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12/23/2002

Pharmacists Expected to Serve in Homeland Security

Donna Young

More than two dozen pharmacists employed by the federal government will join thousands of other federal workers on March 1 to be part of the new Department of Homeland Security (DHS).

The new department, created by Congress in November 2002, will join about 170,000 federal employees from 22 programs, forming the nation's third largest government agency after the Departments of Veterans Affairs and Defense.

DHS will consist of four divisions: Border and Transportation Security; Emergency Preparedness and Response; Chemical, Biological, Radiological, and Nuclear Countermeasures; and Information Analysis and Infrastructure Protection.

The Homeland Security Act of 2002 that created the new department will become effective on January 24, but most agencies proposed to transfer to DHS will not move until March. Other programs, such as the Agriculture Department's Plum Island Animal Disease Center, will not join Homeland Security until June.

Some of the federal programs employing pharmacists that have been proposed by the Bush administration to move to DHS include the Coast Guard, Office of Emergency Response, Immigration and Naturalization Service (INS), and the National Pharmaceutical Stockpile (NPS), according to a Department of Health and Human Services (HHS) spokesman.

Many of the pharmacists in those agencies are nonmilitary, uniformed personnel serving with the Public Health Service (PHS) Commissioned Corps.

There are 760 PHS pharmacists who have been detailed to various agencies within the federal government, said HHS spokesman Marc Wolfson. About half of those pharmacists serve with the Indian Health Service, and about 15% serve with the Federal Bureau of Prisons, he said. Approximately 150 uniformed PHS pharmacists have been detailed to FDA.

FDA, the Indian Health Service, and the Prisons Bureau will not be part of DHS. However, Wolfson noted, during times of crisis, pharmacists in those agencies could be called to temporarily serve with the Commissioned Corps Readiness Force, specially trained PHS officers who respond to public health emergencies and disasters.

Vaccine Provisions in Homeland Security

Included in the Homeland Security Act of 2002 is a provision that protects manufacturers of smallpox vaccine from liability for injuries that result from use of the product.

The Centers for Disease Control and Prevention has estimated that about 1 of every 1 million people vaccinated against smallpox will die and that hundreds of others will have other medical complications.

Under the new law, no legal action can be brought against a vaccine manufacturer. Injured individuals can bring claims only against the federal government under the Federal Torts Claims Act.

Also included in the Homeland Security Act is a provision that modifies the Childhood Vaccine Injury Act of 1986 by changing the definition of vaccine to include "all components and ingredients listed in the vaccine’s product license application and product label."

The 1986 law created the National Vaccine Injury Compensation program, which provides no-fault compensation for children injured or killed by a vaccine and protects vaccine manufacturers from large civil judgments.

Families seeking compensation under the program must file a claim within three years of the onset of a child’s symptoms.

However, in recent years several lawsuits have been filed against manufacturers of vaccine additives, such as mercury-based thimerosal, a preservative that was used in childhood vaccines and was made in this country by Eli Lilly and Company.

FDA asked vaccine makers a few years ago to stop using thimerosal in vaccines.

But the provision in the new Homeland Security Act intervenes in ongoing litigation brought by plaintiffs against companies like Eli Lilly. Because plaintiffs in those suits were not previously included for compensation under the program created in 1986, and the three-year time limit may have passed for some families, many may have no legal recourse against manufacturers of vaccine additives.

About 100 PHS pharmacists serve in other federal agencies, Wolfson said.

The Coast Guard has 16 PHS pharmacists: 1 in Alaska; 1 in Mobile, Alabama; and the other 14 split between the East and West Coast shorelines.

DHS's undersecretary for border transportation and security will oversee the functions of the Coast Guard beginning in March, according to the White House.

Many functions of the INS will also move to border transportation and security.

The Division of Immigration Health Services, the group that provides health care to people detained by INS, has nine pharmacists, including one pharmacist who is an administrator and one who oversees the agency's telehealth program, according to Captain Geralyn S. Johnson, a dental surgeon and the division's chief of staff.

The other seven INS pharmacists dispense prescription drugs to detainees at the agency's detention centers in Arizona, California, Florida, and Texas.

DHS's Division of Emergency Preparedness and Response will include the Office of Emergency Response's National Disaster Medical System, the Metropolitan Medical Response System, and the NPS, a federal repository of antiinfectives, chemical antidotes, antitoxins, and other medical supplies that are deployed to state and local governments in emergencies.

The Office of Emergency Response has five pharmacists, including Rear Admiral John T. Babb, director of the PHS Commissioned Corps Readiness Force, Wolfson said.

NPS has two pharmacists on staff, one of whom is a board-certified toxicologist, according to program spokeswoman Joan Morrissey. Other pharmacists, toxicologists, and physicians with HHS and the Centers for Disease Control and Prevention, the agency that oversees the stockpile, assist with the design and implementation of the program, she added.

Pharmacists trained to serve with the Commissioned Corps Readiness Force have also received special training in deployment of the stockpile, noted Morrissey.

"This support structure provides the NPS program with a depth of expertise that brings with it [a] national perspective on pharmacy issues in response to terrorism threats," she said.

At press time, top Bush administration officials had not informed NPS staff members as to who or how many will transfer to the new department, Morrissey said.

Since DHS is in the early stages of development, Wolfson added, the number of pharmacists with each program could change.

"They will have to determine their needs as they organize," he said.