robert S. Hendler, MD
Vice President, Clinical Quality Regional Chief Medical Officer,
Tenet Healthcare Corporation

Cassandra Arceneaux, MD, MPH
Deputy Health Authority for Galveston County and Director of Community Health Services



Today we are testifying on behalf of the Texas Public Health Coalition in support of Senate Bill 1328 by Sen. Jane Nelson. The Texas Public Health Coalition is an alliance of organizations that have been working together for several years to identify critical public health challenges facing our state. The coalition includes 21 private, nonprofit organizations and represents thousands of public health professionals and consumers in Texas. In addition, numerous experts from academia and state agencies work with coalition members to help us better understand and address the issues.

The coalition wants to thank Senator Nelson for introducing this important, far-reaching legislation. Senate Bill 1328 provides an opportunity for state and local experts in disaster preparedness and response to assess the vaccine needs of first responders before they respond to emergencies and disasters. This is an opportunity for Texas to set standards and make recommendations for the state and local jurisdictions -- recommendations that will help protect the first responders who we must count on to protect our citizens.

In the past few years, Texas has had declared disasters for hurricanes Dean, Rita, Dolly, and most recently, Edouard, Gustav, and Ike. State and local jurisdictions also have responded to hurricanes Katrina and Rita. The first responders working in the aftermath of disasters such as hurricanes face environments that are diverse and unpredictable, and can be dangerously uncontrolled. 

First responders must act quickly to protect the upset and at times uncooperative residents. Almost universally, the first responders' personal safety becomes a secondary concern as they serve the affected residents. Exposure to vaccine-preventable conditions in these emergent events is highly likely. In addition to situations such as contaminated water, infection from blood exposure, or being cut by a nail in a destroyed home, first responders don't know the health status of those they work with. Fewer than half of adult Texans are vaccinated against the flu each year. Nearly two-thirds of adult Texans have no protection against hepatitis B. Many Texans have no protection against tetanus.

SB 1328 will require a study by the Department of State Health Services (DSHS) to assess:

  • The feasibility of providing the hepatitis B vaccine for first responders who may come into contact with blood or other bodily fluids; a tetanus-containing vaccine; and any other Centers for Disease Control and Prevention (CDC)-recommended vaccines or biologicals;
  • Workplace immunization policies and insurance coverage;
  • The ability of the state and local health departments to provide vaccines, and the identification of any other funding sources to procure the needed vaccines for first responders and their families.

A few other states have taken similar steps to address the needs of first responders. Missouri recently established a vaccination program for first responders who may be exposed to infectious diseases when deployed to a disaster location; this vaccination program, however, is limited to bioterrorism events only. Mississippi has established a vaccination program for first responders as part of a comprehensive plan to respond to both bioterrorism and natural disasters. The voluntary vaccination program is for first responders from law enforcement, emergency medical personnel, and public works employees. Vaccinations are offered for hepatitis A and B, influenza, diphtheria, and tetanus. 

The CDC's National Institute for Occupational Safety and Health strongly encourages employers of first responders to have a plan and policies related to minimizing first responders' exposure to blood and other infectious body fluids. The focus of having a plan is to prepare in advance and to identify responsibilities such as how vaccinations can be provided to first responders.

Senate Bill 1328 presents no additional costs but provides the opportunity to educate state and local policy makers and to plan to address the needs of Texas' first responders and their families.

The Texas Public Health Coalition asks members of the committee to support SB 1328. The study will provide a roadmap for the Texas Legislature on how to protect our first responders and their families in all the emergency events. The Texas Public Health Coalition welcomes the opportunity to work with Senator Nelson and DSHS to support the implementation of this legislation.