Vaccine injury

Vaccine injury
Classification and external resources
Specialty
ICD-10	T88.1, Y58-Y59
ICD-9-CM	E948, E949
Patient UK	Vaccine injury

A vaccine injury is an injury caused by vaccination.

Allegations and confirmed instances of vaccine injuries in recent decades have appeared in litigation in the United States. Some families have won substantial awards from sympathetic juries, even though many public health officials have said that the claims of injuries are unfounded. In response, several vaccine makers stopped production, threatening public health, and laws were passed to shield makers from liabilities stemming from vaccine injury claims.

Adverse events following vaccination

All vaccines may cause side effects, and immunization safety is a real concern. Unlike most other medical interventions, vaccines are given to healthy people, and people are far less willing to tolerate vaccines' adverse effects than adverse effects of other treatments. As the success of immunization programs increases and the incidence of disease decreases, public attention shifts away from the risks of disease to the risk of vaccination.

Concerns about immunization safety often follow a pattern. First, some investigators suggest that a medical condition of increasing prevalence or unknown cause is an adverse effect of vaccination. The initial study, and subsequent studies by the same group, have inadequate methodology, typically a poorly controlled or uncontrolled case series. A premature announcement is made of the alleged adverse effect, resonating with individuals suffering the condition, and underestimating the potential harm to those whom the vaccine could protect. The initial study is not reproduced by other groups. Finally, it takes several years to regain public confidence in the vaccine.

Controversies in this area revolve around the question of whether the risks of adverse events following immunization outweigh the benefits of saving people from tragic outcomes of common diseases. There is some scientific evidence that immunizations can cause serious adverse effects, such as gelatin measles-mumps-rubella vaccine (MMR) causing anaphylaxis, a severe allergic reaction. Allegations particularly focus on the MMR vaccine and on thiomersal, a preservative that was used in vaccines routinely given to U.S. infants prior to 2001. Current scientific evidence does not support causation for these disorders.

United States

Vaccine Injury Compensation Program

In 1988, the National Vaccine Injury Compensation Program (VICP) went into effect to compensate individuals and families of individuals who have been injured by covered childhood vaccines. The VICP was adopted in response to an earlier scare over the pertussis portion of the DPT vaccine. These claims were later generally discredited, but some U.S. lawsuits against vaccine makers won substantial awards; most makers ceased production, and the last remaining major manufacturer threatened to do so. It uses a no-fault alternative dispute resolution system for resolving vaccine injury claims. Funding for claims of harm after 1988 comes from a patient fee of 75 cents per vaccination. To win an award, a claimant must show a causal connection; if medical records show a child has one of several listed adverse effects soon after vaccination, the assumption is that it was caused by the vaccine. The proof standard is the civil-law preponderance of the evidence, showing that causation was more likely than not. Claims that are denied can be pursued in regular lawsuits, though this is rare. Some claimants are suing thimerosal makers instead of vaccine makers, filing class-action suits, or demanding monitoring for vaccinated children who do not show signs of autism.

The VICP covers all vaccines listed on the Vaccine Injury Table maintained by the Secretary of Health and Human Services. From 1988 until March 3, 2011, 5,636 claims relating to autism, and 8,119 non-autism claims, were made to the VICP. 2,620 of these claims, one autism-related, were compensated, with 4,463 non-autism and 814 autism claims dismissed; awards (including attorney's fees) totaled over $2 billion. The VICP also applies to claims for injuries suffered before 1988; there were 4,264 of these claims of which 1,189 were compensated with awards totaling $903 million.

Vaccine Adverse Event Reporting System

The Vaccine Adverse Event Reporting System (VAERS) is a passive surveillance program administered jointly by the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC).

VAERS is intended to track adverse events associated with vaccines. VAERS collects and analyzes information from reports of adverse events (possible side effects) that occur after the administration of US licensed vaccines. The program's success in tracking vaccine injuries has been questioned by some, who allege medical practitioners frequently fail to make reports. Others say that it may overstate possible injuries since many neurological problems in childhood may manifest at around the ages when vaccines are routinely administered.

Vaccine Safety Datalink

The Vaccine Safety Datalink (VSD) is composed of databases from several organizations containing information regarding health outcomes for millions of US citizens and to enhance assessment of vaccine injuries. It was designed to allow for such things as comparisons between vaccinated and non-vaccinated populations, and for the identification of possible groups at risk for adverse events.

United Kingdom

In 2003, parents of over 1,000 United Kingdom children diagnosed with autism spectrum disorders, alleging the MMR vaccine was the culprit, were dealt a major setback by decision by the Legal Services Commission to withdraw legal aid. This followed advice to the commission by the lawyers representing the parents themselves that the lawsuit had no reasonable prospects of success.

Vaccine Damage Payment Scheme

Under the Vaccine Damage Payment Scheme (VDPS), it is thought that thousands of unsuccessful claims have been made. The maximum payment per claim is currently £120,000. Disabled vaccine injury patients are allowed to file a claim up to the age of 21. The 'disability threshold' before payments are granted is 60%. The scheme covers vaccinations for illnesses such as tetanus, measles, tuberculosis and meningitis C. As of 2005, the British government had paid out £3.5 million to vaccine injury patients since 1997.