What is vaccine court? – Business Insider
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Inside ‘vaccine court,’ where the US
government pays millions to people who say
they were harmed by vaccines
Hilary Brueck Mar. 16, 2019, 11:30 AM
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Vaccine court is housed in a red brick building, two minutes from the White House. United States Courts/YouTube
Vaccine court in Washington, DC was established in 1988 after a
series of unfounded lawsuits threatened to erase the national
supply of diphtheria, pertussis, tetanus (DPT) vaccines.
The court is a no-fault system where injured people can have their
cases heard, and everyone’s attorneys are compensated through a
special fund.
A 75¢ cent tax on every childhood vaccine and flu shot in the US
pays for the program.
But it’s extremely difficult to prove that vaccines cause harm. Most
successful verdicts in vaccine court are awarded for bad needle
jabs that prompt shoulder injuries.
Over 80% of vaccine court cases settle without making any
scientific conclusions about what caused the injury.
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Just a two minute walk from the front door of the White House, on the
eastern edge of leafy Lafayette Square, sits the Howard T. Markey National
Courts Building, a 9-story red brick structure with dark, narrow windows.
Inside, federal judges oversee a mix of cases and appeals involving patent
disputes, veteran benefits, oil spills, private claims against the government,
and much more.
Eight of those judges belong to the Office of Special Masters, a small unit
within the much larger Court of Federal Claims. For more than two
decades, these legal minds have applied a meticulous understanding of
medical science — including neurology, rheumatology, and pediatrics — to
one of the most contentious corners of the legal system.
This is vaccine court, whose staff adjudicate cases brought by individuals
who claim vaccines harmed them or their children. The tribunal administers
the National Vaccine Injury Compensation Program, which Congress
established in 1986 and funded with a 75¢ tax on every childhood vaccine
sold in America. Since its inception in 1988, the program has awarded more
than $4 billion in damages.
Every year, the court’s special masters receive around 500 petitions for
monetary damages. Much like a lawsuit, each petition is a legal accusation
from someone who says they’ve been hurt by a prick in the arm or jab in
the thigh. For each one, the special masters must answer a medically tricky,
but legally straightforward, question: Was the plaintiff injured by a vaccine?
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Demonstrators gathered in Lafayette Square on February 18, 2019 in Washington, DC. Zach
Gibson/Getty Images
In 2016, vaccine court awarded $230 million to patients who said they were
wronged by vaccines, and paid over $22 million in attorney fees. (The
courts pays those fees even when the petitioner loses their case — a
significant deviation from standard practice that experts believe is unique to
vaccine court.) The system has existed for more than three decades to serve
a single, and very important, purpose: keeping life-saving vaccines on the
market.
“It is a no-fault compensation program designed to encourage vaccination,
encourage vaccine manufacturers to continue making vaccines, and to
compensate the small but significant number of people who are injured by
a vaccine they receive,” the former head of vaccine court, Chief Special
Master Denise Vowell, explained in a 2015 video.
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This doesn’t mean that vaccines are inherently dangerous. More than 80%
of the claims the court receives are settled, without concluding that a
vaccine caused any injury at all. But the existence of the court, and the
history behind its creation, illustrate the complicated realities of modern
medicine — and the consequences, positive and negative, of its efforts to
eradicate disease.
Costly litigation laid the groundwork for
vaccine court
A technician in an incubator at the virus laboratories of Chas. Pfizer & Co. nurtures cells to serve
as hosts for live virus needed for the measles vaccine. AP Photo
The origins of vaccine court can be traced to the 1970s, when parents
began filing lawsuits against doctors and vaccine manufacturers over
allegations that vaccines for diphtheria, pertussis, and tetanus (DPT shots)
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posed a dangerous risk to children. One of the first lawsuits to succeed was
brought by the parents of Kevin Toner, after he was vaccinated in Idaho in
1979.
“Kevin Toner, then a three-month-old infant, was vaccinated with TriImmunol”— a DPT vaccine since discontinued in the US — “and suffered a
rare condition of the spine known as transverse myelitis, the cause of which
is unknown,” court documents state. “As a result of the affliction, Kevin is
permanently paralyzed from the waist down.”
Family lawyer Kenneth Pedersen remembers that as a young attorney in his
early 30s at the time, winning the case helped launch his own budding legal
career. “The argument was that the vaccine could’ve been safer,” he told
Business Insider. “It was a scary proposition, taking on a huge drug
company. We had to prove that’s how he got hurt.”
A jury of six Idahoans awarded the Toners $1.3 million in their case against
vaccine maker Lederle Laboratories. Toner later graduated from college
and settled down in Salt Lake City with his wife and their children. He
currently works for a major bank.
The Toner verdict arrived amid a national debate over the safety of DPT
shots. Shortly before the family’s case made its way through the court
system, a documentary called “Vaccine Roulette” aired on NBC, scaring
parents across the country about the dangers of the vaccine.
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The American Academy of Pediatrics denounced NBC, saying the
documentary’s “total lack of balance of scientific fact [caused] extraordinary
anguish and perhaps irreparable harm to the health and welfare of the
nation’s children.”
Still, the number of DPT injury lawsuits skyrocketed, from what had been
one single case in 1978 to 73 lawsuits in 1984. The cases got more
expensive, too. As Dr. Alan Hinman noted in a 1986 JAMA Pediatrics article,
“the average amount claimed per suit has risen from $10 million to $46.5
million.”
Pedersen believes it would have become much harder to win tort cases like
Toner’s once more scientific literature started coming out about vaccine
safety. “The medical literature kind of turned on us,” he said.
Vaccines are extremely safe, and the
evidence continues to grow stronger
A comprehensive review of DPT shot safety, published in 1991, determined
the shots do not cause autism or other dangerous and chronic conditions
like attention deficit disorder or juvenile diabetes. The study found a few
notable exceptions where children developed allergies or inflammation, and
a different study documented a handful of instances in which children were
diagnosed with neurological damage after receiving a pertussis shot. But
such instances are extremely rare, and it’s very difficult to prove the shot
was the culprit.
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These anomalies are best understood in the broader context of vaccine
safety. The vast majority of vaccines work as promised and do not cause
any serious or permanent side effects. As the 1991 paper put it, “next to
clean water, no single intervention has had so profound an effect on
reducing mortality from childhood diseases as has the widespread
introduction of vaccines.”
Nevertheless, the financial impact of the DPT lawsuits in the 1970s and 80s
caused a nationwide vaccine shortage and threatened to shutter the
manufacture of DPT vaccines altogether. Before long, doctors, public health
experts, and drug companies began lobbying the federal government to do
something about the rising costs of litigation.
Jonas Salk, who invented the first polio vaccine, was one of the experts who
testified before lawmakers. Before his vaccine went into widespread use in
1955, polio outbreaks caused more than 15,000 cases of paralysis in the US
every year.
“The live polio virus vaccine now in general use causes more than the two
cases per year of vaccine-associated paralysis,” Salk told lawmakers. “Such
cases occur to the extent of about 6 to 10 cases per year.” He encouraged
vaccine-makers to focus on administering more of the killed polio virus
vaccine, which did not cause any paralysis.
“In the case of vaccine-associated injuries, it is clear that it would be far
more desirable to avoid them,” Salk said. “In the event that compensation is
necessary, it seems to me that the kind of legislation that you are proposing
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would be desirable.”
Two years later, the House passed the bipartisan National Childhood
Vaccine Injury Act of 1986. Sen. Edward Kennedy later folded its provisions
into a larger health bill already moving through the upper chamber.
President Ronald Reagan signed the amended bill into law that November,
despite his “mixed feelings” and “reservations” about how the plan might
compensate people who wouldn’t need to prove any wrongdoing on the
part of vaccine-makers.
That made the job of defending lawyers like Pederson much easier. “They
got rid of the causation thing, and you didn’t have to prove fault,” he said.
“Overall, I think a lot of people got compensation who wouldn’t have …
Congress responded ‘let’s not go to court, let’s take care of these kids.'”
Today, the special masters hear complaints about alleged injuries from 15 of
the most common childhood vaccines, plus the flu shot. “It absorbs vaccine
injury controversies and keeps them from becoming lawsuits that could
result in large damage awards from juries, which could threaten production
and availability of vaccines,” legal expert Anna Kirkland, author of ” Vaccine
Court: The Law and Politics of Injury,” told Business Insider in an email.
Vaccine court exists, in part, to address the fact that research and lawsuits
move at different speeds. “We know that the pace of science and
publishing is often slower than the pace of litigation,” Kirkland said. “Some
of those claims could have become massive class-action lawsuits that could
have caused manufacturers to exit the vaccine market.”
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Legitimate scientific studies have never shown a link between vaccines and
autism. But it takes a long time to gather and analyze the amount of data
those studies require. The latest study refuting the vaccine-autism link,
published by the Annals of Internal Medicine in early March, was based on
the medical histories of more than 650,000 Danish children collected over a
period of 14 years.
At the same time, scientific authority can be exploited by bad actors. The
first peer-reviewed paper to indicate a connection between vaccines and
autism, published by the medical journal The Lancet in 1998, turned out to
be a fraudulent study whose principal author fudged the underlying data.
Yet it wasn’t until 2010 that The Lancet completely retracted the paper, after
the journalist Brian Deer published a lengthy exposé. In the twelve
intervening years, the study sent vaccination rates plunging in the U.S. and
U.K., and provided a fertile ground for vaccine-related conspiracy theories.
This dynamic occasionally extends to the vaccine court itself. Anti-vaccine
groups have said its very existence shows vaccines are hazardous, and
offered the $4 billion in court payouts as proof of widespread harm — even
though the majority of the money was awarded in settlements where the
court did not determine the precise cause of the plaintiff’s injury. The
court’s relative obscurity, and the understandable difficulty of parsing the
dense legal and medical jargon of its proceedings, likely contribute to the
inaccurate perception that the federal government considers vaccines a
major risk.
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News coverage about vaccines hasn’t always helped, either. In 1994, the
Atlanta Constitution, the New York Times, and the Associated Press all
reported that Miss America had gone deaf because of a bad reaction to a
DPT shot. It took over a week for the Times to correct the record, pointing
out that pageant queen Heather Whitestone was deaf from a case of
meningitis, something (ironically) we now have a vaccine for.
Drug companies might not make vaccines
if they had to deal with injury lawsuits
themselves
Vaccines are not the most profitable things that drug makers can
manufacture: estimates suggest it can cost from $135 to $500 million to
develop a vaccine, and it takes anywhere from months (in the case of an
annual flu vaccine) to well over a decade to perfect a vaccine formula.
When it’s all over, most vaccines are administered just once or twice,
providing a lifetime of protection from debilitating and deadly diseases at a
typical price of around $30 per dose (without insurance).
Not vaccinating can be deadly. It can also be costly. One unvaccinated six
year old in Oregon recently got tetanus when he cut himself while playing
on a farm and had to be airlifted to the hospital. His final medical bill
totaled near $1 million. Tetanus vaccines, on the other hand, typically cost
less than $30 (without any insurance), and have been around for nearly 100
years.
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Joe Raedle / Getty Images
Vaccines are meant to put our bodies on alert by triggering immune
reactions to weakened and killed versions of the diseases they protect
against. But in extremely rare cases, people can develop allergic reactions
or auto-immune responses to vaccines that are dangerous. Guillain-Barré
syndrome is a rare but temporary disorder that prompts the immune
system to attack the nervous system, resulting in anything from mild to lifethreatening paralysis. In rare cases, a flu shot can increase a person’s risk of
developing GBS, upping a person’s odds of developing the syndrome by 1
in 100,000.
One such case was that of Wilma Gundy from Colorado. She told Congress
that she was vaccinated for swine flu on November 26, 1976. “Three weeks
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later,” she said in her testimony, “my feet, legs, arms, hands and the left side
of my face and tongue began to turn numb. I felt as if I had been injected
with Novocaine. Besides the numbness, I felt extremely exhausted and
weak.”
So far this month, the court has decided five different Guillain-Barré cases,
all related to the flu vaccine. One was dismissed for insufficient proof, and
the other four received lump sum payments in a range from $150,150.58 to
$255,829.99. The highest award the court ever gives out for any kind of
pain and suffering, including death, is $250,000, but this doesn’t include
expenses and lost earnings, which means the highest total compensation
vaccine court has ever given out amounts to $9.1 million.
The most common reason people go to
vaccine court: because someone pricked
them the wrong way
The Special Masters work in DC, but often travel to meet clients and witnesses in courtrooms
around the country. United States Courts/YouTube
Most legitimate vaccine cases the federal court sees aren’t about the
extremely minimal risks of vaccines. The vast majority are prompted by
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people who’ve been jabbed the wrong way with a needle. The court calls
this a Shoulder Injury Related to Vaccine Administration (SIRVA), and these
claims account for half of all cases vaccine court sees.
More dubious claims stem from fears that vaccines cause autism— which,
to be clear, is false — or result from people who’ve been injured by
something other than a vaccine coming forward to claim cash.
“They’re hard cases to deal with because you are dealing with people who
are almost 100% of the time undeniably injured, the issue is just what
caused that injury,” Vowell said.
Recently, the court has started cracking down on some of the most
egregious complaints. Take autism, for example. Last year, in a decision
rejecting an autism-related petition originally filed in 2002, Special Master
Brian Corcoran argued that “it is no longer reasonable for Program
attorneys to bring such claims. If they do so, they certainly should not
expect compensation for work performed on them.”
“This matter has required nearly fifteen years to resolve,” Corcoran
explained. “In that time, no non-Table claims asserting autism as a vaccine
injury have succeeded. Absent a shocking and unanticipated scientific
research result that upends what is presently understood about the lack of
a relationship between vaccines and autism, none are likely to in the future.”
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Kirkland says the vaccine court continues to fill a vital role: providing both
people and vaccine makers with an extra layer of security in a teetering and
perilously expensive health care system.
“We otherwise do so little for people with disabilities and those without a
safety net for injuries and healthcare costs,” Kirkland said. She believes that
vaccine court wouldn’t be needed if the US had a better health care system,
because people with disabilities and injuries would simply receive the care
they need, regardless of what caused their injuries in the first place.
“Vaccine court payments,” she said, “are an unusual point of generosity in
our otherwise very pinched and cruel system.”
Read more:
From autism risks to mercury poisoning, here are 10 lies anti-vaxxers are
spreading about the measles vaccine in the Pacific Northwest
A high-school senior who got vaccinated against his mother’s wishes just
testified before the Senate — and accused anti-vaxxers of weaponizing her
love
Amazon just took down a controversial documentary that links vaccines to
autism. Doctors have known for years that it relies on sham science.
Bill Gates’ warning to anti-vaxxers: People in rich countries will die because
they aren’t getting measles shots
Another huge study of over 650,000 kids shows absolutely no link between
vaccines and autism. Doctors say it’s proof we’re living in a ‘fact-resistant’
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world.
Correction: An earlier version of this story misstated how vaccine court’s
special masters are selected for their terms. They are appointed by a majority
vote of Court of Federal Claims judges. Those judges, in turn, are appointed
by the president and approved by the US Senate.
NOW WATCH: Watch Jeff Sachs destroy the anti-vaccine movement
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