80_FR_76782 80 FR 76546 - Smallpox Medical Countermeasures-Amendment

80 FR 76546 - Smallpox Medical Countermeasures-Amendment

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary

Federal Register Volume 80, Issue 236 (December 9, 2015)

Page Range76546-76553
FR Document2015-31092

The Secretary is amending the declaration issued on October 10, 2008, (73 FR 61869) pursuant to section 319F-3 of the Public Health Service Act (42 U.S.C. 247d-6d) to: Include countermeasures authorized for use under sections 564A and 564B of the Federal Food, Drug, and Cosmetic (FD&C) Act (21 U.S.C. 360bbb-3a and 360bbb-3b); clarify the description of covered countermeasures; extend the effective time period of the declaration; reformat the declaration; modify or clarify terms of the declaration; and republish the declaration in its entirety, as amended.

Federal Register, Volume 80 Issue 236 (Wednesday, December 9, 2015)
[Federal Register Volume 80, Number 236 (Wednesday, December 9, 2015)]
[Notices]
[Pages 76546-76553]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-31092]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Smallpox Medical Countermeasures--Amendment

ACTION: Notice of Amendment to the October 10, 2008 Declaration under 
the Public Readiness and Emergency Preparedness Act.

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SUMMARY: The Secretary is amending the declaration issued on October 
10, 2008, (73 FR 61869) pursuant to section 319F-3 of the Public Health 
Service Act (42 U.S.C. 247d-6d) to: Include countermeasures authorized 
for use under sections 564A and 564B of the Federal Food, Drug, and 
Cosmetic (FD&C) Act (21 U.S.C. 360bbb-3a and 360bbb-3b); clarify the 
description of covered countermeasures; extend the effective time 
period of the declaration; reformat the declaration; modify or clarify 
terms of the declaration; and

[[Page 76547]]

republish the declaration in its entirety, as amended.

DATES: The amendment of the October 10, 2008, declaration is effective 
as of January 1, 2016.

FOR FURTHER INFORMATION CONTACT: Nicole Lurie, MD, MSPH, Assistant 
Secretary for Preparedness and Response, Office of the Secretary, 
Department of Health and Human Services, 200 Independence Avenue SW., 
Washington, DC 20201, Telephone 202-205-2882.

SUPPLEMENTARY INFORMATION:

Background

    The Public Readiness and Emergency Preparedness Act (PREP Act) 
authorizes the Secretary of Health and Human Services (the Secretary) 
to issue a declaration to provide liability immunity to certain 
individuals and entities (Covered Persons) against any claim of loss 
caused by, arising out of, relating to, or resulting from the 
administration or use of medical countermeasures (Covered 
Countermeasures), except for claims that meet the PREP Act's definition 
of willful misconduct. The Secretary may, though publication in the 
Federal Register, amend any portion of a declaration. Using this 
authority, the Secretary issued a declaration for smallpox 
countermeasures against variola virus or other orthopoxviruses on 
October 10, 2008, and is amending this declaration.\1\
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    \1\ 73 FR 61869.
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    The major actions taken by this amendment to the smallpox 
countermeasures declaration include are the following: (1) Updating the 
description of covered countermeasures to include countermeasures 
authorized for use under sections 564A and 564B of the FD&C Act; \2\ 
(2) revising the description of covered countermeasures to clarify that 
coverage for vaccines includes all components and constituent materials 
of the vaccines and all devices and their constituent components used 
in the administration of the vaccines, and to add biologics; (3) 
changing the description of qualified persons to include persons 
authorized to prescribe, administer, or dispense covered 
countermeasures in accordance with Section 564A of the FD&C Act; (4) 
clarifying that liability immunity extends to other transactions and to 
activities related to any federal agreements including clinical trials 
agreements by adding the terms ``other transactions'' and ``other 
Federal agreements'' to the clause describing the types of federal 
agreements for which immunity is in effect; (5) deleting references to 
specific federal contracts to clarify that immunity is not limited to 
activities conducted under listed contracts; (6) clarifying that 
liability immunity extends to activities directly conducted by the 
federal government by adding the phrase ``or directly conducted by the 
Federal Government'' to the section describing methods of distribution 
for which liability immunity is in effect; (7) narrowing the definition 
of ``administration'' to cover ``slip-and-fall'' claims only to the 
extent they are directly tied to the operation of a countermeasure 
program; (8) extending the time period for which liability immunity is 
in effect for the Covered Countermeasures to December 31, 2022, and (9) 
changing the entire declaration to the new format that was first used 
with the February 29, 2012, amendment to the declaration for pandemic 
influenza to make the declaration easier for readers to follow. Other 
minor modifications and clarifications are also made, as fully 
explained below.
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    \2\ 21 U.S.C. 360bbb-3a and 360bbb-3b.
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    The declaration is republished in full. We explain both the 
substantive and format changes in this supplementary section.
    The PREP Act was enacted on December 30, 2005, as Public Law 109-
148, Division C, Section 2. It amended the Public Health Service (PHS) 
Act, adding section 319F-3, which addresses liability immunity, and 
section 319F-4, which creates a compensation program. These sections 
are codified in the U.S. Code as 42 U.S.C. 247d-6d and 42 U.S.C. 247d-
6e, respectively.
    The Pandemic and All-Hazards Preparedness Reauthorization Act 
(PAHPRA), Public Law 113-5, was enacted on March 13, 2013. Among other 
things, PAHPRA added sections 564A and 564B to the FD&C Act to provide 
new authorities for the emergency use of approved products in 
emergencies and products held for emergency use. PAHPRA accordingly 
amended the definitions of ``Covered Countermeasures'' and ``qualified 
pandemic and epidemic products'' in section 319F-3 of the Public Health 
Service Act (the PREP Act provisions), so that products made available 
under these new FD&C Act authorities could be covered under PREP Act 
declarations. PAHPRA also extended the definition of qualified pandemic 
and epidemic products to include products or technologies intended to 
enhance the use or effect of a drug, biological product, or device used 
against the pandemic or epidemic or against adverse events from these 
products.
    Unless otherwise noted, all statutory citations below are to the 
U.S. Code.

Section I, Determination of Public Health Emergency or Credible Risk of 
Future Public Health Emergency

    Before issuing a declaration under the PREP Act, the Secretary is 
required to determine that a disease or other health condition or 
threat to health constitutes a public health emergency or that there is 
a credible risk that the disease, condition, or threat may in the 
future constitute such an emergency.\3\ This determination is separate 
and apart from a declaration issued by the Secretary under section 319 
of the PHS Act \4\ that a disease or disorder presents a public health 
emergency or that a public health emergency, including significant 
outbreaks of infectious diseases or bioterrorist attacks, otherwise 
exists, or other declarations or determinations made under other 
authorities of the Secretary. In the previous PREP Act declaration for 
smallpox countermeasures (``declaration''), this determination appeared 
in the declaration's introduction as the conclusion to the ``whereas'' 
clauses. The determination is stated in the first section of the 
declaration. This change was made to improve readability and is not 
intended to have any substantive legal effect.
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    \3\ 42 U.S.C. 247d-6d(b)(1).
    \4\ 42 U.S.C. 247d.
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    In addition, we made a substantive change to the determination. The 
determination made in the ``whereas'' clauses in the October 10, 2008, 
declaration stated that the Secretary ``determined there is a credible 
risk that the exposure to variola virus or other orthopoxvirus disease 
and the resulting disease constitutes a public health emergency.'' The 
Secretary is amending this determination to state that the threat may 
be ``in the future,'' to refer to release of variola virus or orthopox 
virus rather than exposure, and to refer to both diseases and 
conditions, to more accurately describe the risk and to be consistent 
with the language used in the PREP Act.\5\ Thus, in this amended 
declaration, the Secretary determines ``that there is a credible risk 
that the release of variola virus or other orthopoxvirus and the 
resulting disease or conditions may in the future constitute a public 
health emergency.'' This change is provided for clarification.
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    \5\ See 42 U.S.C. 247d-6d(b)(1).
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Section II, Factors Considered

    In deciding whether and under what circumstances to issue a 
declaration

[[Page 76548]]

with respect to a Covered Countermeasure, the Secretary must consider 
the desirability of encouraging the design, development, clinical 
testing or investigation, manufacture, labeling, distribution, 
formulation, packaging, marketing, promotion, sale, purchase, donation, 
dispensing, prescribing, administration, licensing, and use of the 
countermeasure.\6\ We previously stated these considerations in the 
introductory ``whereas'' clauses to the declaration. The declaration 
now states these considerations in section II. We made this change to 
improve readability and do not intend that it have any substantive 
legal effect.
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    \6\ 42 U.S.C. 247d-6d(b)(6).
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Section III, Recommended Activities

    The Secretary must recommend the activities for which the PREP 
Act's liability immunity is in effect. These activities may include, 
under conditions as the Secretary may specify, the manufacture, 
testing, development, distribution, administration, or use of one or 
more Covered Countermeasures (``Recommended Activities'').\7\ In the 
previous declaration, we included the Recommended Activities in section 
I of the declaration, ``Covered Countermeasures.'' The declaration now 
states them in section III. We made this change to improve readability 
and do not intend that it have any substantive legal effect. In 
addition, we deleted the phrases ``as defined in section IX below'' and 
``with respect to the category of disease and population described in 
sections II and IV below'' for consistency with formatting changes, and 
changed ``and usage'' to ``or use'' for consistency with the statute. 
These changes are not intended to have any substantive legal effect.
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    \7\ 42 U.S.C. 247d-6d(b)(1).
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Section IV, Liability Immunity

    The Secretary must also state that liability protections available 
under the PREP Act are in effect with respect to the Recommended 
Activities.\8\ These liability protections provide that, ``[s]ubject to 
other provisions of [the PREP Act], a covered person shall be immune 
from suit and liability under Federal and State law with respect to all 
claims for loss caused by, arising out of, relating to, or resulting 
from the administration to or use by an individual of a covered 
countermeasure if a declaration . . . has been issued with respect to 
such countermeasure.'' \9\ In the previous declaration, we included a 
statement referring to liability immunity specified under the PREP Act 
in section I of the declaration, ``Covered Countermeasures.'' The 
declaration now includes the statement that liability immunity is in 
effect for Recommended Activities in a separate section IV. We made 
this change to improve readability and do not intend that it have any 
substantive legal effect.
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    \8\ 42 U.S.C. 247d-6d(b)(1).
    \9\ 42 U.S.C. 247d-6d(a)(1).
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Section V, Covered Persons

    The PREP Act's liability immunity applies to ``Covered Persons'' 
with respect to administration or use of a Covered Countermeasure. The 
term ``Covered Persons'' has a specific meaning, and is defined in the 
PREP Act to include manufacturers, distributors, program planners, and 
qualified persons, and their officials, agents, and employees, and the 
United States.\10\ The PREP Act further defines the terms 
``manufacturer,'' ``distributor,'' ``program planner,'' and ``qualified 
person'' as described below.\11\
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    \10\ 42 U.S.C. 247d-6d (i)(2).
    \11\ 42 U.S.C. 247d-6d(i).
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    A manufacturer includes a contractor or subcontractor of a 
manufacturer; a supplier or licenser of any product, intellectual 
property, service, research tool or component or other article used in 
the design, development, clinical testing, investigation or 
manufacturing of a Covered Countermeasure; and any or all of the 
parents, subsidiaries, affiliates, successors, and assigns of a 
manufacturer; \12\
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    \12\ 42 U.S.C. 247d-6d(i)(4).
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    A distributor means a person or entity engaged in the distribution 
of drug, biologics, or devices, including but not limited to: 
manufacturers; repackers; common carriers; contract carriers; air 
carriers; own-label distributors; private-label distributors; jobbers; 
brokers; warehouses and wholesale drug warehouses; independent 
wholesale drug traders; and retail pharmacies; \13\
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    \13\ 42 U.S.C. 247d-6d(i)(3).
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    A program planner means a state or local government, including an 
Indian tribe; a person employed by the state or local government; or 
other person who supervises or administers a program with respect to 
the administration, dispensing, distribution, provision, or use of a 
Covered Countermeasure, including a person who establishes 
requirements, provides policy guidance, or supplies technical or 
scientific advice or assistance or provides a facility to administer or 
use a Covered Countermeasure in accordance with the Secretary's 
declaration; \14\ Under this definition, a private sector employer or 
community group or other person can be a program planner when it 
carries out the described activities.
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    \14\ 42 U.S.C. 247d-6d(i)(6).
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    A qualified person means a licensed health professional or other 
individual who is authorized to prescribe, administer, or dispense 
Covered Countermeasures under the law of the state in which the 
countermeasure was prescribed, administered, or dispensed; or a person 
within a category of persons identified as qualified in the Secretary's 
declaration.\15\ Under this definition, the Secretary can describe in 
the declaration other qualified persons, such as volunteers, who are 
Covered Persons. Section V describes other qualified persons covered by 
this declaration. The PREP Act also defines ``person'' as used in the 
Act: A person includes an individual, partnership, corporation, 
association, entity, or public or private corporation, including a 
federal, state, or local government agency or department.\16\
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    \15\ 42 U.S.C. 247d-6d(i)(8).
    \16\ 42 U.S.C. 247d-6d(i)(5).
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    The provisions regarding Covered Persons previously appeared in the 
declaration as a definition in section IX, ``Definitions'' and in 
section VI, ``Qualified Persons.'' We combined these two provisions 
into a new section V, ``Covered Persons'' and added ``to perform an 
activity'' to the description of ``Other Qualified Persons'' authorized 
under an Emergency Use Authorization (EUA) for clarity. We made these 
changes to improve readability and clarity and do not intend them to 
have any substantive legal effect.
    We also modified the description of Covered Persons to include a 
new category of qualified persons: ``Any person authorized to 
prescribe, administer, or dispense covered countermeasures in 
accordance with Section 564A of the FD&C Act.'' This change ensures 
that persons who prescribe, administer, or dispense covered 
countermeasures in accordance with section 564A of the FD&C Act are 
Covered Persons under the declaration.

Section VI, Covered Countermeasures

    As noted above, section III describes the Secretary's Recommended 
Activities for which liability immunity is in effect. This section 
identifies the countermeasures for which the Secretary has recommended 
such activities. The PREP Act states that a ``Covered Countermeasure'' 
must be: A ``qualified pandemic or epidemic product,'' or a ``security 
countermeasure,'' as described immediately below; or a drug, biological 
product or device authorized for emergency use in accordance with

[[Page 76549]]

section 564, 564A, or 564B of the FD&C Act.\17\
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    \17\ 42 U.S.C. 247d-6d(i)(1). Sections 564, 564A, and 564B of 
the FD&C Act may be found at 21 U.S.C. 360bbb-3, 360bbb-3a, and 
360bbb-3b.
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    A qualified pandemic or epidemic product means a drug or device, as 
defined in the FD&C Act or a biological product, as defined in the PHS 
Act \18\ that is: (i) Manufactured, used, designed, developed, 
modified, licensed or procured to diagnose, mitigate, prevent, treat, 
or cure a pandemic or epidemic or limit the harm such a pandemic or 
epidemic might otherwise cause; (ii) manufactured, used, designed, 
developed, modified, licensed, or procured to diagnose, mitigate, 
prevent, treat, or cure a serious or life-threatening disease or 
condition caused by such a drug, biological product or device; (iii) or 
a product or technology intended to enhance the use or effect of such a 
drug, biological product, or device.\19\
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    \18\ 21 U.S.C. 321(g)(1), (h); 42 U.S.C. 262(i).
    \19\ 42 U.S.C. 247d-6d(i)(1)(A), (i)(7).
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    A security countermeasure is a drug or device, as defined in the 
FD&C Act or a biological product, as defined in the PHS Act \20\ that: 
(i) (a) the Secretary determines to be a priority to diagnose, 
mitigate, prevent or treat harm from any biological, chemical, 
radiological, or nuclear agent identified as a material threat by the 
Secretary of Homeland Security, or (b) to diagnose, mitigate, prevent, 
or treat harm from a condition that may result in adverse health 
consequences or death and may be caused by administering a drug, 
biological product, or device against such an agent; and (ii) is 
determined by the Secretary of Health and Human Services to be a 
necessary countermeasure to protect public health.\21\
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    \20\ 21 U.S.C. 321(g)(1), (h);42 U.S.C. 262(i).
    \21\ 42 U.S.C. 247d-6d(i)(1)(B),(c)(1)(B).
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    To be a Covered Countermeasure, qualified pandemic or epidemic 
products and security countermeasures also must be approved or cleared 
under the FD&C Act; \22\ licensed under the PHS Act; \23\ authorized 
for emergency use under sections 564, 564A, or 564B of the FD&C 
Act.\24\
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    \22\ 21 U.S.C. 301 et seq.
    \23\ 42 U.S.C. 262.
    \24\ 21 U.S.C. 360bbb-3, 360bbb-3a, 360bbb-3b.
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    A qualified pandemic or epidemic product also may be a Covered 
Countermeasure when it is subject to an exemption (that is, it is 
permitted to be used under an Investigational Drug Application or an 
Investigational Device Exemption) under the FD&C Act \25\ and is the 
object of research for possible use for diagnosis, mitigation, 
prevention, treatment, cure or limit harm of a pandemic or epidemic or 
serious or life-threatening condition caused by such a drug or device. 
A security countermeasure also may be a Covered Countermeasure if it 
may reasonably be determined to qualify for approval or licensing 
within 10 years after the Department's determination that procurement 
of the countermeasure is appropriate.
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    \25\ 21 U.S.C. 355(i), 360j(g).
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    Provisions regarding Covered Countermeasures appeared in section I 
of the declaration, ``Covered Countermeasures'' and section IX of the 
declaration, ``Definitions.'' Section I included not only a description 
of the Covered Countermeasure but also the Secretary's recommendation, 
statement regarding liability immunity, and additional conditions 
characterizing countermeasures. We have combined sections I and IX and 
simplified the language so that it now only identifies the Covered 
Countermeasures. We have relocated the other conditions included in the 
``Covered Countermeasure'' section to new sections, ``Recommended 
Activities,'' ``Liability Immunity,'' and ``Limitations on 
Distribution,'' to improve readability. We do not intend for this 
change to have any substantive legal effect.
    Section I of the declaration also stated that the declaration 
applied to Covered Countermeasures administered or used during the 
effective time period of the declaration. We have deleted this language 
as it is redundant of the provisions stated in sections XII, 
``Effective Time Period,'' and XIII, ``Additional Time Period of 
Coverage.''
    We also revised the description and definition of the Covered 
Countermeasure that previously appeared in sections I, ``Covered 
Countermeasures'' and IX, ``Definitions.'' Section I referred to the 
Act for the definition of ``Covered Countermeasures,'' and section IX 
defined the term ``Smallpox Countermeasure'' as ``Any vaccine; 
antiviral, other drug; or diagnostic or device to identify, prevent or 
treat smallpox or orthopoxvirus or adverse events from such 
countermeasures (1) Licensed under section 351 of the Public Health 
Service Act; (2) approved under section 505 or section 515 of the 
Federal Food, Drug, and Cosmetic Act (FDCA); (3) cleared under section 
510(k) of the FDCA; (4) authorized for emergency use under section 564 
of the FDCA ; (5) used under section 505(i) of the FDCA or section 
351(a)(3) of the PHS Act, and 21 CFR part 312; or (6) used under 
section 520(g) of the FDCA and 21 CFR part 812.''
    We revised the description of smallpox countermeasures to clarify 
that coverage for vaccines includes components and constituent 
materials of the vaccines and device and constituent components used in 
administration of the vaccines. We also added the term ``biologic'' to 
more accurately describe the types of countermeasures used against 
smallpox and added ``other'' before ``drug'' and ``device'' for 
accuracy. The definition now reads: ``any vaccine, including all 
components and constituent materials of these vaccines, and all devices 
and their constituent components used in the administration of these 
vaccines; any antiviral; any other drug; any biologic; or any 
diagnostic or other device to identify, prevent or treat smallpox or 
orthopoxvirus or adverse events from such countermeasures.'' These 
changes are intended as clarification.
    We also added a statement referencing the statutory definitions of 
Covered Countermeasures to make clear that these statutory definitions 
limit the scope of Covered Countermeasures. Specifically, we noted that 
they must be ``qualified pandemic or epidemic products,'' or ``security 
countermeasures,'' or drugs, biological products, or devices authorized 
for investigational or emergency use, as those terms are defined in the 
PREP Act, the FD&C Act, and the Public Health Service Act.'' By 
referencing the statutory provisions, the revised definition also 
incorporates changes to the PREP Act definitions of covered 
countermeasure and qualified pandemic or epidemic product made by 
PAHPRA.

Section VII, Limitations on Distribution

    The Secretary may specify that liability immunity is in effect only 
to Covered Countermeasures obtained through a particular means of 
distribution.\26\ These limitations on distribution previously appeared 
in section I, ``Covered Countermeasures,'' and section IX, 
``Definitions.'' We now state the limitations in a separate section and 
combine them with relevant definitions for improved readability.
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    \26\ 42 U.S.C. 247d-6d(a)(5), (b)(2)(E).
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    The declaration now states that liability immunity is afforded to 
Covered Persons for Recommended Activities related to:
    (a) Present or future federal contracts, cooperative agreements, 
grants, other transactions, interagency agreements, or memoranda of 
understanding or other federal agreements or activities directly 
conducted by the federal government; or

[[Page 76550]]

    (b) Activities authorized in accordance with the public health and 
medical response of the Authority Having Jurisdiction to prescribe, 
administer, deliver, distribute or dispense the Covered Countermeasures 
following a declaration of an emergency.
    For governmental program planners only, liability immunity is 
afforded only to the extent they obtain Covered Countermeasures through 
voluntary means, such as (1) donation; (2) commercial sale; (3) 
deployment of Covered Countermeasures from Federal stockpiles; or (4) 
deployment of donated, purchased, or otherwise voluntarily obtained 
Covered Countermeasures from State, local, or private stockpiles.
    In regard to (a), we, added the phrase ``other transactions,'' 
which may be used for some Covered Countermeasure activities,\27\ added 
the phrase ``or other Federal agreements'' to clarify that the 
provision is intended to cover all types of Federal agreements, and 
added the phrase ``or activities directly conducted by the Federal 
Government'' to clarify that activities such as manufacture of vaccines 
for clinical trials by the HHS National Institutes of Health Vaccine 
Research Center or distribution of countermeasures by federal employees 
are covered. We changed the conjunction ``and'' to ``or'' between (a) 
and (b) to clarify that immunity is available under either of these 
circumstances; the activities do not have to both relate to a Federal 
award or agreement and be used in a public health and medical response 
in order for immunity to apply. The conjunction ``and'' used in the 
previous declaration was a drafting error; the Secretary's intent in 
that previous declarations has been the meaning conferred by the term 
``or.'' Provisions (a) and (b) are intended to afford immunity to 
Federal government conducted and supported activities that precede a 
public health emergency and to activities in accordance with all 
Authorities Having Jurisdiction during a declared public health 
emergency. These changes are intended as clarifications and to improve 
readability, and are not intended as substantive changes.
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    \27\ See, e.g., 42 U.S.C. 247d-7d(c)(5).
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    In regard to (b), the meaning of the terms ``Authority Having 
Jurisdiction'' and ``Declaration of an Emergency'' are unchanged.
    Finally, we slightly modified the last limitation by deleting 
extraneous statutory references and other language and by replacing the 
final sentence with the word ``only'' after ``planners'' to improve 
readability. We do not intend for the changes to this provision to 
alter its substantive legal effect. As stated in the ``whereas'' 
clauses of the prior declaration, this limitation on distribution is 
intended to deter program planners that are government entities from 
seizing privately held stockpiles of Covered Countermeasures. It does 
not apply to any other Covered Persons, including other program 
planners who are not government entities.

Section VIII, Category of Disease, Health Condition, or Threat

    The Secretary must identify, for each Covered Countermeasure, the 
categories of diseases, health conditions, or threats to health for 
which the Secretary recommends the administration or use of the 
countermeasure.\28\ This information previously appeared in section II, 
``Category of Disease.''
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    \28\ 42 U.S.C. 247d-6d(b)(2)(A).
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Section IX, Administration of Covered Countermeasures

    The PREP Act does not explicitly define the term ``administration'' 
but does assign the Secretary the responsibility to provide relevant 
conditions in the declaration. This definition previously appeared in 
section IX, ``Definitions.'' We have moved it to a separate section to 
improve readability. The Secretary has also narrowed the definition of 
``administration'' that was previously provided in the declaration. The 
declaration previously defined the term ``administration'' to include 
physical provision of a Covered Countermeasure, as well as management 
and operation of systems and locations at which Covered Countermeasures 
may be provided to recipients:
    Administration of a Covered Countermeasure: As used in section 
319F-3(a)(2)(B) of the Act includes, but is not limited to, public and 
private delivery, distribution, and dispensing activities relating to 
physical administration of the countermeasures to patients/recipients, 
management and operation of delivery systems, and management and 
operation of distribution and dispensing locations.
    The definition has been revised as follows:
    Administration of a Covered Countermeasure means physical provision 
of the countermeasures to recipients, or activities and decisions 
directly relating to public and private delivery, distribution and 
dispensing of the countermeasures to recipients; management and 
operation of countermeasure programs; or management and operation of 
locations for purpose of distributing and dispensing countermeasures.
    As clarified, administration extends only to physical provision of 
a countermeasure to a recipient, such as vaccination or handing drugs 
to patients, and to activities related to management and operation of 
programs and locations for providing countermeasures to recipients, 
such as decisions and actions involving security and queuing, but only 
insofar as those activities directly relate to the countermeasure 
activities. Claims for which Covered Persons are provided immunity 
under the Act are losses caused by, arising out of, relating to, or 
resulting from the administration to or use by an individual of a 
Covered Countermeasure consistent with the terms of a declaration 
issued under the Act.\29\ Under the Secretary's definition, these 
liability claims are precluded if the claims allege an injury caused by 
physical provision of a countermeasure to a recipient, or if the claims 
are directly due to conditions of delivery, distribution, dispensing, 
or management and operation of countermeasure programs at distribution 
and dispensing sites.
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    \29\ 42 U.S.C. 247d-6d(a).
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    Thus, it is the Secretary's interpretation that, when a declaration 
is in effect, the Act precludes, for example, liability claims alleging 
negligence by a manufacturer in creating a vaccine, or negligence by a 
health care provider in prescribing the wrong dose, absent willful 
misconduct. Likewise, the Act precludes a liability claim relating to 
the management and operation of a countermeasure distribution program 
or site, such as a ``slip-and-fall'' injury or vehicle collision by a 
recipient receiving a countermeasure at a retail store serving as an 
administration or dispensing location that alleges, for example, lax 
security or chaotic crowd control. However, a liability claim alleging 
an injury occurring at the site that was not directly related to the 
countermeasure activities is not covered, such as a slip and fall with 
no direct connection to the countermeasure's administration or use. In 
each case, whether immunity is applicable will depend on the particular 
facts and circumstances.

Section X, Population

    The Secretary must identify, for each Covered Countermeasure 
specified in a declaration, the population or populations of 
individuals for which liability immunity is in effect with respect to 
administration or use of the

[[Page 76551]]

countermeasure.\30\ This section explains which individuals should use 
the countermeasure or to whom the countermeasure should be 
administered--in short, those who should be vaccinated or take a drug 
or other countermeasure. These provisions previously appeared in 
section IV, ``Population.'' The previous declaration stated that the 
population specified in the declaration included:
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    \30\ 42 U.S.C. 247d-6d(b)(2)(C).
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    The populations specified in this declaration are all persons who 
use a Covered Countermeasure or to whom a Covered Countermeasure is 
administered in accordance with this declaration, including, but not 
limited to: (1) Any person conducting research and development of 
Covered Countermeasures directly for the federal government or pursuant 
to a contract, grant, or cooperative agreement with the federal 
government; (2) any person who receives a Covered Countermeasure from 
persons authorized in accordance with the public health and medical 
emergency response of the Authority Having Jurisdiction to prescribe, 
administer, deliver, distribute, or dispense the Covered 
Countermeasure, and their officials, agents, employees, contractors, 
and volunteers following a declaration of an emergency; (3) any person 
who receives a Covered Countermeasure from a person authorized to 
prescribe, administer or dispense the countermeasure or who is 
otherwise authorized to prescribe, administer or dispense the 
countermeasure under an Emergency Use Authorization; (4) any person who 
receives a Covered Countermeasure as an investigational new drug in 
human clinical trials being conducted directly by the federal 
government or pursuant to a contract, grant, or cooperative agreement 
with the federal government.
    We have amended the declaration to provide that the population 
includes ``any individual who uses or who is administered a Covered 
Countermeasure in accordance with the declaration.'' We believe this 
broad statement accurately encompasses all of the previously listed 
populations given as examples of that phrase and ensures that no 
populations that use or are administered the Covered Countermeasures in 
accordance with the terms of the declaration are omitted.
    In addition, the PREP Act specifies that liability immunity is 
afforded: (1) To manufacturers and distributors without regard to 
whether the countermeasure is used by or administered to this 
population; and (2) to program planners and qualified persons when the 
countermeasure is either used by or administered to this population or 
the program planner or qualified person reasonably could have believed 
the recipient was in this population.\31\ We included these statutory 
conditions in the declaration for clarity.
---------------------------------------------------------------------------

    \31\ 42 U.S.C. 247d-6d(a)(4).
---------------------------------------------------------------------------

Section XI, Geographic Area

    The Secretary must identify, for each Covered Countermeasure 
specified in the declaration, the geographic area or areas for which 
liability immunity is in effect with respect to administration or use 
of the countermeasure, including, as appropriate, whether the 
declaration applies only to individuals physically present in the area 
or, in addition, applies to individuals who have a described connection 
to the area.\32\ This section appeared in section V, ``Geographic 
Area.''
---------------------------------------------------------------------------

    \32\ 42 U.S.C. 247d-6d(b)(2)(D).
---------------------------------------------------------------------------

    In addition, the PREP Act specifies that liability immunity is 
afforded: (1) To manufacturers and distributors without regard to 
whether the countermeasure is used by or administered to individuals in 
the geographic areas; and (2) to program planners and qualified persons 
when the countermeasure is either used or administered in the 
geographic areas or the program planner or qualified person reasonably 
could have believed the countermeasure was used or administered in the 
areas.\33\ We included these statutory conditions in the declaration 
for clarity.
---------------------------------------------------------------------------

    \33\ 42 U.S.C. 247d-6d(a)(4).
---------------------------------------------------------------------------

Section XII, Effective Time Period

    The Secretary must identify, for each Covered Countermeasure, the 
period or periods during which liability immunity is in effect, 
designated by dates, milestones, or other description of events, 
including factors specified in the PREP Act.\34\ This section appeared 
as section III, ``Effective Time Period.''
---------------------------------------------------------------------------

    \34\ 42 U.S.C. 246d-6d(b)(2)(B), (b)(6).
---------------------------------------------------------------------------

    The declaration is amended to clarify when liability takes effect 
for different means of distribution and to delete language referring to 
the Smallpox Emergency Personnel Protection Act (SEPPA) of 2003. These 
changes are intended to have no legal effect. The time frame for filing 
claims under the Secretary's SEPPA declaration expired in January 2010. 
The declaration is also amended to extend the period for which 
liability immunity is in effect. The previous declaration was in effect 
through December 31, 2015. We have extended the effective time period 
to December 31, 2022.

Section XIII, Additional Time Period of Coverage

    The Secretary must specify a date after the ending date of the 
effective period of the declaration that is reasonable for 
manufacturers to arrange for disposition of the Covered Countermeasure, 
including return of the product to the manufacturer, and for other 
Covered Persons to take appropriate actions to limit administration or 
use of the Covered Countermeasure.\35\ In addition, the PREP Act 
specifies that for Covered Countermeasures that are subject to a 
declaration at the time they are obtained for the Strategic National 
Stockpile (SNS) under 42 U.S.C. 247d-6b(a), the effective period of the 
declaration extends through the time the countermeasure is used or 
administered pursuant to a distribution or release from the SNS. 
Liability immunity under the provisions of the PREP Act and the 
conditions of the declaration continues during these additional time 
periods. Thus, liability immunity is afforded during the ``Effective 
Time Period,'' described under XII of the declaration, plus the 
``Additional Time Period'' described under section XIII of the 
declaration.
---------------------------------------------------------------------------

    \35\ 42 U.S.C. 247d-6d(b)(3).
---------------------------------------------------------------------------

    The provision for additional time periods previously appeared as 
section VII, ``Additional Time Periods of Coverage After Expiration of 
the Declaration.'' The provision is amended to clarify the statutory 
provisions as they apply to manufacturers and to other covered persons, 
and to clarify that extended coverage applies to any products obtained 
for the Strategic National Stockpile during the effective period of the 
declaration. We included the statutory provision for clarity.

Section XIV, Countermeasures Injury Compensation Program

    Section 319F-4 of the PREP Act authorizes the Countermeasures 
Injury Compensation Program (CICP) to provide benefits to eligible 
individuals who sustain a serious physical injury or die as a direct 
result of the administration or use of a Covered Countermeasure.\36\ 
Compensation under the CICP for an injury directly caused by a Covered 
Countermeasure is based on the requirements set forth in this 
declaration, the administrative rules for the Program,\37\ and the 
statute.\38\ To show direct causation between a Covered Countermeasure 
and a serious physical injury, the statute requires

[[Page 76552]]

``compelling, reliable, valid, medical and scientific evidence.'' \39\ 
The administrative rules for the Program further explain the necessary 
requirements for eligibility under the CICP. Please note that, by 
statute, requirements for compensation under the CICP may not always 
align with the requirements for liability immunity provided under the 
PREP Act. We have added section XIV, ``Countermeasures Injury 
Compensation Program'' to explain the types of injury and standard of 
evidence needed to be considered for compensation under the CICP. We 
included this information to inform readers of this Program.
---------------------------------------------------------------------------

    \36\ 42 U.S.C. 247d-6e.
    \37\ 42 CFR part 110.
    \38\ 42 U.S.C. 247d-6e.
    \39\ 42 U.S.C. 247d-6e(b)(4).
---------------------------------------------------------------------------

Section XV, Amendments

    The Secretary may amend any portion of a declaration through 
publication in the Federal Register.\40\ This section appeared in 
section VIII, ``Amendments.'' It has been updated to reflect that the 
Republished Declaration amends the prior October 10, 2008, declaration.
---------------------------------------------------------------------------

    \40\ 42 U.S.C. 247d-6d(b)(4).
---------------------------------------------------------------------------

Deleted Sections

    The prior declaration included a number of ``whereas'' clauses as 
introductory to the declaration. As described above, we have 
incorporated ``whereas'' clauses that made necessary findings under the 
PREP Act into the text of the declaration itself. We have deleted the 
remaining ``whereas'' clauses. We do not intend this change to have 
legal effect.
    The prior declaration contained a definitions section. These 
definitions have been incorporated into the relevant sections of the 
declaration as noted above, and modified or deleted where indicated 
above.
    An appendix previously appeared in the declaration that listed 
federal government contracts for research, development, and procurement 
of Covered Countermeasures. We deleted this appendix to clarify that 
liability immunity under the provisions of the PREP Act and terms of 
the declaration is not limited to the contracts listed in the appendix. 
Coverage is available for any award or agreement that meets the 
description provided in section VII of the declaration. In addition, 
deleting the appendix relieves the Department of the need to 
periodically update the appendix.
    We made these deletions for clarity and do not intend them to have 
legal effect.

Republished Declaration

Declaration, as Amended, for Public Readiness and Emergency 
Preparedness Act Coverage for Smallpox Countermeasures

    This declaration amends and republishes the October 10, 2008, 
Declaration Under the Public Readiness and Emergency Preparedness Act 
(``PREP Act'') for smallpox countermeasures. To the extent any term of 
the October 10, 2008, Declaration is inconsistent with any provision of 
this Republished Declaration, the terms of this Republished Declaration 
are controlling.

I. Determination of Public Health Emergency or Credible Risk of Future 
Public Health Emergency

42 U.S.C. 247d-6d(b)(1)

    I have determined that there is a credible risk the release of 
variola virus or other orthopoxvirus and the resulting disease or 
conditions may in the future constitute a public health emergency.

II. Factors Considered

42 U.S.C. 247d-6d(b)(6)

    I have considered the desirability of encouraging the design, 
development, clinical testing or investigation, manufacture, labeling, 
distribution, formulation, packaging, marketing, promotion, sale, 
purchase, donation, dispensing, prescribing, administration, licensing, 
and use of the Covered Countermeasures.

III. Recommended Activities

42 U.S.C. 247d-6d(b)(1)

    I recommend, under the conditions stated in this declaration, the 
manufacture, testing, development, distribution, administration, or use 
of the Covered Countermeasures.

IV. Liability Immunity

42 U.S.C. 247d-6d(a), 247d-6d(b)(1)

    Liability immunity as prescribed in the PREP Act and conditions 
stated in this declaration is in effect for the Recommended Activities 
described in section III.

V. Covered Persons

42 U.S.C. 247d-6d(i)(2),(3),(4),(6),(8)(A) and (B)

    Covered Persons who are afforded liability immunity under this 
declaration are ``manufacturers,'' distributors, program planners, 
qualified persons, and their officials, agents, and employees, as those 
terms are defined in the PREP Act, and the United States.
    In addition, I have determined that the following additional 
persons are qualified persons: (a) Any person authorized in accordance 
with the public health and medical emergency response of the Authority 
Having Jurisdiction, as described in section VII below, to prescribe, 
administer, deliver, distribute or dispense the Covered 
Countermeasures, and their officials, agents, employees, contractors 
and volunteers, following a declaration of an emergency; (b) Any person 
authorized to prescribe, administer, or dispense the Covered 
Countermeasures or who is otherwise authorized to perform an activity 
under an Emergency Use Authorization in accordance with section 564 of 
the FD&C Act; (c) any person authorized to prescribe, administer, or 
dispense Covered Countermeasures in accordance with Section 564A of the 
FD&C Act.

VI. Covered Countermeasures

42 U.S.C. 247d-6b(c)(1)(B), 42 U.S.C. 247d-6d(i)(1) and (7)

    Covered Countermeasures are any vaccine, including all components 
and constituent materials of these vaccines, and all devices and their 
constituent components used in the administration of these vaccines; 
any antiviral; any other drug; any biologic; or any diagnostic or other 
device to identify, prevent or treat smallpox or orthopoxvirus or 
adverse events from such countermeasures.
    Covered Countermeasures must be ``qualified pandemic or epidemic 
products,'' or ``security countermeasures,'' or drugs, biological 
products, or devices authorized for investigational or emergency use, 
as those terms are defined in the PREP Act, the FD&C Act, and the 
Public Health Service Act.

VII. Limitations on Distribution

42 U.S.C. 247d-6d(a)(5) and (b)(2)(E)

    I have determined that liability immunity is afforded to Covered 
Persons only for Recommended Activities involving Covered 
Countermeasures that are related to:
    (a) Present or future federal contracts, cooperative agreements, 
grants, other transactions, interagency agreements, memoranda of 
understanding, or other federal agreements, or activities directly 
conducted by the federal government;
    or
    (b) Activities authorized in accordance with the public health and 
medical response of the Authority Having Jurisdiction to prescribe, 
administer, deliver, distribute or

[[Page 76553]]

dispense the Covered Countermeasures following a declaration of an 
emergency.
    i. The Authority Having Jurisdiction means the public agency or its 
delegate that has legal responsibility and authority for responding to 
an incident, based on political or geographical (e.g., city, county, 
tribal, state, or federal boundary lines) or functional (e.g., law 
enforcement, public health) range or sphere of authority.
    ii. A declaration of emergency means any declaration by any 
authorized local, regional, state, or federal official of an emergency 
specific to events that indicate an immediate need to administer and 
use the Covered Countermeasures, with the exception of a federal 
declaration in support of an Emergency Use Authorization under section 
564 of the FD&C Act unless such declaration specifies otherwise;
    I have also determined that for governmental program planners only, 
liability immunity is afforded only to the extent such program planners 
obtain Covered Countermeasures through voluntary means, such as (1) 
donation; (2) commercial sale; (3) deployment of Covered 
Countermeasures from federal stockpiles; or (4) deployment of donated, 
purchased, or otherwise voluntarily obtained Covered Countermeasures 
from State, local, or private stockpiles.

VIII. Category of Disease, Health Condition, or Threat

42 U.S.C. 247d-6d(b)(2)(A)

    The category of disease, health condition, or threat for which I 
recommend the administration or use of the Covered Countermeasures is 
smallpox resulting from exposure to variola virus and the threat of 
disease resulting from exposure to other orthodox viruses.

IX. Administration of Covered Countermeasures

42 U.S.C. 247d-6d(a)(2)(B)

    Administration of the Covered Countermeasure means physical 
provision of the countermeasures to recipients, or activities and 
decisions directly relating to public and private delivery, 
distribution and dispensing of the countermeasures to recipients, 
management and operation of countermeasure programs, or management and 
operation of locations for purpose of distributing and dispensing 
countermeasures.

X. Population

42 U.S.C. 247d-6d(a)(4), 247d-6d(b)(2)(C)

    The populations of individuals include any individual who uses or 
is administered the Covered Countermeasures in accordance with this 
declaration.
    Liability immunity is afforded to manufacturers and distributors 
without regard to whether the countermeasure is used by or administered 
to this population; liability immunity is afforded to program planners 
and qualified persons when the countermeasure is used by or 
administered to this population or the program planner or qualified 
person reasonably could have believed the recipient was in this 
population.

XI. Geographic Area

42 U.S.C. 247d-6d(a)(4), 247d-6d(b)(2)(D)

    Liability immunity is afforded for the administration or use of a 
Covered Countermeasure without geographic limitation.
    Liability immunity is afforded to manufacturers and distributors 
without regard to whether the countermeasure is used by or administered 
in these geographic areas; liability immunity is afforded to program 
planners and qualified persons when the countermeasure is used by or 
administered in these geographic areas, or the program planner or 
qualified person reasonably could have believed the recipient was in 
these geographic areas.

XII. Effective Time Period

42 U.S.C. 247d-6d(b)(2)(B)

    Liability immunity for Covered Countermeasures obtained through 
means of distribution other than in accordance with the public health 
and medical response of the Authority Having Jurisdiction extends 
through December 31, 2022.
    Liability immunity for Covered Countermeasures administered and 
used in accordance with the public health and medical response of the 
Authority Having Jurisdiction begins with a declaration and lasts 
through (1) the final day the emergency declaration is in effect or (2) 
December 31, 2022, whichever occurs first.

XIII. Additional Time Period of Coverage

42 U.S.C. 247d-6d(b)(3)(A), (B) and (C)

    I have determined that an additional twelve (12) months of 
liability protection is reasonable to allow for the manufacturer(s) to 
arrange for disposition of the Covered Countermeasure, including return 
of the Covered Countermeasures to the manufacturer, and for Covered 
Persons to take such other actions as are appropriate to limit the 
administration or use of the Covered Countermeasures.
    Covered Countermeasures obtained for the SNS during the effective 
period of this declaration for Covered Countermeasures obtained through 
means of distribution other than in accordance with the public health 
and medical response of the Authority Having Jurisdiction are covered 
through the date of administration or use pursuant to a distribution or 
release from the SNS.

XIV. Countermeasures Injury Compensation Program

42 U.S.C. 247d-6e

    The PREP Act authorizes the Countermeasures Injury Compensation 
Program (CICP) to provide benefits to certain individuals or estates of 
individuals who sustain a serious physical covered injury as the direct 
result of the administration or use of the Covered Countermeasures and/
or benefits to certain survivors of individuals who die as a direct 
result of the administration or use of the Covered Countermeasures. The 
causal connection between the countermeasure and the serious physical 
injury must be supported by compelling, reliable, valid, medical and 
scientific evidence in order for the individual to be considered for 
compensation. The CICP is administered by the Health Resources and 
Services Administration, within the Department of Health and Human 
Services. Information about the CICP is available at 855-266-2427 
(toll-free) or http://www.hrsa.gov/cicp/.

XV. Amendments

42 U.S.C. 247d-6d(b)(4)

    The October 10, 2008 Declaration Under the Public Readiness and 
Emergency Preparedness Act for smallpox countermeasures was first 
published on October 17, 2008. This is the first amendment to that 
declaration.
    Any further amendments to this declaration will be published in the 
Federal Register.

    Authority: 42 U.S.C. 247d-6d.

    Dated: December 1, 2015.
Sylvia M. Burwell,
Secretary.
[FR Doc. 2015-31092 Filed 12-8-15; 8:45 am]
BILLING CODE P



                                                  76546                    Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices

                                                  a federal Declaration in support of an                  XI. Geographic Area                                   XIV. Countermeasures Injury
                                                  Emergency Use Authorization under                                                                             Compensation Program
                                                                                                          42 U.S.C. 247d–6d(a)(4), 247d–
                                                  section 564 of the FD&C Act unless such                                                                       42 U.S.C 247d–6e
                                                                                                          6d(b)(2)(D)
                                                  Declaration specifies otherwise;
                                                                                                                                                                  The PREP Act authorizes the
                                                     I have also determined that for                        Liability immunity is afforded for the
                                                                                                                                                                Countermeasures Injury Compensation
                                                  governmental program planners only,                     administration or use of a Covered
                                                                                                                                                                Program (CICP) to provide benefits to
                                                  liability immunity is afforded only to                  Countermeasure without geographic
                                                                                                                                                                certain individuals or estates of
                                                  the extent such program planners obtain                 limitation.                                           individuals who sustain a covered
                                                  Covered Countermeasures through                           Liability immunity is afforded to                   serious physical injury as the direct
                                                  voluntary means, such as (1) donation;                  manufacturers and distributors without                result of the administration or use of the
                                                  (2) commercial sale; (3) deployment of                  regard to whether the countermeasure is               Covered Countermeasures, and benefits
                                                  Covered Countermeasures from federal                    used by or administered in any                        to certain survivors of individuals who
                                                  stockpiles; or (4) deployment of                        designated geographic area; liability                 die as a direct result of the
                                                  donated, purchased, or otherwise                        immunity is afforded to program                       administration or use of the Covered
                                                  voluntarily obtained Covered                            planners and qualified persons when                   Countermeasures. The causal
                                                  Countermeasures from state, local, or                   the countermeasure is used by or                      connection between the countermeasure
                                                  private stockpiles.                                     administered in any designated                        and the serious physical injury must be
                                                                                                          geographic area, or the program planner               supported by compelling, reliable, valid,
                                                  VIII. Category of Disease, Health                                                                             medical and scientific evidence in order
                                                                                                          or qualified person reasonably could
                                                  Condition, or Threat                                                                                          for the individual to be considered for
                                                                                                          have believed the recipient was in that
                                                  42 U.S.C. 247d–6d(b)(2)(A)                              geographic area.                                      compensation. The CICP is
                                                                                                                                                                administered by the Health Resources
                                                    The category of disease, health                       XII. Effective Time Period                            and Services Administration, within the
                                                  condition, or threat for which I                        42 U.S.C. 247d–6d(b)(2)(B)                            Department of Health and Human
                                                  recommend the administration or use of                                                                        Services. Information about the CICP is
                                                  the Covered Countermeasures is Ebola                       Liability immunity for Covered                     available at the toll-free number 1–855–
                                                  virus disease.                                          Countermeasures through means of                      266–2427 or http://www.hrsa.gov/cicp/.
                                                                                                          distribution, as identified in Section                XV. Amendments
                                                  IX. Administration of Covered
                                                                                                          VII(a) of this Declaration, other than in
                                                  Countermeasures                                                                                               42 U.S.C. 247d–6d(b)(4)
                                                                                                          accordance with the public health and
                                                  42 U.S.C. 247d–6d(a)(2)(B)                              medical response of the Authority                       Amendments to this Declaration will
                                                                                                          Having Jurisdiction began on December                 be published in the Federal Register.
                                                    Administration of the Covered                         3, 2014, and extends for twenty-four
                                                  Countermeasure means physical                                                                                   Authority: 42 U.S.C. 247d–6d.
                                                                                                          (24) months from that date.
                                                  provision of the countermeasures to                                                                             Dated: December 1, 2015.
                                                                                                             Liability immunity for Covered
                                                  recipients, or activities and decisions                                                                       Sylvia M. Burwell,
                                                                                                          Countermeasures administered and
                                                  directly relating to public and private                                                                       Secretary.
                                                                                                          used in accordance with the public
                                                  delivery, distribution and dispensing of                health and medical response of the                    [FR Doc. 2015–31088 Filed 12–8–15; 8:45 am]
                                                  the countermeasures to recipients,                      Authority Having Jurisdiction begins                  BILLING CODE P
                                                  management and operation of                             with a Declaration and lasts through (1)
                                                  countermeasure programs, or                             the final day the emergency Declaration
                                                  management and operation of locations                                                                         DEPARTMENT OF HEALTH AND
                                                                                                          is in effect or (2) twenty-four (24)                  HUMAN SERVICES
                                                  for purpose of distributing and                         months from December 3, 2014,
                                                  dispensing countermeasures.                             whichever occurs first.                               Office of the Secretary
                                                  X. Population                                           XIII. Additional Time Period of                       Smallpox Medical Countermeasures—
                                                  42 U.S.C. 247d–6d(a)(4), 247d–                          Coverage                                              Amendment
                                                  6d(b)(2)(C)                                             42 U.S.C. 247d–6d(b)(3)(B) and (C)
                                                                                                                                                                ACTION: Notice of Amendment to the
                                                     The populations of individuals                         I have determined that an additional                October 10, 2008 Declaration under the
                                                  include any individual who uses or is                   twelve (12) months of liability                       Public Readiness and Emergency
                                                  administered the Covered                                protection is reasonable to allow for the             Preparedness Act.
                                                  Countermeasures in accordance with                      manufacturer(s) to arrange for
                                                  this Declaration.                                                                                             SUMMARY:    The Secretary is amending the
                                                                                                          disposition of the Covered
                                                                                                                                                                declaration issued on October 10, 2008,
                                                     Liability immunity is afforded to                    Countermeasure, including return of the
                                                                                                                                                                (73 FR 61869) pursuant to section 319F–
                                                  manufacturers and distributors without                  Covered Countermeasures to the
                                                                                                                                                                3 of the Public Health Service Act (42
                                                  regard to whether the countermeasure is                 manufacturer, and for Covered Persons
                                                                                                                                                                U.S.C. 247d–6d) to: Include
                                                  used by or administered to this                         to take such other actions as are
                                                                                                                                                                countermeasures authorized for use
                                                  population; liability immunity is                       appropriate to limit the administration
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                                                                                                                                under sections 564A and 564B of the
                                                  afforded to program planners and                        or use of the Covered Countermeasures.                Federal Food, Drug, and Cosmetic
                                                  qualified persons when the                                Covered Countermeasures obtained                    (FD&C) Act (21 U.S.C. 360bbb–3a and
                                                  countermeasure is used by or                            for the SNS during the effective period               360bbb–3b); clarify the description of
                                                  administered to this population, or the                 of this Declaration are covered through               covered countermeasures; extend the
                                                  program planner or qualified person                     the date of administration or use                     effective time period of the declaration;
                                                  reasonably could have believed the                      pursuant to a distribution or release                 reformat the declaration; modify or
                                                  recipient was in this population.                       from the SNS.                                         clarify terms of the declaration; and


                                             VerDate Sep<11>2014   19:29 Dec 08, 2015   Jkt 238001   PO 00000   Frm 00104   Fmt 4703   Sfmt 4703   E:\FR\FM\09DEN1.SGM   09DEN1


                                                                           Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices                                             76547

                                                  republish the declaration in its entirety,              types of federal agreements for which                    Unless otherwise noted, all statutory
                                                  as amended.                                             immunity is in effect; (5) deleting                   citations below are to the U.S. Code.
                                                  DATES: The amendment of the October                     references to specific federal contracts
                                                                                                                                                                Section I, Determination of Public
                                                  10, 2008, declaration is effective as of                to clarify that immunity is not limited
                                                                                                                                                                Health Emergency or Credible Risk of
                                                  January 1, 2016.                                        to activities conducted under listed
                                                                                                                                                                Future Public Health Emergency
                                                  FOR FURTHER INFORMATION CONTACT:
                                                                                                          contracts; (6) clarifying that liability
                                                                                                          immunity extends to activities directly                  Before issuing a declaration under the
                                                  Nicole Lurie, MD, MSPH, Assistant                                                                             PREP Act, the Secretary is required to
                                                  Secretary for Preparedness and                          conducted by the federal government by
                                                                                                          adding the phrase ‘‘or directly                       determine that a disease or other health
                                                  Response, Office of the Secretary,                                                                            condition or threat to health constitutes
                                                  Department of Health and Human                          conducted by the Federal Government’’
                                                                                                          to the section describing methods of                  a public health emergency or that there
                                                  Services, 200 Independence Avenue                                                                             is a credible risk that the disease,
                                                                                                          distribution for which liability
                                                  SW., Washington, DC 20201, Telephone                                                                          condition, or threat may in the future
                                                                                                          immunity is in effect; (7) narrowing the
                                                  202–205–2882.                                                                                                 constitute such an emergency.3 This
                                                                                                          definition of ‘‘administration’’ to cover
                                                  SUPPLEMENTARY INFORMATION:                              ‘‘slip-and-fall’’ claims only to the extent           determination is separate and apart from
                                                  Background                                              they are directly tied to the operation of            a declaration issued by the Secretary
                                                                                                          a countermeasure program; (8)                         under section 319 of the PHS Act 4 that
                                                     The Public Readiness and Emergency                   extending the time period for which                   a disease or disorder presents a public
                                                  Preparedness Act (PREP Act) authorizes                  liability immunity is in effect for the               health emergency or that a public health
                                                  the Secretary of Health and Human                       Covered Countermeasures to December                   emergency, including significant
                                                  Services (the Secretary) to issue a                     31, 2022, and (9) changing the entire                 outbreaks of infectious diseases or
                                                  declaration to provide liability                        declaration to the new format that was                bioterrorist attacks, otherwise exists, or
                                                  immunity to certain individuals and                     first used with the February 29, 2012,                other declarations or determinations
                                                  entities (Covered Persons) against any                  amendment to the declaration for                      made under other authorities of the
                                                  claim of loss caused by, arising out of,                pandemic influenza to make the                        Secretary. In the previous PREP Act
                                                  relating to, or resulting from the                      declaration easier for readers to follow.             declaration for smallpox
                                                  administration or use of medical                        Other minor modifications and                         countermeasures (‘‘declaration’’), this
                                                  countermeasures (Covered                                clarifications are also made, as fully                determination appeared in the
                                                  Countermeasures), except for claims                     explained below.                                      declaration’s introduction as the
                                                  that meet the PREP Act’s definition of                     The declaration is republished in full.            conclusion to the ‘‘whereas’’ clauses.
                                                  willful misconduct. The Secretary may,                  We explain both the substantive and                   The determination is stated in the first
                                                  though publication in the Federal                       format changes in this supplementary                  section of the declaration. This change
                                                  Register, amend any portion of a                        section.                                              was made to improve readability and is
                                                  declaration. Using this authority, the                     The PREP Act was enacted on                        not intended to have any substantive
                                                  Secretary issued a declaration for                      December 30, 2005, as Public Law 109–                 legal effect.
                                                  smallpox countermeasures against                        148, Division C, Section 2. It amended                   In addition, we made a substantive
                                                  variola virus or other orthopoxviruses                  the Public Health Service (PHS) Act,                  change to the determination. The
                                                  on October 10, 2008, and is amending                    adding section 319F–3, which addresses                determination made in the ‘‘whereas’’
                                                  this declaration.1                                      liability immunity, and section 319F–4,               clauses in the October 10, 2008,
                                                     The major actions taken by this                      which creates a compensation program.                 declaration stated that the Secretary
                                                  amendment to the smallpox                               These sections are codified in the U.S.               ‘‘determined there is a credible risk that
                                                  countermeasures declaration include are                 Code as 42 U.S.C. 247d–6d and 42                      the exposure to variola virus or other
                                                  the following: (1) Updating the                         U.S.C. 247d–6e, respectively.                         orthopoxvirus disease and the resulting
                                                  description of covered countermeasures                     The Pandemic and All-Hazards                       disease constitutes a public health
                                                  to include countermeasures authorized                   Preparedness Reauthorization Act                      emergency.’’ The Secretary is amending
                                                  for use under sections 564A and 564B                    (PAHPRA), Public Law 113–5, was                       this determination to state that the
                                                  of the FD&C Act; 2 (2) revising the                     enacted on March 13, 2013. Among                      threat may be ‘‘in the future,’’ to refer
                                                  description of covered countermeasures                  other things, PAHPRA added sections                   to release of variola virus or orthopox
                                                  to clarify that coverage for vaccines                   564A and 564B to the FD&C Act to                      virus rather than exposure, and to refer
                                                  includes all components and                             provide new authorities for the                       to both diseases and conditions, to more
                                                  constituent materials of the vaccines                   emergency use of approved products in                 accurately describe the risk and to be
                                                  and all devices and their constituent                   emergencies and products held for                     consistent with the language used in the
                                                  components used in the administration                   emergency use. PAHPRA accordingly                     PREP Act.5 Thus, in this amended
                                                  of the vaccines, and to add biologics; (3)              amended the definitions of ‘‘Covered                  declaration, the Secretary determines
                                                  changing the description of qualified                   Countermeasures’’ and ‘‘qualified                     ‘‘that there is a credible risk that the
                                                  persons to include persons authorized                   pandemic and epidemic products’’ in                   release of variola virus or other
                                                  to prescribe, administer, or dispense                   section 319F–3 of the Public Health                   orthopoxvirus and the resulting disease
                                                  covered countermeasures in accordance                   Service Act (the PREP Act provisions),                or conditions may in the future
                                                  with Section 564A of the FD&C Act; (4)                  so that products made available under                 constitute a public health emergency.’’
                                                  clarifying that liability immunity                      these new FD&C Act authorities could
                                                                                                                                                                This change is provided for
                                                  extends to other transactions and to                    be covered under PREP Act
                                                                                                                                                                clarification.
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                                                  activities related to any federal                       declarations. PAHPRA also extended
                                                  agreements including clinical trials                    the definition of qualified pandemic and              Section II, Factors Considered
                                                  agreements by adding the terms ‘‘other                  epidemic products to include products                   In deciding whether and under what
                                                  transactions’’ and ‘‘other Federal                      or technologies intended to enhance the               circumstances to issue a declaration
                                                  agreements’’ to the clause describing the               use or effect of a drug, biological
                                                                                                          product, or device used against the                     3 42 U.S.C. 247d–6d(b)(1).
                                                    1 73 FR 61869.                                        pandemic or epidemic or against                         4 42 U.S.C. 247d.
                                                    2 21 U.S.C. 360bbb–3a and 360bbb–3b.                  adverse events from these products.                     5 See 42 U.S.C. 247d–6d(b)(1).




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                                                  76548                    Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices

                                                  with respect to a Covered                               immunity specified under the PREP Act                 be a program planner when it carries out
                                                  Countermeasure, the Secretary must                      in section I of the declaration, ‘‘Covered            the described activities.
                                                  consider the desirability of encouraging                Countermeasures.’’ The declaration now                   A qualified person means a licensed
                                                  the design, development, clinical testing               includes the statement that liability                 health professional or other individual
                                                  or investigation, manufacture, labeling,                immunity is in effect for Recommended                 who is authorized to prescribe,
                                                  distribution, formulation, packaging,                   Activities in a separate section IV. We               administer, or dispense Covered
                                                  marketing, promotion, sale, purchase,                   made this change to improve readability               Countermeasures under the law of the
                                                  donation, dispensing, prescribing,                      and do not intend that it have any                    state in which the countermeasure was
                                                  administration, licensing, and use of the               substantive legal effect.                             prescribed, administered, or dispensed;
                                                  countermeasure.6 We previously stated                                                                         or a person within a category of persons
                                                                                                          Section V, Covered Persons                            identified as qualified in the Secretary’s
                                                  these considerations in the introductory
                                                  ‘‘whereas’’ clauses to the declaration.                    The PREP Act’s liability immunity                  declaration.15 Under this definition, the
                                                  The declaration now states these                        applies to ‘‘Covered Persons’’ with                   Secretary can describe in the declaration
                                                  considerations in section II. We made                   respect to administration or use of a                 other qualified persons, such as
                                                  this change to improve readability and                  Covered Countermeasure. The term                      volunteers, who are Covered Persons.
                                                  do not intend that it have any                          ‘‘Covered Persons’’ has a specific                    Section V describes other qualified
                                                  substantive legal effect.                               meaning, and is defined in the PREP Act               persons covered by this declaration. The
                                                                                                          to include manufacturers, distributors,               PREP Act also defines ‘‘person’’ as used
                                                  Section III, Recommended Activities                     program planners, and qualified                       in the Act: A person includes an
                                                     The Secretary must recommend the                     persons, and their officials, agents, and             individual, partnership, corporation,
                                                  activities for which the PREP Act’s                     employees, and the United States.10 The               association, entity, or public or private
                                                  liability immunity is in effect. These                  PREP Act further defines the terms                    corporation, including a federal, state,
                                                  activities may include, under conditions                ‘‘manufacturer,’’ ‘‘distributor,’’                    or local government agency or
                                                  as the Secretary may specify, the                       ‘‘program planner,’’ and ‘‘qualified                  department.16
                                                  manufacture, testing, development,                      person’’ as described below.11                           The provisions regarding Covered
                                                  distribution, administration, or use of                    A manufacturer includes a contractor               Persons previously appeared in the
                                                  one or more Covered Countermeasures                     or subcontractor of a manufacturer; a                 declaration as a definition in section IX,
                                                  (‘‘Recommended Activities’’).7 In the                   supplier or licenser of any product,                  ‘‘Definitions’’ and in section VI,
                                                  previous declaration, we included the                   intellectual property, service, research              ‘‘Qualified Persons.’’ We combined
                                                  Recommended Activities in section I of                  tool or component or other article used               these two provisions into a new section
                                                  the declaration, ‘‘Covered                              in the design, development, clinical                  V, ‘‘Covered Persons’’ and added ‘‘to
                                                  Countermeasures.’’ The declaration now                  testing, investigation or manufacturing               perform an activity’’ to the description
                                                  states them in section III. We made this                of a Covered Countermeasure; and any                  of ‘‘Other Qualified Persons’’ authorized
                                                  change to improve readability and do                    or all of the parents, subsidiaries,                  under an Emergency Use Authorization
                                                  not intend that it have any substantive                 affiliates, successors, and assigns of a              (EUA) for clarity. We made these
                                                  legal effect. In addition, we deleted the               manufacturer; 12                                      changes to improve readability and
                                                  phrases ‘‘as defined in section IX                         A distributor means a person or entity             clarity and do not intend them to have
                                                  below’’ and ‘‘with respect to the                       engaged in the distribution of drug,                  any substantive legal effect.
                                                  category of disease and population                      biologics, or devices, including but not                 We also modified the description of
                                                  described in sections II and IV below’’                 limited to: manufacturers; repackers;                 Covered Persons to include a new
                                                  for consistency with formatting changes,                common carriers; contract carriers; air               category of qualified persons: ‘‘Any
                                                  and changed ‘‘and usage’’ to ‘‘or use’’ for             carriers; own-label distributors; private-            person authorized to prescribe,
                                                  consistency with the statute. These                     label distributors; jobbers; brokers;                 administer, or dispense covered
                                                  changes are not intended to have any                    warehouses and wholesale drug                         countermeasures in accordance with
                                                  substantive legal effect.                               warehouses; independent wholesale                     Section 564A of the FD&C Act.’’ This
                                                                                                          drug traders; and retail pharmacies; 13               change ensures that persons who
                                                  Section IV, Liability Immunity                             A program planner means a state or                 prescribe, administer, or dispense
                                                     The Secretary must also state that                   local government, including an Indian                 covered countermeasures in accordance
                                                  liability protections available under the               tribe; a person employed by the state or              with section 564A of the FD&C Act are
                                                  PREP Act are in effect with respect to                  local government; or other person who                 Covered Persons under the declaration.
                                                  the Recommended Activities.8 These                      supervises or administers a program                   Section VI, Covered Countermeasures
                                                  liability protections provide that,                     with respect to the administration,
                                                  ‘‘[s]ubject to other provisions of [the                 dispensing, distribution, provision, or                  As noted above, section III describes
                                                  PREP Act], a covered person shall be                    use of a Covered Countermeasure,                      the Secretary’s Recommended Activities
                                                  immune from suit and liability under                    including a person who establishes                    for which liability immunity is in effect.
                                                  Federal and State law with respect to all               requirements, provides policy guidance,               This section identifies the
                                                  claims for loss caused by, arising out of,              or supplies technical or scientific advice            countermeasures for which the
                                                  relating to, or resulting from the                      or assistance or provides a facility to               Secretary has recommended such
                                                  administration to or use by an                          administer or use a Covered                           activities. The PREP Act states that a
                                                  individual of a covered countermeasure                  Countermeasure in accordance with the                 ‘‘Covered Countermeasure’’ must be: A
                                                  if a declaration . . . has been issued                  Secretary’s declaration; 14 Under this                ‘‘qualified pandemic or epidemic
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                                                  with respect to such countermeasure.’’ 9                definition, a private sector employer or              product,’’ or a ‘‘security
                                                  In the previous declaration, we included                community group or other person can                   countermeasure,’’ as described
                                                  a statement referring to liability                                                                            immediately below; or a drug, biological
                                                                                                            10 42 U.S.C. 247d–6d (i)(2).                        product or device authorized for
                                                    6 42 U.S.C. 247d–6d(b)(6).                              11 42 U.S.C. 247d–6d(i).                            emergency use in accordance with
                                                    7 42 U.S.C. 247d–6d(b)(1).                              12 42 U.S.C. 247d–6d(i)(4).
                                                    8 42 U.S.C. 247d–6d(b)(1).                              13 42 U.S.C. 247d–6d(i)(3).                           15 42   U.S.C. 247d–6d(i)(8).
                                                    9 42 U.S.C. 247d–6d(a)(1).                              14 42 U.S.C. 247d–6d(i)(6).                           16 42   U.S.C. 247d–6d(i)(5).



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                                                                           Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices                                                        76549

                                                  section 564, 564A, or 564B of the FD&C                   for diagnosis, mitigation, prevention,                   We revised the description of
                                                  Act.17                                                   treatment, cure or limit harm of a                    smallpox countermeasures to clarify
                                                     A qualified pandemic or epidemic                      pandemic or epidemic or serious or life-              that coverage for vaccines includes
                                                  product means a drug or device, as                       threatening condition caused by such a                components and constituent materials
                                                  defined in the FD&C Act or a biological                  drug or device. A security                            of the vaccines and device and
                                                  product, as defined in the PHS Act 18                    countermeasure also may be a Covered                  constituent components used in
                                                  that is: (i) Manufactured, used,                         Countermeasure if it may reasonably be                administration of the vaccines. We also
                                                  designed, developed, modified, licensed                  determined to qualify for approval or                 added the term ‘‘biologic’’ to more
                                                  or procured to diagnose, mitigate,                       licensing within 10 years after the                   accurately describe the types of
                                                  prevent, treat, or cure a pandemic or                    Department’s determination that                       countermeasures used against smallpox
                                                  epidemic or limit the harm such a                        procurement of the countermeasure is                  and added ‘‘other’’ before ‘‘drug’’ and
                                                  pandemic or epidemic might otherwise                     appropriate.                                          ‘‘device’’ for accuracy. The definition
                                                  cause; (ii) manufactured, used,                             Provisions regarding Covered                       now reads: ‘‘any vaccine, including all
                                                  designed, developed, modified,                           Countermeasures appeared in section I                 components and constituent materials
                                                  licensed, or procured to diagnose,                       of the declaration, ‘‘Covered                         of these vaccines, and all devices and
                                                  mitigate, prevent, treat, or cure a serious              Countermeasures’’ and section IX of the               their constituent components used in
                                                  or life-threatening disease or condition                 declaration, ‘‘Definitions.’’ Section I               the administration of these vaccines;
                                                  caused by such a drug, biological                        included not only a description of the                any antiviral; any other drug; any
                                                  product or device; (iii) or a product or                 Covered Countermeasure but also the                   biologic; or any diagnostic or other
                                                  technology intended to enhance the use                   Secretary’s recommendation, statement                 device to identify, prevent or treat
                                                  or effect of such a drug, biological                     regarding liability immunity, and                     smallpox or orthopoxvirus or adverse
                                                  product, or device.19                                    additional conditions characterizing                  events from such countermeasures.’’
                                                     A security countermeasure is a drug                   countermeasures. We have combined                     These changes are intended as
                                                  or device, as defined in the FD&C Act                    sections I and IX and simplified the                  clarification.
                                                  or a biological product, as defined in the               language so that it now only identifies                  We also added a statement referencing
                                                  PHS Act 20 that: (i) (a) the Secretary                   the Covered Countermeasures. We have                  the statutory definitions of Covered
                                                  determines to be a priority to diagnose,                 relocated the other conditions included               Countermeasures to make clear that
                                                  mitigate, prevent or treat harm from any                 in the ‘‘Covered Countermeasure’’                     these statutory definitions limit the
                                                  biological, chemical, radiological, or                   section to new sections, ‘‘Recommended                scope of Covered Countermeasures.
                                                  nuclear agent identified as a material                   Activities,’’ ‘‘Liability Immunity,’’ and             Specifically, we noted that they must be
                                                  threat by the Secretary of Homeland                      ‘‘Limitations on Distribution,’’ to                   ‘‘qualified pandemic or epidemic
                                                  Security, or (b) to diagnose, mitigate,                  improve readability. We do not intend                 products,’’ or ‘‘security
                                                  prevent, or treat harm from a condition                  for this change to have any substantive               countermeasures,’’ or drugs, biological
                                                  that may result in adverse health                        legal effect.                                         products, or devices authorized for
                                                  consequences or death and may be                            Section I of the declaration also stated
                                                                                                                                                                 investigational or emergency use, as
                                                  caused by administering a drug,                          that the declaration applied to Covered
                                                                                                                                                                 those terms are defined in the PREP Act,
                                                  biological product, or device against                    Countermeasures administered or used
                                                                                                           during the effective time period of the               the FD&C Act, and the Public Health
                                                  such an agent; and (ii) is determined by                                                                       Service Act.’’ By referencing the
                                                  the Secretary of Health and Human                        declaration. We have deleted this
                                                                                                           language as it is redundant of the                    statutory provisions, the revised
                                                  Services to be a necessary                                                                                     definition also incorporates changes to
                                                  countermeasure to protect public                         provisions stated in sections XII,
                                                                                                           ‘‘Effective Time Period,’’ and XIII,                  the PREP Act definitions of covered
                                                  health.21                                                                                                      countermeasure and qualified pandemic
                                                     To be a Covered Countermeasure,                       ‘‘Additional Time Period of Coverage.’’
                                                                                                              We also revised the description and                or epidemic product made by PAHPRA.
                                                  qualified pandemic or epidemic
                                                  products and security countermeasures                    definition of the Covered                             Section VII, Limitations on Distribution
                                                  also must be approved or cleared under                   Countermeasure that previously
                                                                                                           appeared in sections I, ‘‘Covered                        The Secretary may specify that
                                                  the FD&C Act; 22 licensed under the PHS
                                                                                                           Countermeasures’’ and IX,                             liability immunity is in effect only to
                                                  Act; 23 authorized for emergency use
                                                                                                           ‘‘Definitions.’’ Section I referred to the            Covered Countermeasures obtained
                                                  under sections 564, 564A, or 564B of the
                                                                                                           Act for the definition of ‘‘Covered                   through a particular means of
                                                  FD&C Act.24
                                                                                                           Countermeasures,’’ and section IX                     distribution.26 These limitations on
                                                     A qualified pandemic or epidemic
                                                  product also may be a Covered                            defined the term ‘‘Smallpox                           distribution previously appeared in
                                                  Countermeasure when it is subject to an                  Countermeasure’’ as ‘‘Any vaccine;                    section I, ‘‘Covered Countermeasures,’’
                                                  exemption (that is, it is permitted to be                antiviral, other drug; or diagnostic or               and section IX, ‘‘Definitions.’’ We now
                                                  used under an Investigational Drug                       device to identify, prevent or treat                  state the limitations in a separate
                                                  Application or an Investigational Device                 smallpox or orthopoxvirus or adverse                  section and combine them with relevant
                                                  Exemption) under the FD&C Act 25 and                     events from such countermeasures (1)                  definitions for improved readability.
                                                  is the object of research for possible use               Licensed under section 351 of the                        The declaration now states that
                                                                                                           Public Health Service Act; (2) approved               liability immunity is afforded to
                                                    17 42 U.S.C. 247d–6d(i)(1). Sections 564, 564A,        under section 505 or section 515 of the               Covered Persons for Recommended
                                                  and 564B of the FD&C Act may be found at 21              Federal Food, Drug, and Cosmetic Act                  Activities related to:
                                                  U.S.C. 360bbb–3, 360bbb–3a, and 360bbb–3b.                                                                        (a) Present or future federal contracts,
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                                                                                                           (FDCA); (3) cleared under section 510(k)
                                                    18 21 U.S.C. 321(g)(1), (h); 42 U.S.C. 262(i).
                                                                                                           of the FDCA; (4) authorized for                       cooperative agreements, grants, other
                                                    19 42 U.S.C. 247d–6d(i)(1)(A), (i)(7).
                                                    20 21 U.S.C. 321(g)(1), (h);42 U.S.C. 262(i).
                                                                                                           emergency use under section 564 of the                transactions, interagency agreements, or
                                                    21 42 U.S.C. 247d–6d(i)(1)(B),(c)(1)(B).               FDCA ; (5) used under section 505(i) of               memoranda of understanding or other
                                                    22 21 U.S.C. 301 et seq.                               the FDCA or section 351(a)(3) of the                  federal agreements or activities directly
                                                    23 42 U.S.C. 262.                                      PHS Act, and 21 CFR part 312; or (6)                  conducted by the federal government; or
                                                    24 21 U.S.C. 360bbb–3, 360bbb–3a, 360bbb–3b.           used under section 520(g) of the FDCA
                                                    25 21 U.S.C. 355(i), 360j(g).                          and 21 CFR part 812.’’                                  26 42   U.S.C. 247d–6d(a)(5), (b)(2)(E).



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                                                  76550                        Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices

                                                     (b) Activities authorized in                            for the changes to this provision to alter             management and operation of locations
                                                  accordance with the public health and                      its substantive legal effect. As stated in             for purpose of distributing and
                                                  medical response of the Authority                          the ‘‘whereas’’ clauses of the prior                   dispensing countermeasures.
                                                  Having Jurisdiction to prescribe,                          declaration, this limitation on                           As clarified, administration extends
                                                  administer, deliver, distribute or                         distribution is intended to deter                      only to physical provision of a
                                                  dispense the Covered Countermeasures                       program planners that are government                   countermeasure to a recipient, such as
                                                  following a declaration of an emergency.                   entities from seizing privately held                   vaccination or handing drugs to
                                                     For governmental program planners                       stockpiles of Covered Countermeasures.                 patients, and to activities related to
                                                  only, liability immunity is afforded only                  It does not apply to any other Covered                 management and operation of programs
                                                  to the extent they obtain Covered                          Persons, including other program                       and locations for providing
                                                  Countermeasures through voluntary                          planners who are not government                        countermeasures to recipients, such as
                                                  means, such as (1) donation; (2)                           entities.                                              decisions and actions involving security
                                                  commercial sale; (3) deployment of                                                                                and queuing, but only insofar as those
                                                  Covered Countermeasures from Federal                       Section VIII, Category of Disease,                     activities directly relate to the
                                                  stockpiles; or (4) deployment of                           Health Condition, or Threat                            countermeasure activities. Claims for
                                                  donated, purchased, or otherwise                             The Secretary must identify, for each                which Covered Persons are provided
                                                  voluntarily obtained Covered                               Covered Countermeasure, the categories                 immunity under the Act are losses
                                                  Countermeasures from State, local, or                      of diseases, health conditions, or threats             caused by, arising out of, relating to, or
                                                  private stockpiles.                                        to health for which the Secretary                      resulting from the administration to or
                                                     In regard to (a), we, added the phrase                  recommends the administration or use                   use by an individual of a Covered
                                                  ‘‘other transactions,’’ which may be                       of the countermeasure.28 This                          Countermeasure consistent with the
                                                  used for some Covered Countermeasure                       information previously appeared in                     terms of a declaration issued under the
                                                  activities,27 added the phrase ‘‘or other                  section II, ‘‘Category of Disease.’’                   Act.29 Under the Secretary’s definition,
                                                  Federal agreements’’ to clarify that the                                                                          these liability claims are precluded if
                                                                                                             Section IX, Administration of Covered
                                                  provision is intended to cover all types                                                                          the claims allege an injury caused by
                                                  of Federal agreements, and added the                       Countermeasures
                                                                                                                                                                    physical provision of a countermeasure
                                                  phrase ‘‘or activities directly conducted                     The PREP Act does not explicitly                    to a recipient, or if the claims are
                                                  by the Federal Government’’ to clarify                     define the term ‘‘administration’’ but                 directly due to conditions of delivery,
                                                  that activities such as manufacture of                     does assign the Secretary the                          distribution, dispensing, or management
                                                  vaccines for clinical trials by the HHS                    responsibility to provide relevant                     and operation of countermeasure
                                                  National Institutes of Health Vaccine                      conditions in the declaration. This                    programs at distribution and dispensing
                                                  Research Center or distribution of                         definition previously appeared in                      sites.
                                                  countermeasures by federal employees                       section IX, ‘‘Definitions.’’ We have                      Thus, it is the Secretary’s
                                                  are covered. We changed the                                moved it to a separate section to                      interpretation that, when a declaration
                                                  conjunction ‘‘and’’ to ‘‘or’’ between (a)                  improve readability. The Secretary has                 is in effect, the Act precludes, for
                                                  and (b) to clarify that immunity is                        also narrowed the definition of                        example, liability claims alleging
                                                  available under either of these                            ‘‘administration’’ that was previously                 negligence by a manufacturer in creating
                                                  circumstances; the activities do not have                  provided in the declaration. The                       a vaccine, or negligence by a health care
                                                  to both relate to a Federal award or                       declaration previously defined the term                provider in prescribing the wrong dose,
                                                  agreement and be used in a public                          ‘‘administration’’ to include physical                 absent willful misconduct. Likewise, the
                                                  health and medical response in order for                   provision of a Covered Countermeasure,                 Act precludes a liability claim relating
                                                  immunity to apply. The conjunction                         as well as management and operation of                 to the management and operation of a
                                                  ‘‘and’’ used in the previous declaration                   systems and locations at which Covered                 countermeasure distribution program or
                                                  was a drafting error; the Secretary’s                      Countermeasures may be provided to                     site, such as a ‘‘slip-and-fall’’ injury or
                                                  intent in that previous declarations has                   recipients:                                            vehicle collision by a recipient receiving
                                                  been the meaning conferred by the term                        Administration of a Covered                         a countermeasure at a retail store
                                                  ‘‘or.’’ Provisions (a) and (b) are intended                Countermeasure: As used in section                     serving as an administration or
                                                  to afford immunity to Federal                              319F–3(a)(2)(B) of the Act includes, but               dispensing location that alleges, for
                                                  government conducted and supported                         is not limited to, public and private                  example, lax security or chaotic crowd
                                                  activities that precede a public health                    delivery, distribution, and dispensing                 control. However, a liability claim
                                                  emergency and to activities in                             activities relating to physical                        alleging an injury occurring at the site
                                                  accordance with all Authorities Having                     administration of the countermeasures                  that was not directly related to the
                                                  Jurisdiction during a declared public                      to patients/recipients, management and                 countermeasure activities is not
                                                  health emergency. These changes are                        operation of delivery systems, and                     covered, such as a slip and fall with no
                                                  intended as clarifications and to                          management and operation of                            direct connection to the
                                                  improve readability, and are not                           distribution and dispensing locations.                 countermeasure’s administration or use.
                                                  intended as substantive changes.                              The definition has been revised as                  In each case, whether immunity is
                                                     In regard to (b), the meaning of the                    follows:                                               applicable will depend on the particular
                                                  terms ‘‘Authority Having Jurisdiction’’                       Administration of a Covered                         facts and circumstances.
                                                  and ‘‘Declaration of an Emergency’’ are                    Countermeasure means physical
                                                  unchanged.                                                 provision of the countermeasures to                    Section X, Population
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                                                     Finally, we slightly modified the last                  recipients, or activities and decisions                   The Secretary must identify, for each
                                                  limitation by deleting extraneous                          directly relating to public and private                Covered Countermeasure specified in a
                                                  statutory references and other language                    delivery, distribution and dispensing of               declaration, the population or
                                                  and by replacing the final sentence with                   the countermeasures to recipients;                     populations of individuals for which
                                                  the word ‘‘only’’ after ‘‘planners’’ to                    management and operation of                            liability immunity is in effect with
                                                  improve readability. We do not intend                      countermeasure programs; or                            respect to administration or use of the
                                                    27 See,   e.g., 42 U.S.C. 247d–7d(c)(5).                   28 42   U.S.C. 247d–6d(b)(2)(A).                       29 42   U.S.C. 247d–6d(a).



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                                                                              Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices                                            76551

                                                  countermeasure.30 This section explains                   either used by or administered to this                  Section XIII, Additional Time Period of
                                                  which individuals should use the                          population or the program planner or                    Coverage
                                                  countermeasure or to whom the                             qualified person reasonably could have                     The Secretary must specify a date
                                                  countermeasure should be                                  believed the recipient was in this                      after the ending date of the effective
                                                  administered—in short, those who                          population.31 We included these                         period of the declaration that is
                                                  should be vaccinated or take a drug or                    statutory conditions in the declaration                 reasonable for manufacturers to arrange
                                                  other countermeasure. These provisions                    for clarity.                                            for disposition of the Covered
                                                  previously appeared in section IV,                                                                                Countermeasure, including return of the
                                                  ‘‘Population.’’ The previous declaration                  Section XI, Geographic Area
                                                                                                                                                                    product to the manufacturer, and for
                                                  stated that the population specified in                      The Secretary must identify, for each                other Covered Persons to take
                                                  the declaration included:                                 Covered Countermeasure specified in                     appropriate actions to limit
                                                     The populations specified in this                      the declaration, the geographic area or                 administration or use of the Covered
                                                  declaration are all persons who use a                     areas for which liability immunity is in                Countermeasure.35 In addition, the
                                                  Covered Countermeasure or to whom a                       effect with respect to administration or                PREP Act specifies that for Covered
                                                  Covered Countermeasure is                                 use of the countermeasure, including, as                Countermeasures that are subject to a
                                                  administered in accordance with this                      appropriate, whether the declaration                    declaration at the time they are obtained
                                                  declaration, including, but not limited                   applies only to individuals physically                  for the Strategic National Stockpile
                                                  to: (1) Any person conducting research                    present in the area or, in addition,                    (SNS) under 42 U.S.C. 247d–6b(a), the
                                                  and development of Covered                                applies to individuals who have a                       effective period of the declaration
                                                  Countermeasures directly for the federal                  described connection to the area.32 This                extends through the time the
                                                  government or pursuant to a contract,                     section appeared in section V,                          countermeasure is used or administered
                                                  grant, or cooperative agreement with the                  ‘‘Geographic Area.’’                                    pursuant to a distribution or release
                                                  federal government; (2) any person who                       In addition, the PREP Act specifies                  from the SNS. Liability immunity under
                                                  receives a Covered Countermeasure                         that liability immunity is afforded: (1)                the provisions of the PREP Act and the
                                                  from persons authorized in accordance                     To manufacturers and distributors                       conditions of the declaration continues
                                                  with the public health and medical                        without regard to whether the                           during these additional time periods.
                                                  emergency response of the Authority                       countermeasure is used by or                            Thus, liability immunity is afforded
                                                  Having Jurisdiction to prescribe,                         administered to individuals in the                      during the ‘‘Effective Time Period,’’
                                                  administer, deliver, distribute, or                       geographic areas; and (2) to program                    described under XII of the declaration,
                                                  dispense the Covered Countermeasure,                      planners and qualified persons when                     plus the ‘‘Additional Time Period’’
                                                  and their officials, agents, employees,                   the countermeasure is either used or                    described under section XIII of the
                                                  contractors, and volunteers following a                   administered in the geographic areas or                 declaration.
                                                  declaration of an emergency; (3) any                      the program planner or qualified person                    The provision for additional time
                                                  person who receives a Covered                             reasonably could have believed the                      periods previously appeared as section
                                                  Countermeasure from a person                              countermeasure was used or                              VII, ‘‘Additional Time Periods of
                                                  authorized to prescribe, administer or                    administered in the areas.33 We                         Coverage After Expiration of the
                                                  dispense the countermeasure or who is                     included these statutory conditions in                  Declaration.’’ The provision is amended
                                                  otherwise authorized to prescribe,                        the declaration for clarity.                            to clarify the statutory provisions as
                                                  administer or dispense the                                                                                        they apply to manufacturers and to
                                                  countermeasure under an Emergency                         Section XII, Effective Time Period
                                                                                                                                                                    other covered persons, and to clarify
                                                  Use Authorization; (4) any person who                        The Secretary must identify, for each                that extended coverage applies to any
                                                  receives a Covered Countermeasure as                      Covered Countermeasure, the period or                   products obtained for the Strategic
                                                  an investigational new drug in human                      periods during which liability immunity                 National Stockpile during the effective
                                                  clinical trials being conducted directly                  is in effect, designated by dates,                      period of the declaration. We included
                                                  by the federal government or pursuant                     milestones, or other description of                     the statutory provision for clarity.
                                                  to a contract, grant, or cooperative                      events, including factors specified in the
                                                  agreement with the federal government.                    PREP Act.34 This section appeared as                    Section XIV, Countermeasures Injury
                                                     We have amended the declaration to                     section III, ‘‘Effective Time Period.’’                 Compensation Program
                                                  provide that the population includes                         The declaration is amended to clarify                  Section 319F–4 of the PREP Act
                                                  ‘‘any individual who uses or who is                       when liability takes effect for different               authorizes the Countermeasures Injury
                                                  administered a Covered Countermeasure                     means of distribution and to delete                     Compensation Program (CICP) to
                                                  in accordance with the declaration.’’ We                  language referring to the Smallpox                      provide benefits to eligible individuals
                                                  believe this broad statement accurately                   Emergency Personnel Protection Act                      who sustain a serious physical injury or
                                                  encompasses all of the previously listed                  (SEPPA) of 2003. These changes are                      die as a direct result of the
                                                  populations given as examples of that                     intended to have no legal effect. The                   administration or use of a Covered
                                                  phrase and ensures that no populations                    time frame for filing claims under the                  Countermeasure.36 Compensation under
                                                  that use or are administered the Covered                  Secretary’s SEPPA declaration expired                   the CICP for an injury directly caused by
                                                  Countermeasures in accordance with                        in January 2010. The declaration is also                a Covered Countermeasure is based on
                                                  the terms of the declaration are omitted.                 amended to extend the period for which                  the requirements set forth in this
                                                     In addition, the PREP Act specifies                    liability immunity is in effect. The                    declaration, the administrative rules for
                                                  that liability immunity is afforded: (1)                  previous declaration was in effect                      the Program,37 and the statute.38 To
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                                                  To manufacturers and distributors                         through December 31, 2015. We have                      show direct causation between a
                                                  without regard to whether the                             extended the effective time period to                   Covered Countermeasure and a serious
                                                  countermeasure is used by or                              December 31, 2022.                                      physical injury, the statute requires
                                                  administered to this population; and (2)
                                                  to program planners and qualified                           31 42 U.S.C. 247d–6d(a)(4).                             35 42 U.S.C. 247d–6d(b)(3).
                                                  persons when the countermeasure is                          32 42 U.S.C. 247d–6d(b)(2)(D).                          36 42 U.S.C. 247d–6e.
                                                                                                              33 42 U.S.C. 247d–6d(a)(4).                             37 42 CFR part 110.
                                                    30 42   U.S.C. 247d–6d(b)(2)(C).                          34 42 U.S.C. 246d–6d(b)(2)(B), (b)(6).                  38 42 U.S.C. 247d–6e.




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                                                  76552                       Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices

                                                  ‘‘compelling, reliable, valid, medical                    Republished Declaration                                 In addition, I have determined that
                                                  and scientific evidence.’’ 39 The                                                                               the following additional persons are
                                                                                                            Declaration, as Amended, for Public
                                                  administrative rules for the Program                                                                            qualified persons: (a) Any person
                                                                                                            Readiness and Emergency Preparedness
                                                  further explain the necessary                                                                                   authorized in accordance with the
                                                                                                            Act Coverage for Smallpox
                                                  requirements for eligibility under the                                                                          public health and medical emergency
                                                                                                            Countermeasures
                                                  CICP. Please note that, by statute,                                                                             response of the Authority Having
                                                  requirements for compensation under                          This declaration amends and                        Jurisdiction, as described in section VII
                                                  the CICP may not always align with the                    republishes the October 10, 2008,                     below, to prescribe, administer, deliver,
                                                  requirements for liability immunity                       Declaration Under the Public Readiness                distribute or dispense the Covered
                                                  provided under the PREP Act. We have                      and Emergency Preparedness Act                        Countermeasures, and their officials,
                                                  added section XIV, ‘‘Countermeasures                      (‘‘PREP Act’’) for smallpox                           agents, employees, contractors and
                                                  Injury Compensation Program’’ to                          countermeasures. To the extent any                    volunteers, following a declaration of an
                                                  explain the types of injury and standard                  term of the October 10, 2008,                         emergency; (b) Any person authorized
                                                  of evidence needed to be considered for                   Declaration is inconsistent with any                  to prescribe, administer, or dispense the
                                                  compensation under the CICP. We                           provision of this Republished                         Covered Countermeasures or who is
                                                  included this information to inform                       Declaration, the terms of this                        otherwise authorized to perform an
                                                  readers of this Program.                                  Republished Declaration are controlling.              activity under an Emergency Use
                                                                                                                                                                  Authorization in accordance with
                                                  Section XV, Amendments                                    I. Determination of Public Health
                                                                                                                                                                  section 564 of the FD&C Act; (c) any
                                                                                                            Emergency or Credible Risk of Future
                                                     The Secretary may amend any portion                                                                          person authorized to prescribe,
                                                                                                            Public Health Emergency
                                                  of a declaration through publication in                                                                         administer, or dispense Covered
                                                  the Federal Register.40 This section                      42 U.S.C. 247d–6d(b)(1)                               Countermeasures in accordance with
                                                  appeared in section VIII,                                   I have determined that there is a                   Section 564A of the FD&C Act.
                                                  ‘‘Amendments.’’ It has been updated to                    credible risk the release of variola virus            VI. Covered Countermeasures
                                                  reflect that the Republished Declaration                  or other orthopoxvirus and the resulting
                                                  amends the prior October 10, 2008,                        disease or conditions may in the future               42 U.S.C. 247d–6b(c)(1)(B), 42 U.S.C.
                                                  declaration.                                              constitute a public health emergency.                 247d–6d(i)(1) and (7)
                                                  Deleted Sections                                          II. Factors Considered                                   Covered Countermeasures are any
                                                                                                                                                                  vaccine, including all components and
                                                     The prior declaration included a                       42 U.S.C. 247d–6d(b)(6)                               constituent materials of these vaccines,
                                                  number of ‘‘whereas’’ clauses as                                                                                and all devices and their constituent
                                                                                                               I have considered the desirability of
                                                  introductory to the declaration. As                                                                             components used in the administration
                                                                                                            encouraging the design, development,
                                                  described above, we have incorporated                                                                           of these vaccines; any antiviral; any
                                                                                                            clinical testing or investigation,
                                                  ‘‘whereas’’ clauses that made necessary                                                                         other drug; any biologic; or any
                                                                                                            manufacture, labeling, distribution,
                                                  findings under the PREP Act into the                                                                            diagnostic or other device to identify,
                                                                                                            formulation, packaging, marketing,
                                                  text of the declaration itself. We have                                                                         prevent or treat smallpox or
                                                                                                            promotion, sale, purchase, donation,
                                                  deleted the remaining ‘‘whereas’’                                                                               orthopoxvirus or adverse events from
                                                                                                            dispensing, prescribing, administration,
                                                  clauses. We do not intend this change                                                                           such countermeasures.
                                                                                                            licensing, and use of the Covered
                                                  to have legal effect.                                                                                              Covered Countermeasures must be
                                                                                                            Countermeasures.
                                                     The prior declaration contained a                                                                            ‘‘qualified pandemic or epidemic
                                                  definitions section. These definitions                    III. Recommended Activities                           products,’’ or ‘‘security
                                                  have been incorporated into the relevant                  42 U.S.C. 247d–6d(b)(1)                               countermeasures,’’ or drugs, biological
                                                  sections of the declaration as noted                                                                            products, or devices authorized for
                                                  above, and modified or deleted where                        I recommend, under the conditions                   investigational or emergency use, as
                                                  indicated above.                                          stated in this declaration, the                       those terms are defined in the PREP Act,
                                                                                                            manufacture, testing, development,                    the FD&C Act, and the Public Health
                                                     An appendix previously appeared in                     distribution, administration, or use of
                                                  the declaration that listed federal                                                                             Service Act.
                                                                                                            the Covered Countermeasures.
                                                  government contracts for research,                                                                              VII. Limitations on Distribution
                                                  development, and procurement of                           IV. Liability Immunity
                                                  Covered Countermeasures. We deleted                                                                             42 U.S.C. 247d–6d(a)(5) and (b)(2)(E)
                                                                                                            42 U.S.C. 247d–6d(a), 247d–6d(b)(1)
                                                  this appendix to clarify that liability                                                                            I have determined that liability
                                                  immunity under the provisions of the                        Liability immunity as prescribed in                 immunity is afforded to Covered
                                                  PREP Act and terms of the declaration                     the PREP Act and conditions stated in                 Persons only for Recommended
                                                  is not limited to the contracts listed in                 this declaration is in effect for the                 Activities involving Covered
                                                  the appendix. Coverage is available for                   Recommended Activities described in                   Countermeasures that are related to:
                                                  any award or agreement that meets the                     section III.                                             (a) Present or future federal contracts,
                                                  description provided in section VII of                    V. Covered Persons                                    cooperative agreements, grants, other
                                                  the declaration. In addition, deleting the                                                                      transactions, interagency agreements,
                                                  appendix relieves the Department of the                   42 U.S.C. 247d–6d(i)(2),(3),(4),(6),(8)(A)            memoranda of understanding, or other
                                                  need to periodically update the                           and (B)                                               federal agreements, or activities directly
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                                                  appendix.                                                    Covered Persons who are afforded                   conducted by the federal government;
                                                     We made these deletions for clarity                    liability immunity under this                            or
                                                  and do not intend them to have legal                      declaration are ‘‘manufacturers,’’                       (b) Activities authorized in
                                                  effect.                                                   distributors, program planners, qualified             accordance with the public health and
                                                                                                            persons, and their officials, agents, and             medical response of the Authority
                                                    39 42   U.S.C. 247d–6e(b)(4).                           employees, as those terms are defined in              Having Jurisdiction to prescribe,
                                                    40 42   U.S.C. 247d–6d(b)(4).                           the PREP Act, and the United States.                  administer, deliver, distribute or


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                                                                           Federal Register / Vol. 80, No. 236 / Wednesday, December 9, 2015 / Notices                                                  76553

                                                  dispense the Covered Countermeasures                    X. Population                                         manufacturer(s) to arrange for
                                                  following a declaration of an emergency.                                                                      disposition of the Covered
                                                                                                          42 U.S.C. 247d–6d(a)(4), 247d–
                                                     i. The Authority Having Jurisdiction                                                                       Countermeasure, including return of the
                                                                                                          6d(b)(2)(C)
                                                  means the public agency or its delegate                                                                       Covered Countermeasures to the
                                                                                                             The populations of individuals                     manufacturer, and for Covered Persons
                                                  that has legal responsibility and                       include any individual who uses or is                 to take such other actions as are
                                                  authority for responding to an incident,                administered the Covered                              appropriate to limit the administration
                                                  based on political or geographical (e.g.,               Countermeasures in accordance with                    or use of the Covered Countermeasures.
                                                  city, county, tribal, state, or federal                 this declaration.
                                                  boundary lines) or functional (e.g., law                   Liability immunity is afforded to                     Covered Countermeasures obtained
                                                  enforcement, public health) range or                    manufacturers and distributors without                for the SNS during the effective period
                                                  sphere of authority.                                    regard to whether the countermeasure is               of this declaration for Covered
                                                                                                          used by or administered to this                       Countermeasures obtained through
                                                     ii. A declaration of emergency means                                                                       means of distribution other than in
                                                  any declaration by any authorized local,                population; liability immunity is
                                                                                                          afforded to program planners and                      accordance with the public health and
                                                  regional, state, or federal official of an                                                                    medical response of the Authority
                                                                                                          qualified persons when the
                                                  emergency specific to events that                                                                             Having Jurisdiction are covered through
                                                                                                          countermeasure is used by or
                                                  indicate an immediate need to                           administered to this population or the                the date of administration or use
                                                  administer and use the Covered                          program planner or qualified person                   pursuant to a distribution or release
                                                  Countermeasures, with the exception of                  reasonably could have believed the                    from the SNS.
                                                  a federal declaration in support of an                  recipient was in this population.                     XIV. Countermeasures Injury
                                                  Emergency Use Authorization under
                                                                                                          XI. Geographic Area                                   Compensation Program
                                                  section 564 of the FD&C Act unless such
                                                  declaration specifies otherwise;                        42 U.S.C. 247d–6d(a)(4), 247d–                        42 U.S.C. 247d–6e
                                                     I have also determined that for                      6d(b)(2)(D)
                                                                                                                                                                  The PREP Act authorizes the
                                                  governmental program planners only,                        Liability immunity is afforded for the             Countermeasures Injury Compensation
                                                  liability immunity is afforded only to                  administration or use of a Covered                    Program (CICP) to provide benefits to
                                                  the extent such program planners obtain                 Countermeasure without geographic                     certain individuals or estates of
                                                  Covered Countermeasures through                         limitation.                                           individuals who sustain a serious
                                                  voluntary means, such as (1) donation;                     Liability immunity is afforded to                  physical covered injury as the direct
                                                  (2) commercial sale; (3) deployment of                  manufacturers and distributors without                result of the administration or use of the
                                                  Covered Countermeasures from federal                    regard to whether the countermeasure is               Covered Countermeasures and/or
                                                  stockpiles; or (4) deployment of                        used by or administered in these                      benefits to certain survivors of
                                                  donated, purchased, or otherwise                        geographic areas; liability immunity is               individuals who die as a direct result of
                                                  voluntarily obtained Covered                            afforded to program planners and                      the administration or use of the Covered
                                                  Countermeasures from State, local, or                   qualified persons when the                            Countermeasures. The causal
                                                                                                          countermeasure is used by or                          connection between the countermeasure
                                                  private stockpiles.
                                                                                                          administered in these geographic areas,               and the serious physical injury must be
                                                  VIII. Category of Disease, Health                       or the program planner or qualified                   supported by compelling, reliable, valid,
                                                  Condition, or Threat                                    person reasonably could have believed                 medical and scientific evidence in order
                                                                                                          the recipient was in these geographic                 for the individual to be considered for
                                                  42 U.S.C. 247d–6d(b)(2)(A)                              areas.                                                compensation. The CICP is
                                                    The category of disease, health                       XII. Effective Time Period                            administered by the Health Resources
                                                  condition, or threat for which I                                                                              and Services Administration, within the
                                                                                                          42 U.S.C. 247d–6d(b)(2)(B)                            Department of Health and Human
                                                  recommend the administration or use of
                                                  the Covered Countermeasures is                             Liability immunity for Covered                     Services. Information about the CICP is
                                                  smallpox resulting from exposure to                     Countermeasures obtained through                      available at 855–266–2427 (toll-free) or
                                                  variola virus and the threat of disease                 means of distribution other than in                   http://www.hrsa.gov/cicp/.
                                                  resulting from exposure to other                        accordance with the public health and
                                                                                                          medical response of the Authority                     XV. Amendments
                                                  orthodox viruses.
                                                                                                          Having Jurisdiction extends through                   42 U.S.C. 247d–6d(b)(4)
                                                  IX. Administration of Covered                           December 31, 2022.
                                                  Countermeasures                                            Liability immunity for Covered                       The October 10, 2008 Declaration
                                                                                                          Countermeasures administered and                      Under the Public Readiness and
                                                  42 U.S.C. 247d–6d(a)(2)(B)                              used in accordance with the public                    Emergency Preparedness Act for
                                                                                                          health and medical response of the                    smallpox countermeasures was first
                                                    Administration of the Covered
                                                                                                          Authority Having Jurisdiction begins                  published on October 17, 2008. This is
                                                  Countermeasure means physical
                                                                                                          with a declaration and lasts through (1)              the first amendment to that declaration.
                                                  provision of the countermeasures to
                                                                                                          the final day the emergency declaration                 Any further amendments to this
                                                  recipients, or activities and decisions
                                                                                                          is in effect or (2) December 31, 2022,                declaration will be published in the
                                                  directly relating to public and private                 whichever occurs first.
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                                                  delivery, distribution and dispensing of                                                                      Federal Register.
                                                  the countermeasures to recipients,                      XIII. Additional Time Period of                         Authority: 42 U.S.C. 247d–6d.
                                                  management and operation of                             Coverage                                                Dated: December 1, 2015.
                                                  countermeasure programs, or                             42 U.S.C. 247d–6d(b)(3)(A), (B) and (C)               Sylvia M. Burwell,
                                                  management and operation of locations                                                                         Secretary.
                                                                                                            I have determined that an additional
                                                  for purpose of distributing and
                                                                                                          twelve (12) months of liability                       [FR Doc. 2015–31092 Filed 12–8–15; 8:45 am]
                                                  dispensing countermeasures.                             protection is reasonable to allow for the             BILLING CODE P




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Document Created: 2015-12-14 13:32:35
Document Modified: 2015-12-14 13:32:35
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice of Amendment to the October 10, 2008 Declaration under the Public Readiness and Emergency Preparedness Act.
DatesThe amendment of the October 10, 2008, declaration is effective as of January 1, 2016.
ContactNicole Lurie, MD, MSPH, Assistant Secretary for Preparedness and Response, Office of the Secretary, Department of Health and Human Services, 200 Independence Avenue SW., Washington, DC 20201, Telephone 202-205-2882.
FR Citation80 FR 76546 

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