Vaccine Injury Payouts

A very interesting article in the Wall Street Journal today discussed the increase in payouts for vaccine related injuries.  This is interesting for a number of reasons:

(1) The claims are paid from a no fault system
(2) The system was designed to avoid discouraging companies from making vaccines and individuals from getting vaccines
(3) The increase in payouts has been for injuries related to the administration of the vaccines

It seems like the risk that this was supposed to deal with was a risk faced by the manufacturers of their vaccines.  If what was in the vaccine caused harm to someone (even after all the appropriate testing had been done to get the vaccine approved) the company would not suffer economic consequences.  This seems to be in line with item #2 above.  And if patients feel confident that they will be compensated for harm and not have to go through a traditional court to do so, they may be less likely to be discouraged to get a vaccine.

However, the risk of causing an injury to a patient because the vaccine is administered too high in the shoulder and may cause damage to the musculoskeletal system, is not a risk that the manufacturer has anything to do with.  This is a risk created by the health care provider (and potentially the health care system for whom the provider works.)  Covering these shoulder injuries under the same claim system reduces the risk for a very different stakeholder.

And given the actual number of cases, the trajectory in the number of cases, and the size of the awards, it is easy to imagine that these injuries will could account for a very large proportion of the payout.

Policy makers should take stock of the situation and decide whether this removing the risk from the providers and the organizations for which they work is appropriate.  While there may be clinical risks from the vaccines that show up in 1 in 1,000,000 patients that would never be detected in a clinical trial for approval of the drug, appropriate administration of the vaccination is a medical practice that is completely under the control of the practitioner and for which there are clear best practices.  Placing the risk back on the provider and the organization for which a provider works would provide a very strong incentive to vaccinate appropriately.  Unless it is determined that there is so much uncertainty that the government should also bear this risk in order to avoid discouraging the providers and organizations from administering the vaccines.

This tradeoffs here are interesting.  But the level of risk and the control over the risk seem much different.  Public policy should not be "one size fits all" for solutions.