Vaccines are generally safe, but in rare cases, they may cause a serious problem, such as a severe allergic reaction. Individuals injured by vaccines can file a petition for financial compensation through the National Vaccine Injury Compensation Program (VICP). Parents and legal representatives can also file on behalf of affected children, disabled adults, and deceased individuals. For compensation to occur, it must be proven that the claimed injury occurred from a VICP-covered vaccine. The Program was created in the 1980s to encourage vaccination and prevent the resurgence of vaccine-preventable diseases. At the time, those affected were filing lawsuits against vaccine manufacturing companies and healthcare providers, which led to a decline in vaccination rates.
VICP Claim Process
For you to be considered for compensation under VICP, you must file a vaccine injury petition with the U.S. Court of Federal Claims. Your attorney can assist you in preparing and filing the petition. The petition is a legal document requesting compensation under the VICP. It contains details on the injured person, the vaccine that caused the injury, the administration dates and location, the type of injury, when the symptoms first appeared, and how long they lasted. When submitting your claim, you should also include your medical records and supporting documents, the Court’s cover sheet, and a $400.00 filing fee.
The original application, two copies, and the $400.00 filing fee should be sent to the Clerk, U.S. Court of Federal Claims, 717 Madison Place, N.W. Washington, D.C. 20439.
You should also send a copy of the claim to the Director, Division of Injury Compensation Programs, HRSA, Healthcare Systems Bureau, 5600 Fishers Lane, 8N146B Rockville, Maryland 20857
Upon receiving your petition, the Department of Health and Human Services reviews the application to determine if you meet the established compensation criteria and makes a preliminary recommendation. The case is then forwarded to the Department of Justice, which develops a report on the medical recommendation and legal analysis. A court-appointed special master decides whether you should be compensated and the type and amount of compensation based on the DOJ findings. The special master may hold a hearing with both parties, allowing them to present evidence. If your claim is approved, the Court orders the Department of Health and Human Services to compensate you. If certain requirements are met, the Court may also direct the vaccine injury program to pay attorneys’ fees and costs even if the petition is dismissed. You can also appeal the special master’s decision if it is not satisfactory. Alternatively, you can file a claim in civil court against the vaccine company and the health care provider who administered the vaccine.
Vaccines covered by VICP include:
- Diphtheria, tetanus, pertussis (DTP, DTaP, Tdap, DT, Td, or TT)
- Haemophilus influenzae type b (Hib)
- Hepatitis A (HAV)
- Hepatitis B (HBV)
- Human papillomavirus (HPV)
- Influenza (TIV, LAIV) (given annually)
- Measles, mumps, rubella (MMR, MR, M, R)
- Meningococcal (MCV4, MPSV4, MenB-FHbp, MenB-4C)
- Polio (OPV or IPV)
- Pneumococcal conjugate (PCV)
- Rotavirus (RV)
- Varicella (VZV)
Eligibility for vaccine injury compensation under VICP
Injured non-U.S. citizens may also be eligible for compensation, as well as some people who receive vaccines outside of the country. Only vaccines that are covered by the VICP and administered in a U.S. trust territory are covered. Vaccines administered outside the U.S. or its trust territories are only compensated if the injured person was a U.S. citizen serving in the military, or was a U.S. government employee, or was a dependent of such a citizen. You may also be compensated if you received a vaccine manufactured by a vaccine company located in the U.S. and returned to the U.S. within 6 months after the date of vaccination.
To be eligible for compensation, the vaccine injury must have resulted in either of the following:
- The effects of the vaccine/injury must have lasted for more than 6 months after the vaccine was given, or
- The vaccine injury must have resulted in a hospital stay and surgery, or
- The injury must have resulted in death
Medical records and other evidence
For timely review of your claim, you must submit your claim along with certain medical records, as well as any other appropriate documents. You must also identify any missing records and explain why. Failure to include the required records may delay the review and processing of your claim. Critical records when filing a claim under VICP are:
- Prenatal and Birth Records
- The individual’s medical records before vaccination
- Vaccination records (if available): Lot number and the manufacturer
- Any post-injury hospital records
- Vaccine Adverse Event Reporting System (VAERS) form (if submitted)
- Long-term records related to your injury
- Death records and autopsy reports (if available)
Do I need a lawyer to file a VICP claim?
If you are looking to file a vaccine injury claim, it is best to seek the representation of a qualified attorney. The program pays your attorney fees and other legal costs if your claim is approved. They may also pay your lawyer’s fees if certain minimum requirements are met, even when your claim is denied. However, the VICP does not pay you any representation fees if you choose to represent yourself, even if your claim is accepted, except if you incur legal costs.
Time limitations of filing a vaccine injury claim under the VICP claim
You should file a claim as soon as possible if you believe you or a loved one was injured by a vaccine covered by the VICP program. There are certain timelines within which you can be compensated following a vaccine injury. You must file a claim for injury within three years from the time the first symptom of the vaccine injury occurred. Claims related to the death of a loved one must be filed within two years of the death, or within four years after the occurrence of the first symptom of the vaccine-injury which caused the death.
If a vaccine was recently added to the program, you can only claim compensation within 2 years from the date the vaccine and relevant injury are included in the program. You can only file a death claim for a vaccine-related death that occurred up to eight years before the vaccine was added to VICP.
Vaccine-related injuries presumptions
Certain injuries are linked to certain vaccines and are compensated if they meet eligibility requirements as follows:
| Vaccine | Vaccine-Related Injury and the time period for the first symptom |
| Tetanus toxoid (DTaP, DTP, DT, Td, or TT) | 1. Anaphylaxis-≤4 hours
2. Brachial Neuritis- 2-28 days (not less than 2 days and not more than 28 days) 3. Shoulder Injury Related to Vaccine – ≤48 hours 4. Vasovagal syncope-≤1 hour |
| Vaccines containing whole cell pertussis bacteria, extracted or partial cell pertussis bacteria, or specific pertussis antigen(s) (DTP, DTaP, P, DTP-Hib) | 1. Anaphylaxis – ≤4 hours
2. Encephalopathy or encephalitis- ≤72 hours 3. Shoulder Injury Related to Vaccine- ≤48 hours 4. Vasovagal syncope- ≤1 hour |
| Vaccines containing measles, mumps, and rubella virus or any of its components (MMR, MM, MMRV) | 1. Anaphylaxis- ≤4 hours
2. Encephalopathy or encephalitis – 5-15 days (not less than 5 days and not more than 15 days) 3. Shoulder Injury Related to Vaccine Administration- ≤48 hours 4. Vasovagal syncope- ≤1 hour. |
| Vaccines containing the rubella virus (MMR, MMRV) | 1. Chronic arthritis- 7-42 days (not less than 7 days and not more than 42 days) |
| Vaccines containing measles virus (MMR, MM, MMRV) | 1. Thrombocytopenic purpura- 7-30 days (not less than 7 days and not more than 30 days)
2. Vaccine-Strain Measles Viral Disease in an immunodeficient recipient: Vaccine-strain virus must be identified- ≤12 months |
| Vaccines containing polio live virus (OPV) | 1. Paralytic Polio: non-immunodeficient recipient -≤30 days; An immunodeficient recipient- ≤6 months
2. Vaccine-Strain Polio Viral Infection: non-immunodeficient recipient -≤30 days; An immunodeficient recipient- ≤6 months |
| Vaccines containing the inactivated polio virus (IPV) | 1. Anaphylaxis – ≤4 hours
2. Shoulder Injury Related to Vaccine Administration- ≤48 hours 3. Vasovagal syncope – ≤1 hour |
| Hepatitis B vaccines | 1. Anaphylaxis -≤4 hours
2. Shoulder Injury Related to Vaccine Administration -≤48 hours 3. Vasovagal syncope – ≤1 hour
|
| Haemophilus influenzae type b (Hib) vaccines | 1. Shoulder Injury Related to Vaccine Administration- ≤48 hours
2. Vasovagal syncope- ≤1 hour |
| Varicella vaccines | 1. Anaphylaxis- ≤4 hours
2. Disseminated varicella vaccine strain viral disease- 7-42 days (not less than 7 days and not more than 42 days) 3. Varicella vaccine-strain viral reactivation 4. Shoulder Injury Related to Vaccine Administration- ≤48 hours 5. Vasovagal syncope- ≤1 hour |
| Rotavirus vaccines | 1. Intussusception- 1-21 days (not less than 1 day and not more than 21 days) |
| Pneumococcal conjugate vaccines | 1. Shoulder Injury Related to Vaccine Administration- ≤48 hours
2. Vasovagal syncope – ≤1 hour |
| Hepatitis A vaccines | 1. Shoulder Injury Related to Vaccine Administration- ≤48 hours
2. Vasovagal syncope – ≤1 hour |
| Seasonal influenza vaccines | 1. Anaphylaxis – ≤4 hours
2. Shoulder Injury Related to Vaccine Administration – ≤48 hours 3. Vasovagal syncope – ≤1 hour 4. Guillain-Barré Syndrome – 3-42 days (not less than 3 days and not more than 42 days) |
| Meningococcal vaccines | 1. Anaphylaxis – ≤4 hours
2. Shoulder Injury Related to Vaccine Administration – ≤48 hours 3. Vasovagal syncope – ≤1 hour |
| Human papillomavirus (HPV) vaccines Human papillomavirus (HPV) vaccines | 1. Anaphylaxis – ≤4 hours.
2. Shoulder Injury Related to Vaccine Administration – ≤48 hours 3. Vasovagal syncope- ≤1 hour |
| All new vaccines recommended by the CDC for routine administration to children, after the publication of a notice of coverage | 1. Shoulder Injury Related to Vaccine Administration – ≤48 hours
2. Vasovagal syncope – ≤1hour |
If the injured person received one or more of the vaccines listed above and the first symptom of the injury/condition occurred within the defined time periods, it is presumed that the vaccine/s caused the condition unless another cause is found. As a result, it must be proven that the injury or death did not result from any other possible causes. The court may also award you compensation if you can prove that the vaccine significantly aggravated an existing illness.
If your injury or condition is not listed or does not meet the specified requirements, you must prove through evidence that the injury or death occurred from the vaccine. Evidence may include expert witness testimony, medical records, or medical opinion. You can consult a VICP compensation lawyer for guidance.
How much does VICP pay in compensation?
Compensation for injuries depends on the seriousness of the condition and injury-related needs. There is no maximum amount of compensation for these types of expenses. The program may award you an amount for past and future non-reimbursable medical, custodial care, and rehabilitation expenses. The program awards up to $250,000 for actual and projected pain and suffering, lost earnings, and legal costs.
For cases involving vaccine-related death, the program pays up to $250,000 as a death benefit for the estate of the deceased, as well as attorney fees and other legal costs if your claim was filed on a reasonable basis and in good faith.
Final Thoughts
The National Vaccine Injury Compensation Program resolves vaccine injury petitions without petitioners having to go through the tort system. Only vaccine manufacturers and administrators of vaccines covered under the program are protected from liability under the National Childhood Vaccine Injury Act of 1986. For you to pursue legal actions against vaccine manufacturers or administrators for vaccine-related injuries or deaths, you must first exhaust your compensation options under the VICP. To pursue a legal action against a vaccine manufacturer or administrator outside of the VICP, you must withdraw your petition if the courts fail to issue a decision or reject the VICP judgment.