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Pandemic Influenza

Pandemic inluenza refers to any of a variety of flu strains that could and have spread thoughout the world with an infection rate much larger than is considered statistically "normal". Entries on this page refer to the legal basics, such as legal authority and vaccine management. Avian flu (H5N1) is one variety that is included in this collection.

The following article reviews a noteworthy and historic case pertaining to immunization in the early 20th century.

Wendy E. Parmet, J.D., Richard A. Goodman, M.D., J.D., M.P.H., and Amy Farber, Ph.D., Individual Rights versus the Public Health - 100 years after Jacobson v. Massachusetts, N Engl J Med 2005; 352:652-654, February 17, 2005.
Background to and a commentary about the 1905 U.S. Supreme Court decision in the case of Jacobson v. Massachusetts on the 100th anniversary of the Court's decision.
(Posted: 02/18/2005)

Federal Laws

U.S. President, Legal Authorities Index in the National Strategy for Pandemic Influenza: Implementation Plan, May 3, 2006.
President Bush released the National Strategy for Pandemic Influenza: Implementation Plan on May 3, 2006. Appendix C from this document provides a comprehensive listing and description of the federal legal authorities and references that apply to the Plan.
(posted 05/04/2006).

Department of Health and Human Services, Centers for Disease Control and Prevention, Legal Preparedness in the HHS Pandemic Influenza Plan, Nov. 2, 2005.
Legal preparedness is critical to public health agencies' ability to address pandemic influenza and other major health threats. On Nov. 2, 2005, the U.S. Department of Health and Human Services published the "HHS Pandemic Influenza Plan," which identifies many elements that states and localities should consider as they assess their legal preparedness. Click here for the full text of the Plan, prefaced with a directory to the legal preparedness elements and action steps contained therein.
(posted 05/04/2006).

Department of Health and Human Services, Centers for Disease Control and Prevention, Order lifting the embargo ban for birds products in Hong Kong, March 10, 2004).
(Posted: 03/22/2004)

State Laws

NGA (National Governor's Association), Pandemic Influenza preparation guide, June 1, 2006.
(Posted: 06/01/2006)

Delaware Health and Social Services, Order to Control Inluenza Vaccination
An Order to Control Influenza Vaccination signed by Delaware Health and Social Services Secretary Vincent P. Meconi ordering that the influenza vaccine be administered only to those individuals in the high-risk category.   Authority Cited: Title 16, Section 122 of Delaware Code, Health and Safety .
(Posted: 10/27/2004 )

Florida Department of Health,Influenza Vacciantion Press Release, October 7, 2004
Statement from Florida Department of Health Secretary of John O. Agwunobi, MD, MBA, MPH encouraging influenza vaccination prioritization for high-risk individuals, and authorizing the distribution of flu vaccine between doctors, hospitals, and pharmacies during the 2004-2005 flu season.
(Posted: 10/13/2004)

Florida Department of Health,   Distributions of 2004-05 Flu Vaccines, October, 2004.
An Emergency Rule issued by the Florida Department of Health authorizing the administration of surplus influenza vaccine by health care entities to be administered to specified priority high-risk groups.  Authority cited: s. 499.012(1)(a)2.b. F.S.
(Posted: 10/13/2004)

Florida Department of Health, Pandemic Influenza Annex State of Florida Emergency Operations Plan, October 9, 2006.
(Posted: 10/11/2006)

Hawaii Department of Health, DOH Outlines Priorities for Administering Flu Vaccine Press release from the Department of Health outlining priorities for administrating flu vaccine for the 2004-2005 influenza season.
(Posted: 11/9/2004)

Kansas Department of Health and Environment, Further Guidance on Priority Groups for Inactivated Influenza Vaccination,October 15, 2004.
Guidelines provided by the Kansas Department of Health and Environment that specifically define high-risk groups and assist vaccine providers in the responsible use of vaccine during the 2004-2005 influenza season.
(Posted: 10/20/2004)

Maine Department of Health, Updated Guidance on InfluenzaOctober 13, 2004.
A memo from the Maine Department of Health, State Health Officer Dora Anne Mills provides additional updated guidance to various Emergency Departments, Hospital Associations, and Local Health Departments on the administration of the extremely limited influenza vaccine.
(Posted: 10/14/2004)

Department of Public Health, Massachusetts, Emergency Executive Order, October 13, 2004.
An Executive Order issued by the Governor of Massachusetts requiring certain agencies administering trivalent inactivated influenza vaccines to give priority to individuals who are members of high-risk or targeted populations.
(Posted: 10/25/2004)

Michigan Department of Community Health,   Michigan Public Health Order, October 14, 2004.
A copy of a health order issued by Janet Olszewski, Director, Michigan Department of Community Health limiting the administration of the influenza vaccine to those priority populations outlined by the CDC, and imposing penalties for noncompliance.
(Posted: 10/18/2004)

Missouri Governor, Executive Order 4-22, October 25, 2004. Missouri Governor Bob Holden ordering all health care providers to limit influenza vaccinations to individuals in the high-risk category.
(Posted: 10/27/2004)

Nebraska Health and Human Services, Health Alert Network, October 13, 2004.
Guidelines for specifically defining high-risk groups for the influenza vaccination
(Posted: 10/13/2004)

New Jersey Senate and General Assembly, An Act concerning influenza vaccine distribution, 10/26/2004.
A bill authorizing the Commissioner of Health and Senior Services to reallocate flu vaccine to high-risk persons, and imposes penalties for non-compliance.  Approved by Governor 10/27/2004; became P.L.2004, c.153.
(Posted: 11/1/2004)

New Jersey Deaprtment of Health and Senior Services,.Order of The New Jersey Commissioner of Health And Senior Services Concerning the Distribution of Influenza Vaccine,October 5, 2004.
An Order issued by the New Jersey Commissioner of Health and Senior Services authorizing the reallocation of influenza vaccine to certain priority groups, and imposing penalties for non-compliance.
(Posted: 11/5/2004)

New York State Department of Health, Pandemic Influenza Plan.
(Posted: 02/07/2008)

Local Laws

Los Angeles County Department of Health Services, California, Memo: Influenza Vaccine
An influenza vaccine memorandum advising supervisors of the Los Angeles Department of Health Services of the Department's plan for responding the flu vaccine shortage.
(Posted: 10/20/2004)

Santa Clara Valley Public Health Department, California - Pandemic Influenza Preparedness and Response Plan, May 31, 2006.
(Posted: 03/31/2006)

Tribal laws


Articles and Reports

Centers for Law and the Public's Health Dismissal of School Children in the Context of Pandemic Influenza, April, 2008.
In response to national pandemic preparedness priorities, CDC commissioned the independent Centers for Law and the Public's Health: A Collaborative at Johns Hopkins and Georgetown Universities to review the state-level legal framework for reducing the density of school classrooms, with specific focus on closure of schools, as a social distancing or social mitigation measure to slow the spread of an H5N1 influenza pandemic or similar highly contagious infectious disease. The Centers' researchers restricted their scope of inquiry to laws adopted at the state level and to laws that expressly address school closure. (The study did not address any relevant laws adopted at the local level, nor did it address any relevant general laws.) The Centers' report Legal Preparedness for School Closures in Response to Pandemic Influenza and Other Emergencies presents a summary description of the express state laws reviewed by the researchers as of late 2006, together with the authors' observations about those laws (click here to view the report). The report is also accessible on the federal government's comprehensive pandemic influenza website ( and on the Centers' website (
(Posted: 07/08/2008)

Department of Health and Human Services, Centers for Disease Control and Prevention,The Travel Industry Pandemic Influenza Planning Checklist.
Identifies important steps that businesses in the travel industry can take now to prepare for an influenza pandemic. This checklist provides a general framework for developing a pandemic influenza plan.
(Posted: 04/17/2007)




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