We shouldn’t dismantle a system that has served patients well for decades.
We shouldn’t dismantle a system that has served patients well for decades.
A s a physician and former member of Congress, I’ve learned that the best public policies solve more than one problem at a time. The National Vaccine Injury Compensation Program (VICP) is just such a policy. The program provides fair compensation for people who experience rare but serious vaccine-related injuries, while helping ensure manufacturers can continue producing vaccines. That balance has protected patients and safeguarded public health for 40 years now.
But the program is now at risk. Reports suggest that Health and Human Services Secretary Robert F. Kennedy Jr. is considering a major overhaul of the VICP. One proposal could add conditions such as autism and diabetes to the program despite extensive scientific evidence finding no causal relationship between vaccines and either condition.
The VICP could benefit from modernization. But Congress should reject efforts to weaken or dismantle a system that has served patients and the public well for decades.
Congress created the VICP in response to an acute crisis. During the 1980s, lawsuits against vaccine manufacturers surged even though plaintiffs often struggled to prove negligence. Legal costs for drugmakers soared, liability insurance became nearly impossible to obtain, and manufacturers began leaving the market.
By 1985, only one company was producing the pertussis vaccine for the U.S., forcing federal officials to recommend rationing doses because supply could no longer meet demand. Lawmakers in Washington recognized that this was more than a legal problem, but an urgent public-health problem as well.
Congress responded by creating the VICP, drawing on the nonpartisan analysis of experts convened by the U.S. Institute of Medicine. Instead of forcing families into lengthy, expensive litigation, lawmakers created a no-fault compensation system, allowing people to recover damages without first proving negligence in court. They funded it through a small 75-cent excise tax on each covered vaccine antigen. Manufacturers gained a more predictable liability environment that allowed them to continue investing in vaccine research and production while remaining fully accountable for misconduct.
Since the VICP was established, routine childhood immunizations have prevented an estimated 508 million illnesses, 32 million hospitalizations, and more than 1 million deaths, while generating approximately $2.7 trillion in societal savings. More than 80 vaccines and improvements have reached patients since the program’s creation, giving physicians more tools than ever to prevent serious infectious diseases. Equally important, the program has demonstrated that rare vaccine injuries — a risk that comes with almost any medical intervention — can be acknowledged and compensated without undermining confidence in vaccination or destabilizing the market.
Across more than 5.65 billion doses of covered vaccines distributed between 2006 and 2024, the VICP compensated roughly one individual per 1 million doses administered. Those patients deserve compassionate treatment and fair compensation. The VICP provides exactly that while preserving the broader public-health benefits vaccines deliver to hundreds of millions of Americans.
That carefully balanced system could be fundamentally altered under the proposed overhaul. The reforms reportedly under consideration would broaden the conditions eligible for compensation and lower the evidentiary standard used to evaluate claims. Those changes would depart from the evidence-based approach that has defined the VICP since 1986.
To be sure, the program is in serious need of modernization. As the list of covered vaccines has expanded and caseloads have increased, the number of special masters responsible for adjudicating claims has remained capped by law. As a result, claims now take far longer than Congress originally intended. At the same time, compensation limits established on pain and suffering in 1986 have never been adjusted for inflation. Several newer vaccines remain outside the program because Congress must separately authorize their inclusion, leaving unnecessary gaps in both patient protections and market stability.
These are genuine problems. But the proper response is for lawmakers to strengthen the VICP, not abandon it. Fortunately, they seem to be taking steps in that direction: In July, the House introduced the bipartisan Vaccine Injury Compensation Modernization Act.
As they discuss such reforms, policymakers should reinforce the program’s original promise that individuals who experience rare vaccine injuries deserve timely, fair compensation — and that a strong, innovative vaccine industry is essential to America’s public health.
America depends on companies willing to invest billions of dollars over many years to develop, manufacture, and distribute vaccines. Those investments require scientific expertise, sophisticated manufacturing, and long-term financial commitment. They also require a predictable liability framework. Weakening the VICP would make vaccines more expensive, discourage investment, and ultimately limit patient access. It could also make it harder for injured patients to secure compensation.
The principles behind the VICP remain as relevant today as they were in 1986. Now that the program is under threat, it’s up to Congress to preserve and strengthen the VICP for the next generation of American patients.