[Congressional Bills 118th Congress] [From the U.S. Government Publishing Office] [S. 3219 Introduced in Senate (IS)] <DOC> 118th CONGRESS 1st Session S. 3219 To protect against seasonal and pandemic influenza, and for other purposes. _______________________________________________________________________ IN THE SENATE OF THE UNITED STATES November 2, 2023 Ms. Baldwin (for herself, Ms. Klobuchar, Mr. Blumenthal, and Ms. Smith) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions _______________________________________________________________________ A BILL To protect against seasonal and pandemic influenza, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Protecting America from Seasonal and Pandemic Influenza Act of 2023'' or the ``Influenza Act''. SEC. 2. FINDINGS. Congress finds the following: (1) Influenza occurs seasonally each year, and, throughout history, has caused devastating pandemics. The 1918 influenza pandemic killed an estimated 675,000 people in the United States. (2) In an average season, influenza results in 12,000 to 52,000 deaths in the United States, including over 100 pediatric deaths. Additionally, influenza causes hundreds of thousands of hospitalizations and millions of illnesses. (3) The Council of Economic Advisors issued a report in 2019 estimating that seasonal influenza costs the United States approximately $361,000,000,000 per year, and that an influenza pandemic has the potential to cause up to $3,790,000,000,000 in losses. This report was issued prior to the COVID-19 pandemic, which will cost the United States an estimated $16,000,000,000,000. (4) Most funding for pandemic influenza preparedness up until fiscal year 2018 was derived from supplemental appropriations that dated back to the 2009 H1N1 pandemic. (5) Centers for Disease Control and Prevention (referred to in this section as the ``CDC'') studies of influenza hospitalization rates by race and ethnicity during 10 influenza seasons from 2009 to 2019 showed that individuals from racial and ethnic minority groups are at higher risk for being hospitalized with influenza. (6) The COVID-19 pandemic response has been built on the pandemic influenza response ecosystem. (7) Strategies that increase seasonal influenza vaccination rates will also improve pandemic readiness. (8) The National Influenza Vaccine Modernization Strategy of 2020-2030 of the Department of Health and Human Services should be implemented as quickly as possible to ensure the Nation's vaccine enterprise is highly responsive, flexible, scalable, and effective at reducing the impact of seasonal and pandemic influenza viruses. (9) Influenza surveillance has been improved significantly through advances in next-generation gene sequencing tools to analyze circulating influenza viruses. The technology allows the CDC to study more influenza viruses faster and in more detail, and to monitor genetic changes in influenza viruses to better understand and improve the effectiveness of influenza vaccines. (10) Influenza diagnosis and surveillance has improved significantly through advances in influenza testing. Timely infection control and prevention strategies would be significantly bolstered by accurate and readily accessible at- home diagnostic tests. Rapid diagnostics can improve access for underserved populations and allow for better antibiotic stewardship. (11) Vaccine hesitancy in the United States has reached a tipping point where it is adversely affecting public health. Misinformation is widely available on social media, and traditional sources of information on the value and efficacy of vaccines are not trusted by many people of the United States, especially those who are vaccine hesitant. (12) Support for vaccine communication, outreach, and administration across public health and health care settings is critical to drive demand of influenza vaccines, treatments, and medical countermeasures and ensure equitable uptake of such innovations. SEC. 3. STRENGTHENING AND DIVERSIFYING INFLUENZA VACCINE, THERAPEUTICS, AND DIAGNOSTICS DEVELOPMENT, MANUFACTURING, AND SUPPLY CHAIN. (a) Timely Delivery of First Doses of Finished Influenza Vaccine.-- (1) National goal.--It is a national goal for the United States to have, not later than 3 years after the date of enactment of this Act, the capacity to deliver first doses of finished influenza vaccine within 12 weeks of emergence of an influenza strain with pandemic potential. (2) Plan.--Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Assistant Secretary for Preparedness and Response and the Director of the Biomedical Advanced Research and Development Authority, shall publish a plan to achieve the goal specified in paragraph (1). (b) Universal Influenza Vaccine.-- (1) National goal.--It is a national goal for the United States to have developed a universal influenza vaccine, not later than 10 years after the date of enactment of this Act. (2) Plan.-- (A) Publication.--Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services, acting through the Director of the National Institutes of Health and the Director of the Biomedical Advanced Research and Development Authority, shall publish a plan to achieve the goal specified in paragraph (1) in partnership with vaccine manufacturers. (B) Interim support.--The plan under subparagraph (A) shall include provisions, as necessary to achieve such goal, for support over the period of 5 years following the publication of such plan of the following: (i) Incremental vaccine efficacy improvements. (ii) The research workforce. (c) Strengthening the Vaccine Supply Chain.-- (1) Public-private partnerships.-- (A) In general.--The Secretary of Health and Human Services shall-- (i) establish public-private partnerships to strengthen the domestic vaccine supply chain; and (ii) evaluate the capabilities, capacity, and utilization of such partnerships, including by assessing and testing relevant logistical and interoperable technology with stakeholders in the supply chain. (B) Domestic vaccine supply chain.--For purposes of this paragraph, the term ``domestic vaccine supply chain'' includes the full domestic supply chain, including-- (i) production of ingredients and manufacturing and distribution of finished vaccines; (ii) fill-finish capacity; and (iii) the supply chain of ancillary supplies such as needles and syringes. (2) Evaluation of using dpa.--The Secretary of Health and Human Services, in coordination with the Administrator of the Federal Emergency Management Agency and the Secretary of Defense, shall-- (A) evaluate the use of the Defense Production Act of 1950 (50 U.S.C. 4501 et seq.) for COVID-19 pandemic response; (B) not later than 1 year after the date of enactment of this Act, complete such evaluation and submit a report to Congress on the results of such evaluation; and (C) include in such report-- (i) recommendations on using the Defense Production Act of 1950 (50 U.S.C. 4501 et seq.) for building domestic capacity to respond to an influenza pandemic; and (ii) input from external stakeholders. (d) National Influenza Vaccine Modernization Strategy.--The Secretary of Health and Human Services shall-- (1) implement the portions of the National Influenza Vaccine Modernization Strategy 2020-2030 that are within the authority of the Department of Health and Human Services to carry out (under other applicable provisions of law); and (2) by June 15 each calendar year through 2030, submit to Congress a report on such implementation. (e) Assistant Secretary for Preparedness and Response.--Section 2811 of the Public Health Service Act (42 U.S.C. 300hh-10) is amended-- (1) in subsection (b)-- (A) in paragraph (3), by inserting ``, including the pandemic influenza medical countermeasures program under paragraphs (2)(E) and (4)(H) of section 319L(c)'' after ``qualified pandemic or epidemic products (as defined in section 319F-3)''; and (B) in paragraph (7), in the matter preceding subparagraph (A), by inserting ``, including through the pandemic influenza medical countermeasures program under paragraphs (2)(E) and (4)(H) of section 319L(c)'' after ``for each such threat''; and (2) in subsection (d)(2)-- (A) in subparagraph (J)(v), by striking ``and'' at the end; (B) by redesignating subparagraph (K) as subparagraph (L); and (C) by inserting after subparagraph (J) the following: ``(K) evaluate progress with respect to implementing the National Influenza Vaccine Modernization Strategy, issued in June 2020, or any successor strategy; and''. (f) Biomedical Advanced Research and Development Authority.-- (1) Preparedness activities.--Section 319L(c) of the Public Health Service Act (42 U.S.C. 247d-7e(c)) is amended-- (A) in paragraph (2)-- (i) in subparagraph (C), by striking ``and'' at the end; (ii) in subparagraph (D), by striking the period at the end and inserting ``; and''; and (iii) by adding at the end of the following: ``(E) supporting pandemic influenza countermeasure preparedness.''; and (B) in paragraph (4), by adding at the end of the following: ``(H) Pandemic influenza medical countermeasures program.--In carrying out paragraph (2)(E), the Secretary shall establish and implement a program that-- ``(i) supports research and development activities for qualified pandemic or epidemic products (as defined in section 319F-3), including by-- ``(I) developing innovative technologies to enhance rapid response to pandemic influenza threats; ``(II) developing influenza vaccines with potential universal vaccination capability; ``(III) developing enhanced influenza vaccines with longer lasting broad spectrum protective immunity against a wider range of antigenically divergent influenza strains; ``(IV) developing alternative vaccine delivery approaches; ``(V) developing novel small- and large-molecule novel influenza antivirals, monoclonal antibodies, and other products that provide better influenza treatment and prevention; ``(VI) developing innovative technologies to enhance rapid diagnosis of influenza; and ``(VII) implementing the National Influenza Vaccine Modernization Strategy, issued in June 2020, or any successor strategy; ``(ii) ensures readiness to respond to qualified pandemic and epidemic threats, including by-- ``(I) supporting development and manufacturing of influenza virus seeds, clinical trial lots, and stockpiles of novel influenza strains; ``(II) supporting the stockpile of influenza antivirals through diversifying and replenishing the existing stockpile of influenza antivirals; ``(III) supporting manufacturing and fill-finish rapid response infrastructure; ``(IV) supporting the stockpile of influenza testing equipment and supplies; and ``(V) testing and evaluating pandemic threat rapid response capabilities through regular preparedness drills with key public and private sector partners that examine the range of activities (including production and clinical testing of influenza diagnostics, vaccines, and therapeutics) required to effectively respond to novel threats; and ``(iii) builds, sustains, and replenishes qualified pandemic and epidemic stockpiles of bulk antigen and adjuvant material, including by-- ``(I) annually testing the potency and shelflife potential of all existing pandemic and epidemic stockpiles held by the Department of Health and Human Services; and ``(II) developing, and disseminating to key public and private sector partners, a life cycle management plan.''. (g) Authorization of Appropriations.--Section 319L(d) of the Public Health Service Act (42 U.S.C. 247d-7e(d)) is amended by adding at the end the following: ``(3) Pandemic influenza.--To carry out this section and section 2811 with respect to pandemic influenza, in addition to amounts authorized to be appropriated by paragraph (2) and any amounts authorized to be appropriated by section 2811, there is authorized to be appropriated $335,000,000 for each of fiscal years 2024 through 2028, to remain available until expended.''. SEC. 4. PROMOTING INNOVATIVE APPROACHES AND USE OF NEW TECHNOLOGIES TO DETECT, PREVENT, AND RESPOND TO INFLUENZA. (a) Sense of Congress.--It is the sense of Congress that the Centers for Disease Control and Prevention should support interoperable immunization information systems that enable bidirectional data exchange among States, localities, and community immunization providers. (b) Prioritizing Influenza, Influenza Combination, and Pathogen Agnostic Tools.-- (1) NIH.--The Director of the National Institutes of Health may conduct or support basic research prioritizing the development of-- (A) agnostic tools to detect influenza and other pathogens; and (B) technologies that automate sample preparation for such tools. (2) BARDA.--The Director of the Biomedical Advanced Research and Development Authority may conduct or support advanced development of novel sequencing modalities prioritizing tools described in paragraph (1)(A) and technologies described in paragraph (1)(B). (c) Development of Point-of-Care and Self-Testing Diagnostics.--The Director of the Biomedical Advanced Research and Development Authority, in collaboration with the Director of the Centers for Disease Control and Prevention, the Director of the National Institutes of Health, and the Commissioner of Food and Drugs, may conduct or support development of rapid, accurate, easily accessible, self-administrable diagnostic tests that are readable at the point of care or at home. (d) Incorporating Diagnostics Supply Chain Resiliency Into Influenza Pandemic Planning.--The Assistant Secretary for Preparedness and Response, in collaboration with the Commissioner of Food and Drugs, the Director of the Centers for Disease Control and Prevention, the Secretary of Commerce, and the Secretary of Transportation, shall-- (1) incorporate diagnostics supply chain resiliency into influenza pandemic planning that supports a health care system that tests to treat and bolsters testing and vaccine delivery supply chains; and (2) not later than 1 year after the date of enactment of this Act, publish a plan for rapidly expanding public and private diagnostic testing capacity (including at clinical