Who is Eligible to File a Vaccine Injury Claim

The National Vaccine Injury Compensation Program (“VICP”), often referred to as “Vaccine Court,” provides a no-fault alternative to the traditional civil tort system for individuals who allege injury by certain vaccines. The Program was established by Congress in 1986 to ensure an adequate supply of vaccines while providing a fair and efficient process for compensating individuals injured by covered vaccines. See National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-10 to -34.

One of the most common questions prospective claimants ask is: “Am I eligible to file a claim?”

While every case is unique, several threshold requirements must be satisfied before a claim may proceed in the VICP.

1. The Claim Must Involve a Covered Vaccine

Not every vaccine is covered by the VICP. The Program applies only to vaccines listed on the Vaccine Injury Table, which is maintained by the Secretary of Health and Human Services. The Vaccine Injury Table is periodically updated, so individuals should consult current resources or speak with an attorney regarding whether a particular vaccine is covered. See 42 U.S.C. § 300aa-14; 42 C.F.R. § 100.3. The Vaccine Injury Table is publicly available on the Health Resources and Services Administration website. https://www.hrsa.gov/sites/default/files/hrsa/vicp/vaccine-injury-table-01-03-2022.pdf

2. The Vaccine Must Have Been Administered in the United States

In most cases, the vaccine must have been administered in the United States or one of its trust territories. Claims involving vaccines administered outside the United States may still qualify in certain limited circumstances, such as when the vaccine was administered to a member of the Armed Forces or a United States government employee serving abroad. See 42 U.S.C. § 300aa-11(c)(1)(B).

3. The Claim Must Involve a Qualifying Injury or Death

A petitioner may file a claim alleging either:

• A vaccine-related injury; or
• A vaccine-related death.

The Vaccine Act requires that the alleged injury either:

• Lasted for more than six months after vaccination;
• Resulted in inpatient hospitalization and surgical intervention; or
• Resulted in death.

See 42 U.S.C. § 300aa-11(c)(1)(D).

Importantly, a person does not need to prove that a healthcare provider, vaccine administrator, or manufacturer acted negligently. The VICP is a no-fault compensation system. See 42 U.S.C. § 300aa-10(a).

4. The Claim Must Be Filed Within the Applicable Time Limits

The Vaccine Act contains strict statutes of limitation.

Generally:

• A claim alleging a vaccine-related injury must be filed within three years after the first symptom or manifestation of onset of the alleged vaccine injury.
• A claim alleging a vaccine-related death generally must be filed within two years of the death and no later than four years after the first symptom or manifestation of onset of the injury from which the death resulted.

See 42 U.S.C. § 300aa-16(a).

Because these deadlines can be complicated and are strictly enforced, individuals who believe they may have a claim should seek legal advice as soon as possible.

5. The Alleged Injury Does Not Have to Appear on the Vaccine Injury Table

Many people mistakenly believe that they may pursue a claim only if their injury appears on the Vaccine Injury Table. That is not the case.

The VICP recognizes two general categories of claims:

Table Claims

A “Table injury” is an injury specifically listed on the Vaccine Injury Table that occurred within the time period specified by the Table. If those requirements are met, causation is presumed unless rebutted by the government. See 42 U.S.C. §§ 300aa-11(c)(1)(C)(i), 300aa-14(a).

Off-Table Claims

Individuals may also pursue compensation for injuries that do not appear on the Vaccine Injury Table. In these cases, the petitioner must affirmatively prove that the vaccine caused the injury. See 42 U.S.C. § 300aa-11(c)(1)(C)(ii). The United States Court of Appeals for the Federal Circuit has explained that petitioners pursuing off-Table claims generally must demonstrate, by a preponderance of the evidence, a medical theory causally connecting the vaccination and injury, a logical sequence of cause and effect, and a proximate temporal relationship between vaccination and injury. Althen v. Sec’y of Health & Hum. Servs., 418 F.3d 1274, 1278 (Fed. Cir. 2005).

Who May File a Petition?

Depending on the circumstances, a petition may be filed by:

• The injured person;
• A parent or legal guardian on behalf of a minor child;
• A legal representative of a disabled adult; or
• The legal representative of a deceased person’s estate.

See 42 U.S.C. § 300aa-11(b).

Final Thoughts

Eligibility under the Vaccine Act depends on the specific facts of each case. Even if an injury does not appear on the Vaccine Injury Table, or if there are questions regarding causation, a claim may still be viable.

Because the Vaccine Act contains unique procedural requirements and strict filing deadlines, individuals who believe they may have suffered a vaccine-related injury should consult with an attorney experienced in Vaccine Program litigation to evaluate their potential claim.

This article is intended for informational purposes only and does not constitute legal advice. Every case is different, and individuals should consult qualified counsel regarding their specific circumstances.