National Vaccine Injury Compensation Program Aims to Address Vaccine Hesitancy

The National Vaccine Injusty Compensation Program (VICP) was introduced through the National Childhood Vaccine Injury Act of 1986 to compensate individuals who experience severe adverse effects from an eligible vaccine. The program was intended to decrease vaccine hesitancy caused by alleged severe adverse effects in children who received the diphtheria-tetanus-pertussis (DTaP) vaccine.¹

Although only 18 of 15,752 DTaP recipients in findings from a 1981 study experienced serious reactions, the media capitalized on the conspiracy by presenting stories of affected children in documentaries such as DPT: Vaccine Roulette from 1982 or inviting celebrities to discuss and promote vaccine avoidance.^2,3 Behaviors such as these caused disruptions in vaccine distribution pipelines and hindered completion of necessary vaccination schemes. Considering the threat that an increasingly unvaccinated population posed to national health, stakeholders appealed to the US Congress hoping for the establishment of a nationwide program to compensate individuals for injuries related to vaccines or their administration.¹

To claim compensation for a vaccination-related injury, a patient must file a petition by submitting a cover sheet along with relevant medical records to the US Court of Federal Claims and the Division of Injury Compensation Programs. Anyone who has experienced a severe adverse effect from an eligible vaccine and is within the accepted time frame can file a claim with the VICP; for vulnerable groups and deceased individuals, their legal guardians may apply for compensation. Anyone who received an eligible vaccine within the United States, did so elsewhere but is a US citizen or dependent, or received an American vaccine abroad and returned to the US within 6 months is eligible to apply for VICP compensation.¹

The most common injury types covered under VICP include anaphylaxis, shoulder injury related to vaccine administration, and vasovagal syncope. An updated list of all covered injuries, vaccines, and accepted time periods for first symptom manifestation can be found on the Health Resources & Services Administration website. Patients should be encouraged to consult this site before filing. Petitioners can engage a lawyer to help file the claim and have VICP pay all associated costs, or they can do so on their own. Additionally, a $400 filing fee must be paid to process the application, but financial assistance is available.¹

The limited number of covered vaccines, the strict guidelines of what constitutes a feasible injury, and the lengthy legal process could be reasons why the percentage of successful claims is at only 34%.⁴ Because of the limited number of court officials trained to deal with VICP claims, many patients also wait up to 3 years for their petitions to be adjudicated, with no guarantee they will be compensated.⁵ Although the success rate is consistent with other similar programs in Norway, Sweden, or Taiwan, it is much lower than in countries such as Japan, where as many as 80% of petitioners receive compensation. The American VICP offers some of the highest compensation, with a maximum award of $250,000, but it is still lower than in Japan, where a petitioner can receive up to $1 million.^4,6

More than 25,000 petitioners have filed a vaccine-related injury claim since the program began in 1988.⁷ The yearly number of petitions has fluctuated, but record numbers of complaints were usually registered after the introduction of new vaccines in the VICP table.⁵ However, episodes of medical conspiracy have also caused peaks in complaint numbers. Between 1998 and 2003, the Daily Mail fueled mass hysteria with more than 700 articles covering the alleged link between autism and the measles-mumps-rubella vaccine; more than 2400 autism-related complaints were registered with the VICP in the fiscal year 2003, whereas only 155 complaints were related to other types of alleged injuries.⁸

The COVID-19 pandemic has led to millions of new vaccinations for Americans. Because this was in response to a national health crisis, the Countermeasures Injury Compensation Program (CICP) was assigned to deal with complaints from COVID-19 vaccination injuries. However, the CICP’s limited authority and modest funding made it highly inefficient at dealing with these petitions, with only 1138 concluded and 4 compensated from a total of 12,025 petitions.^5,9

With the goal of improving the compensation process by transitioning the responsibility of COVID-19 vaccination complaints to the VICP, Lloyd Doggett, representative from the state of Texas, and Lloyd Smucker, representative from the state of Pennsylvania, introduced the Vaccine Injury Compensation Modernization Act (HR 3655) in August 2021.¹⁰ This latest legislation is also intended to adjust the compensation award using the current inflation rate and extend the cap to $600,000; increase the number of judicial authorities in charge of VICP hearings; and extend the deadline to file a complaint to 5 years after the vaccine administration.⁶ The introduction of HR 3655 has long been awaited by stakeholders and is anticipated to bring a valuable update to 36-year-old legislation.^5,10

References

1. 1What You Need to Know About the National Vaccine Injury Compensation Program. Health Resources & Services Administration. April 2019. Accessed October 30, 2023. https://www.hrsa.gov/sites/default/files/hrsa/vicp/aboutvaccine-injury-compensation-program-booklet.pdf
2. Centers for Disease Control (CDC). Pertussis surveillance, 1979-1981. MMWR Morb Mortal Wkly Rep. 1982;31(25):333-336.
3. Benner AL, Vasterling A, Wolter T. A Qualitative Examination of Vaccine Hesitancy Among Mothers. Master’s thesis. Bethel University; 2019. Accessed October 30, 2023. https://spark.bethel.edu/etd/62/
4. Crum T, Mooney K, Tiwari BR. Current situation of vaccine injury compensation program and a future perspective in light of COVID-19 and emerging viral diseases. F1000Res. 2021;10:652. doi:10.12688/f1000research.51160.2
5. Gentry RJ. National Vaccine Injury Program needs modernizing. Bloomberg Law. March 8, 2022. Accessed October 30, 2023. https://news.bloomberglaw.com/product-liability-and-toxics-law/national-vaccine-injuryprogram-needs-modernizing
6. Vaccine Injury Compensation Modernization Act of 2021, HR 3655, 117th Cong (2021). Accessed October 30, 2023. https://www.congress.gov/bill/117th-congress/housebill/3655
7. Vaccine Injury Compensation Program Data and Statistics. Health Resources & Services Administration. Updated July 1, 2022. Accessed October 30, 2023. https://www.hrsa.gov/sites/default/files/hrsa/vicp/vicp-stats-07-01-22.pdf
8. Moore A. Bad science in the headlines: who takes responsibility when science is distorted in the mass media? EMBO Rep. 2006;7(12):1193-1196. doi:10.1038/sj.embor.7400862
9. Countermeasures Injury Compensation Program (CICP) data. Health Resources & Services Administration. Updated October 1, 2023. Accessed October 30, 2023. https://www.hrsa.gov/cicp/cicp-data
10. Rep. Doggett files legislation to modernize Vaccine Injury Compensation Program. News release. Congressman Lloyd Doggett. August 4, 2023. Accessed October 30, 2023. https://doggett.house.gov/media/press-releases/rep-doggett-files-legislation-modernize-vaccine-injurycompensation-program