A vaccination tax is needed for equity and public confidence

Vaccination is not without risk. The Prime Minister, Scott Morrison, has declared indemnification for vaccine manufacturers for adverse vaccine outcomes. What is missing is compensation for vax-injured individuals.

The USA has had a vaccine injury compensation scheme (VICS) for the past three decades. The US National Vaccine Injury Compensation Program (VICP) has paid out US$4.4 billion (A$5.7 billion) for 7,575 vax injuries (from 1989 through 2020). The average settled claim was US$585,000 (A$760,000). There were 1.4 compensated injuries per million distributed vaccine doses.

Of the total vax injury claims filed in the USA (n= 22,372), 94% were claims for non-fatal injury (n=21,035) and 6% were claims for death (n=1,337). Of the total claims filed, 34% were successful (n=7611), 52% were dismissed (n=11,671), and 14% did not progress to adjudication (n=3,090).

The US vax-injury scheme is funded by a vax-tax of about A$1 per dose (US 75 cents). The VICP has operated to the benefit of all. Vaccine manufacturers avoid costly litigation and adverse publicity. Vax-injured victims avoid lengthy and costly litigation, where an unfavourable outcome may bankrupt them.

In Australia, the Database of Adverse Event Notifications (DAEN) records 17,835 vaccine adverse event reports, including 54 deaths, across 69 approved vaccines (1971-2020). Eleven of the vax-deaths are recorded as due to “Injury, poisoning and procedural complications”, with six described as “vaccination failure”and five as “vaccination error”. In the first ten months of 2020, there were 955 reports of vax adverse outcomes including six deaths, with two reported as “vaccination error”. In 2019, there were 1,229 reports of adverse outcomes and six deaths, with one reported as “vaccination error” and another as “expired product administered”. There are 157 different adverse outcomes categorised. Causation is not proven: “The TGA [Therapeutic Goods Administration] think there is a possibility that the medicine caused the adverse event”.

The prevailing Covid-19 pandemic has precipitated the call to vaccinate the world. Based on the historical data of the US VICP, vaccinating a billion people with Covid vaccines, can be anticipated to result in US$813 million (A$1.06 billion) of vaccine injuries. Vaccinating the world’s population (n=7.8 billion) with an initial Covid vaccine dose may generate US$6.3 billion (A$8.2 billion) of vaccine injuries. A two dose Covid vaccine (prime-boost regimen) may generate US$12.7 billion (A$16.5 billion) of vaccine injuries. These could be annual harm dividends if the Covid vaccines are refreshed annually. These scenario extrapolations assume that the Covid vaccines (although developed and administered under pandemic duress), are neither more nor less injurious than the vaccines of VICP experience, which have been tested, certified, manufactured, stored and administered to US standards, and that there is no differential between the compensable value of US and non-US injuries.

The US VICP is a no-fault vaccine injury compensation scheme, and a further 24 countries have similar such schemes. This means that most countries (87%) have no such scheme. Australia has no such scheme. In the absence of a VICS, to achieve compensation for vaccine injuries, a vax-injured party would have to proceed through tort claims, which will be expensive and time consuming and quite likely beyond the capacity of most injured parties (including vaccine injured children and the deceased).

Covid vaccines have been developed at an unprecedented ‘warp speed’. Some Covid vaccines have recently been authorised for emergency use. Pfizer’s “Fact Sheet for Recipients and Caregivers” states that “The Pfizer-BioTech Covid-19 vaccine is an unapproved vaccine”. The vaccine is, nevertheless, being distributed and administered under “Emergency Use Authorisation (EUA)”.

The unprecedented speed of Covid vax deployment has engendered some consumer resistance. Aljazeera reports that “58 per cent of the French population are sceptical of getting the Covid-19 vaccine, compared with 33 percent of people in the UK and 41 percent in the US”.

An Australian VICS would not directly address public vax scepticism (the World Health Organisation calls it “vaccine hesitancy”). However a VICS enables vax-harms to be acknowledged and compensated. It moves beyond the denial of vax-injury. A VICS recognises that some unfortunate individuals will bear a disproportionate burden of harm, while vax-corporates reap profits (shielded by indemnification), and the country reaps real or perceived societal benefits.

Australia could use the long established US VICP as a template for implementing its own VICS. A VICS requires a dedicated vax-injury compensation agency. It requires a national dedicated and centralised vax-injury collection database (not data filtered through various State government lenses, as with the present DAEN). And the public and researchers need transparent VICS data that is timely and open-access. Australia’s VICS could be funded by a vax-tax of, say, $1 per distributed vax dose.