Serious injury from vaccination is extraordinarily rare — but it does happen. In 1986, Congress established the National Vaccine Injury Compensation Program to provide financial support for those few individuals that suffer a vaccine injury. We’re extremely fortunate to have such a program.

The 1970s and 1980s were rough on vaccine manufacturers. Some parents of children with physical or developmental disorders blamed vaccines for their child’s condition. Many sued the vaccine manufacturer, as well as the doctors and nurses that vaccinated their child.

In turn, juries often awarded these families huge cash settlements based not on the facts, but rather out of sympathy for the child. Many manufacturers quit producing vaccines fearing bankruptcy.

The resultant vaccine shortages threatened public health. As a “no fault” compensation program, the Vaccine Injury Compensation Program allows manufacturers to produce vaccines and health professionals to vaccinate without fear of being sued except in cases of criminal negligence.

As an aside, we now know that vaccines hadn’t played a role in a majority of these children’s conditions. Through advances in medicine, we now know many of these children suffered from rare metabolic and mitochondrial disorders that were unknown at the time.

Under the Vaccine Injury Compensation Program, any person who believes they were injured by a routine vaccine can file a claim. Family members can file on behalf of children, disabled adults and deceased individuals.

Clear-cut cases such as an allergic reaction occurring minutes after vaccination are settled without debate. More complex cases, where it’s not obvious that vaccination is the cause, are heard by a special master. Special masters are judges with a deep understanding of medicine, immunology and vaccination.

Claimants are allowed to present their evidence to the special master. The special master decides if compensation should be awarded, the type of compensation and the amount. Claimants unhappy with the outcome can appeal to a judge of the Court, then to the U.S. Court of Appeals for the Federal Circuit, and finally, to the U.S. Supreme Court.

Unlike criminal cases where a defendant is presumed innocent, the presumption is that vaccination is the cause. About 70 percent of all compensation awarded is as a result of a negotiated settlement in which it’s not clearly established that the vaccine caused the condition.

The intent is for the Vaccine Injury Compensation Program to facilitate claims. The program helps those filing claims navigate the system and fill out necessary paperwork.

Still, most people retain lawyers, and the program pays their legal fees no matter the case outcome as long as certain minimal standards are met. Compensation is awarded for past and future medical treatment, custodial care, rehabilitation costs and lost earnings. There’s no limit on the payout for these types of expenses. Compensation for pain and suffering is limited to $250,000.

According to the Centers for Disease Control, from 2006 to 2017, over 3.4 billion doses of covered vaccines were given. For claims filed in this time period, 6,411 were adjudicated by the Court, and of those 4,408 were compensated.

This means for about every million doses of vaccine given, approximately one individual was compensated. Shoulder injury, from giving the vaccine too high in the arm, is the most common compensated injury.

Public health depends on vaccine manufacturers, health care professionals to vaccinate and the willingness of individuals to be vaccinated. The Vaccine Injury Compensation Program is an important program protecting all three.

Vaccine Smarts is written by Sealy Institute for Vaccine Sciences faculty members Drs. Megan Berman, an associate professor of internal medicine, and Richard Rupp, a professor of pediatrics at the University of Texas Medical Branch. For questions about vaccines, email vaccine.smarts@utmb.edu.

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