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The government compensates those injured by vaccines. Who knew?

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96860 full

Last month, the U.S. Government Accountability Office released a report about the federal Vaccine Injury Compensation Program.

Wait… you didn’t know that a program like this existed?  

That's actually one of the issues the report raises. It notes that the Health Resources and Services Administration, which oversees the program, "has acknowledged being criticized for years for not adequately promoting public awareness" of the fund.

The report continues: "Without awareness of the program, individuals who might otherwise receive compensation for a vaccine-related injury or death could be denied compensation because of a failure to file their claim within the statutory deadlines."

I discussed this point – and others – with Marcia Crosse, a health care director at the GAO.

The issue of publicity is tricky, she said, because public health officials "don't want to make a big deal out of the program."

Why wouldn't the government want the public to know about the Vaccine Injury Compensation Program? 

It's not because the feds are being stingy; rather, as an Associated Press investigation published last month explained:

Seven former federal officials acknowledged in interviews what one called a "large concern" that vaccine court cases could reduce vaccination rates. One called it "part of the daily work context."

This is not surprising, given the intense battle over vaccinations in recent years. The last thing the government wants to do is feed the flames of the anti-vaccination movement, since, as the CDC says, vaccines rarely cause serious problems:

Most vaccine adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking acetaminophen before or after vaccination. More serious adverse events occur rarely (on the order of one per thousands to one per millions of doses), and some are so rare that risk cannot be accurately assessed. 

But at the same time, Crosse said, "people need to be aware that this exists, if they do suffer an injury."

Now that you know it exists, there are a couple more things you should know about this fund. But first, some background:

Origins

In the 1980s, some parents filed lawsuits against drug companies, alleging their children were injured by the DTP shot, which protects against diphtheria, tetanus and pertussis, according to Crosse.

She said there was concern that the drug companies might stop making vaccines because of these lawsuits. To prevent that from happening, the government created the Vaccine Injury Compensation Program, shifting liability from the companies to the government. It took effect in 1988.

How does it work?

The program is funded through vaccines: There's a 75-cent charge for each vaccine administered. As of the end of fiscal year 2013, the program boasted a nearly $3.3 billion fund, according to the GAO.

It applies to all vaccines that the Centers for Disease Control and Prevention recommends for routine administration to children. The program acknowledges and covers certain scientifically proven risks of these vaccines. So, for example, if a child goes into anaphylactic shock within four hours of receiving a tetanus vaccine, then a family is likely eligible for compensation.

If you think you or your child has suffered an illness or injury due to a vaccination, you can check this Health Resources and Services Administration table that lists the adverse reactions that have been linked to different vaccines, and the time frame in which symptoms typically appear.  

If someone is injured – and the condition's link to a particular shot is unproven, or not yet acknowledged by the government – then it's up to the family to prove the vaccine was to blame.

And that is not a rare occurrence, according to the AP:

Many claims fall into a vast gray area: The science is clear on only nine of 144 vaccine-injury combinations that a shot could — or could not — cause the illness. 

If a family has to prove a vaccine injured a child, the federal government will cover the cost of any lawyers or experts, whether the case is successful or not, Marcia Crosse told me. This is intended to ensure the program is accessible to all families, she said. But it has also contributed to another problem, noted the AP: "...the kind of litigation the court was created to avoid is routine."

Some lawyers are clogging the court - sometimes with cases with no medical merit, according to the AP. The reporters write: "By pushing quantity of cases over quality, a practice known as 'churning,' some of the most prolific attorneys have tied up the court with flimsy claims."

How many claims?

Since 1999, the program has received between 200 and 500 non-autism claims annually. That's a very small number, when you consider the millions of children who get vaccinated each year.

Autism-related claims peaked in 2003 - at about 2,500 submissions - following the publication of a now-debunked and retracted study linking autism and the MMR shot, which protects against measles, mumps and rubella. The Vaccine Injury Compensation Program has rejected every autism-related claim; these types of claims virtually stopped after 2010.

Number of claims has increased with flu shot

From fiscal years 1999 to 2009, the Vaccine Injury Compensation Program paid less than $125 million in compensation almost every year. But beginning in 2010, the number of compensated claims, and the amount the program has paid out, have ticked up. In fiscal year 2013, the program paid more than 350 claims, for a total of more than $250 million.

The GAO links this increase to the influenza vaccine, which was added to the Compensation Program's list of covered shots in 2005. Marcia Crosse explained that this vaccine is now recommended not just for kids, but for everyone 6 months of age and older. This means that people of all ages are eligible for compensation if they're injured by the flu vaccine.

The government has not yet listed any specific injuries that are possibly associated with the flu vaccine, but the GAO said there have been "numerous settlements for cases alleging Guillain-Barré Syndrome as an injury associated with the influenza vaccine."

To refresh: Why does this program exist?

Vaccines are one of the great public health achievements of the past century. Everyone –including you, me and government officials - has an interest in ensuring that as many people are vaccinated as possible. This maintains herd immunity, and prevents the spread of contagious diseases.

But again, as Crosse noted, vaccine injures are "rare events, but not zero events." This fund is available, in the rare and tragic situation when someone sustains a serious injury from vaccination.

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