Understanding Vaccine Injury Compensation

The Vaccine Injury Compensation Program (VICP) is a federal no-fault program created by the National Childhood Vaccine Injury Act of 1986. It provides compensation to individuals who are injured by vaccines covered under the program.

VICP was created to:

1. Shield vaccine manufacturers from liability after litigation in the 1980s threatened to drive companies out of the vaccine market
2. Provide a streamlined process for injured individuals to seek compensation without lengthy court battles against manufacturers

VICP was created through the National Childhood Vaccine Injury Act (NCVIA), signed into law by President Ronald Reagan on November 14, 1986. The program became operational on October 1, 1988.

VICP covers vaccines routinely recommended for children and pregnant women, including:

• DTaP (Diphtheria, Tetanus, Pertussis)
• MMR (Measles, Mumps, Rubella)
• Polio (IPV)
• Hepatitis A and B
• Hib (Haemophilus influenzae type b)
• Varicella (Chickenpox)
• Pneumococcal vaccines
• Rotavirus
• Seasonal Influenza (flu shots)
• HPV (Human Papillomavirus)
• Meningococcal vaccines

VICP operates through the U.S. Court of Federal Claims with Special Masters who hear vaccine injury cases:

1. Filing: A petition is filed with the Court of Federal Claims within 3 years of symptom onset
2. Medical Review: HHS medical staff review the petition and submit a report to the court
3. Proceedings: A Special Master reviews evidence, may hold hearings, and considers arguments from both the petitioner's attorneys and Department of Justice attorneys representing HHS
4. Decision: After what can be extensive back-and-forth between parties, the Special Master issues a decision on entitlement and damages
5. Appeal: Decisions can be appealed to the Court of Federal Claims and federal appellate courts

VICP is funded through the Vaccine Injury Compensation Trust Fund, which collects an excise tax of $0.75 per vaccine dose.

• Taxpayers do not directly fund vaccine injury compensation
• The cost is built into the price of vaccines
• The fund has accumulated substantial reserves over time

According to HRSA statistics, VICP has an approval rate of approximately 48% for petitions adjudicated since 1988. More recent data (2006-2023) shows a higher rate of approximately 73% (9,675 compensated of 13,326 adjudicated).

Compensation can occur through:

• Claims where the injury is listed on the Vaccine Injury Table (presumptive causation)
• Claims where the petitioner proves causation through medical evidence
• Negotiated settlements between petitioners and HHS

Note: HRSA states that approximately 60% of all compensation awarded comes through negotiated settlements in which HHS has not concluded the vaccine caused the alleged injury.

The Countermeasures Injury Compensation Program (CICP) is a federal program created by the Public Readiness and Emergency Preparedness Act (PREP Act) of 2005. It provides compensation for injuries caused by "covered countermeasures" during declared public health emergencies.

CICP covers:

• COVID-19 vaccines
• Pandemic flu vaccines (H1N1)
• Smallpox vaccines
• Anthrax vaccines
• Certain diagnostic tests and therapeutics

CICP was created in 2005 as part of the PREP Act to address a specific problem: ensuring that manufacturers would produce vaccines and medical countermeasures during public health emergencies without fear of liability.

The PREP Act provides near-complete immunity from lawsuits for manufacturers, distributors, healthcare providers, and government officials involved in administering covered countermeasures. CICP was included as the exclusive remedy for injured individuals, meaning they cannot sue in court.

As of December 2025, CICP has rendered decisions on 6,273 COVID-19 claims, finding only 87 eligible for compensation (1.4%). Of those, 42 have been paid. This compares to VICP's approximately 48% compensation rate.

Several factors contribute to this low rate:

1. No COVID-19 Injury Table: While CICP has injury tables for smallpox and pandemic influenza, HHS has not established one for COVID-19 vaccines. Claimants must independently prove causation for every claim.
2. Higher burden of proof: Claimants must demonstrate injury was the "direct result" of the countermeasure based on "compelling, reliable, valid, medical and scientific evidence."
3. One-year filing deadline: Claims must be filed within 1 year of administration (vs. 3 years from symptom onset for VICP).
4. Limited compensation: No pain and suffering damages are available.
5. No attorney fee coverage: While claimants may hire attorneys, fees are not covered by the program.

CICP allows claimants to request reconsideration of a decision, but there is no independent judicial review. The Secretary of HHS makes the final decision.

This means:

• HRSA, an agency within HHS that also promotes vaccines, adjudicates injury claims
• Claimants can request reconsideration, but it is reviewed by the same agency
• There is no appeal to any court or independent tribunal
• No legal precedent is established to guide future claims

This contrasts with VICP, where claims are heard by Special Masters in the U.S. Court of Federal Claims, with full judicial review available through the federal court system.

As of December 2025, CICP has compensated 42 COVID-19 vaccine injury claims with payments totaling approximately $575,000 for COVID-specific injuries.

Context on these payments:

• Most compensated injuries are myocarditis, pericarditis, anaphylaxis, and Guillain-Barré Syndrome
• The majority of myocarditis payments range from $1,000 to $5,500
• One outlier payment of $370,000 skews the average significantly
• The median payment (excluding outliers) is approximately $4,000

For context, VICP's average payment per compensated claim is approximately $450,000.

The Public Readiness and Emergency Preparedness Act (PREP Act), enacted in 2005, provides immunity from liability for manufacturers, distributors, and healthcare providers of "covered countermeasures" during declared public health emergencies.

When the Secretary of HHS issues a PREP Act declaration, it creates:

1. Broad liability immunity for anyone involved in manufacturing, distributing, or administering covered countermeasures
2. CICP as the exclusive remedy for individuals injured by those countermeasures
3. Prohibition on lawsuits except in cases of "willful misconduct," which requires intentional wrongdoing with knowing disregard of obvious risk

The Act was designed to ensure companies would participate in emergency response without fear of litigation.

Secretary of HHS Alex Azar issued a PREP Act declaration for COVID-19 on March 10, 2020, effective February 4, 2020. The declaration has been amended twelve times since then.

Several factors contributed to COVID-19 vaccines being placed under CICP instead of VICP:

1. Speed of deployment: Vaccines were developed and deployed under Emergency Use Authorization before the standard VICP process could be completed.
2. PREP Act already active: The PREP Act declaration was issued in March 2020, automatically placing any COVID countermeasures under CICP.
3. Legislative inaction: Congress has not passed legislation to add COVID vaccines to VICP, despite multiple bills being introduced.

Now that COVID-19 vaccines have full FDA approval and are routinely administered (including to children), there is a strong case for treating them like other routine vaccines under VICP.

No, with extremely limited exceptions. The PREP Act provides immunity from lawsuits for manufacturers, distributors, and healthcare providers. CICP is your exclusive remedy.

The only exception is "willful misconduct." This is an extremely high bar; to our knowledge, no plaintiff has successfully proven willful misconduct under the PREP Act.

For VICP-covered vaccines: You must first file a VICP claim. If you are unsatisfied with the outcome, you may then have the option to pursue traditional litigation, though this is rarely successful.

There are compelling reasons to add COVID-19 vaccines to VICP coverage:

1. Proven system: VICP has operated for 35+ years with established infrastructure, legal precedents, and procedural protections including judicial review.
2. Public confidence: Thorough and expeditious compensation for adverse reactions bolsters confidence in vaccination programs.
3. Routine administration: COVID-19 vaccines are now routinely administered, including to children, and have received full FDA approval.
4. Consistent treatment: Americans injured by COVID vaccines currently have access to fewer procedural protections than those injured by other routine vaccines.

Yes. There are strong arguments for allowing CICP claimants to seek compensation through VICP:

1. Due process: CICP claimants were denied the procedural protections that VICP provides, including independent judicial review and the ability to appeal to federal court.
2. Administrative denials: Many CICP claims were denied based on the administrative process itself, not a substantive determination that the injury did not occur.
3. Precedent: When vaccines have been added to VICP, Congress has included transitional provisions.
4. Constitutional considerations: The combination of mandatory or coerced vaccination with denial of both compensation and legal recourse raises questions about due process.

The VICP Trust Fund currently holds approximately $4.5 billion. Here is an illustrative analysis of potential costs:

Current VICP obligations:

• Approximately 5,000 claims currently pending in VICP
• Ongoing claims from existing covered vaccines

Potential COVID-19 claim costs:

• CICP claims filed: ~14,000
• If 40% were compensated at an average of $300,000: ~$1.7 billion

Considerations:

• The Trust Fund continues to collect $0.75 excise tax per vaccine dose
• A COVID-19 vaccine excise tax could be implemented to offset costs
• Depending on claim volume and approval rates, additional appropriations may be needed

Bills such as HR 5142 and HR 5143 have been introduced to address COVID-19 vaccine injury compensation. New versions of this legislation are currently in development.

Additionally, the Government Accountability Office (GAO) has issued reports highlighting CICP's shortcomings and recommending reforms.

No. VICP has operated for 35+ years without decreasing vaccination rates. Transparent acknowledgment of rare adverse events and a functioning compensation system demonstrates that:

• The government acknowledges that rare vaccine injuries occur
• Injured individuals have access to a defined process for seeking compensation
• The system includes procedural protections and accountability

Vaccination programs benefit from public confidence, which is supported by transparency about both benefits and risks.

There are several ways you can help advocate for reform:

1. Contact your representatives: Call or write your U.S. Representative and Senators. Ask them to support legislation adding COVID-19 vaccines to VICP coverage.
2. Share information: Help spread awareness about the compensation gap. Many people don't know that COVID vaccines are treated differently.
3. Tell your story: If you or someone you know was injured, sharing your experience (publicly or with policymakers) can be powerful.
4. Support advocacy organizations: Groups like React19 and others are working to support injured individuals and advocate for reform.
5. Engage with officials: Attend town halls, submit public comments on proposed regulations, and make your voice heard.