Building Awareness About Vaccines, Offering Help If Things Go Wrong

Little-known program compensates people for problems that can be traced to inoculations

Back to school often means new clothes, notebooks, pens, and maybe even a laptop. Years ago health advocates dubbed August National Immigration Awareness Month to remind parents to add immunizations to the seasonal to-do list.

Now some are also using this annual campaign to highlight the existence of a little-known government fund created to compensate those harmed by vaccines. Since its creation in 1988, the National Vaccine Injury Compensation Program has paid some $3.4 billion to help more than 4,800 people deal with complications that resulted from certain immunizations.

Vaccines have been used for nearly 80 years to help prevent against potentially deadly or disabling infections that are spread by close human contact; they are credited for helping to largely eradicate measles and end polio in the United States. Although some parents have questioned the adverse effects of giving infants multiple shots, the federal Centers for Disease Control and Prevention has said the chance of experiencing a severe allergic reaction to a common inoculation is no more than one in a million.

The compensation program was formed to help care for these rare cases, as well as to stem the growing tide of lawsuits that began to emerge in the 1980s, which pharmaceutical companies warned could bankrupt vaccine makers. Since then, more than 17,000 petitions have been filed by families seeking compensation; nearly 10,000 were dismissed.

“We know that vaccines do a lot of good. We know they are only truly as beneficial as they can be if everyone gets vaccinated,” explained E. Drew Britcher, a medical malpractice trial attorney who has long been involved with immunization issues. “But lets all be fair to one another and agree there are dangers. Minimal — but there are dangers. But let’s be willing to have that conversation.”

New Jersey requires grade school students to submit proof to education officials that they have been inoculated against more than a dozen diseases. Children attending preschool or child-care programs must also get immunized against many of the same infections, as well as receive an annual flu shot. Parents are urged to talk to their family doctor or check the state Department of Health website, since some vaccines cover multiple diseases and most require a series of shots as children age.

“In preparation for back-to-school, parents should speak with their healthcare providers to make sure their children are vaccinated,” Health Commissioner Cathleen Bennett said. “When children are not vaccinated, they are at increased risk for illness and can spread disease to others in their play groups, child care centers, classrooms and communities.”

Bennett noted that, while the requirements are focused primarily on children, who are most at-risk to infections, adults can also benefit from the additional protection offered by some vaccines. Adults should receive booster shots for tetanus, diphtheria and pertussis (Tdap) each decade; pregnant woman should receive the same shot to protect their newborns against pertussis, or whooping cough; and those over age 60 should be inoculated against shingles, she said. Travelers are reminded to check the CDC site for specifics related to their destination.

[related]After an outbreak was confirmed earlier this year, Rutgers University announced that all undergraduate students at Rutgers-New Brunswick receive the meningitis B vaccine, in addition to the meningitis ACWY shot already required. The mandate applies to those living on-campus and off-campus, as well as commuter students.

The state’s guidelines are based on recommendations from multiple physician groups and the CDC, and permit parents to request an exemption for religious or medical reasons. Legislative efforts to revise these exemption guidelines have stirred strong feelings in the past; despite a lack of a scientific connection to vaccines, some parents have maintained that certain shots are linked to autism and other conditions.

These parents are often frustrated to learn that, because no medical correlation has been established, the compensation program does not cover petitions related to autism, Britcher explained. The program also does not pay for injuries associated with vaccines for shingles, certain pneumococcal infections and non-seasonal flu.

Britcher said the autism provision has “been the largest battle,” for parents to understand.

Changes in the way vaccines are formulated have also made them much safer. In the late 1980s as many as one in 350,000 children was impaired or killed by pertussis vaccines, Britcher recalled, before it was reengineered to use a virus that is no longer alive. (Vaccines are designed to build immunity by triggering the body’s reaction to a very weak, effectively harmless form of the disease.)

While the chance for bad outcomes has dropped dramatically, “It is horrible when your kid is that one in a million,” Britcher said. “It’s also horrible to deny that there are risks. Limited risk. But this program exists because there are risk.”

Those who are concerned about a vaccine-related injury are encouraged to act quickly. Unlike the decades-long statute of limitations associated with most medical malpractice cases, petitions for compensation related to bad immunization outcomes must be filed within three years of the first symptoms or within two years of death. The program is funded by a 75-cent excise tax on vaccines.

While his firm, Britcher Leone LLC, is not currently handling vaccine compensation petitions, Britcher said he can refer families to one of the 60 other firms nationwide that are eligible to handle these cases; while petitioners can be represented by an attorney from any state, several lawyers in New Jersey do handle the procedure, Britcher said. The process is overseen by the U.S. Court of Federal Petitions, before which only certain attorneys can appear, and the federal Department of Health and Human Services.