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Just two minutes walk from the front door of the White House, east of Lafayette Square, is the Howard T. Markey National Courts Building, a 9-storey red brick structure with dark and narrow windows. Inside, federal judges oversee a multitude of cases and appeals involving patent litigation, benefits for veterans, oil spills, private claims against the government, and much more.
Eight of these judges belong to the Office of the Special Masters, a small unit within the much larger Court of the Federal Court of Claims. For over two decades, these jurists have applied a meticulous understanding of medical science – including neurology, rheumatology and pediatrics – to one of the most controversial aspects of the legal system.
This is the Vaccine Court, whose staff rule on cases brought by people who claim that the vaccines were harmful to them or to those of their children. The court administers the National Vaccine Injury Compensation Program, established by Congress in 1986 and funded by a 75 ¢ tax on all childhood vaccines sold in the United States. Since its inception in 1988, the program has awarded more than $ 4 billion in damages.
Each year, the special masters of the court, appointed by the president and approved by the United States Senate, receive about 500 claims for damages. Just like a lawsuit, each petition is a legal charge of someone who says they have been hurt by a sting in their arm or a blow in their thigh. For each of them, the special masters have to answer a medically sensitive but legally simple question: was the applicant injured by a vaccine?
In 2016, the Vaccine Court allocated $ 230 million to patients who claimed to be injured by vaccines and who had paid more than $ 22 million in legal fees. (The courts pay these costs even when the petitioner loses his case – a deviation from the usual practice which, according to the experts, is unique to the Vaccine Court). The system has been around for more than three decades to serve one and very important purpose: to keep vital vaccines on the market.
"This is a no-fault compensation program designed to encourage vaccination, encourage vaccine manufacturers to continue to manufacture vaccines, and to compensate for the small but significant number of people injured by a vaccine." received vaccine, "said former Chief of Immunization Court Special Master Denise Vowell, explained in a video of 2015.
This does not mean that vaccines are inherently dangerous. More than 80% of the applications received by the court are settled, without concluding that there is no injury at all with a vaccine. But the existence of the court and the history of its creation illustrate the complex realities of modern medicine – and the consequences, both positive and negative, of its efforts to eradicate the disease.
An expensive litigation laid the foundation for a vaccine court
The origins of the Vaccine Tribunal date back to the 1970s, when parents began to prosecute doctors and vaccine manufacturers for allegations that vaccines against diphtheria, whooping cough, and tetanus posed a dangerous risk to women. children. One of the first successful trials was carried out by Kevin Toner's parents after his vaccination in Idaho in 1979.
Kevin Toner, then a three-month-old infant, was vaccinated with Tri-Immunol, an anti-DTC vaccine administered in the United States – and suffered a rare spinal disease called transverse myelitis, the cause of which is unknown. ., "court documents declare. "Because of the affliction, Kevin is permanently paralyzed from the waist up."
Family Lawyer Kenneth Pedersen recalls that as a young lawyer in his thirties, winning the case has helped launch his own legal career. "The argument was that the vaccine could have been safer," he told Business Insider. "It was a scary proposal to take a huge drug company – we had to prove that it was like that that he had been hurt."
A jury of six Idahoens awarded Toners $ 1.3 million in their case against vaccine manufacturer Lederle Laboratories. Later, Toner graduated and settled in Salt Lake City with his wife and children. He is currently working for a large bank.
The Toner verdict came in the context of a national debate on TDP shooting safety. Shortly before the family's case was handled by the court system, a documentary titled "Vaccine Roulette" was broadcast on NBC, scare parents across the country about the dangers of the vaccine.
The American Academy of Pediatrics denounced NBC, claiming "the total absence of balance between scientific and documentary facts" [caused] extraordinary anxiety and perhaps irreparable harm to the health and well-being of the country's children. "
Nevertheless, the number of claims for damages caused by the DPT has exploded from a single case in 1978 to 73 in 1984. Trials have also become more expensive. As Dr. Alan Hinman pointed out in a 1986 JAMA Pediatrics article, "the average amount claimed per prosecution has increased from $ 10 million to $ 46.5 million".
Pedersen believes that it would have been much more difficult to win tort cases, as was once again the case in the vaccine safety literature. "The medical literature has somehow turned against us," he said.
Vaccines are extremely safe and evidence continues to grow
A comprehensive review of the safety of DPT injections, published in 1991, determined that injections did not cause autism and other dangerous and chronic conditions such as attention deficit disorder or juvenile diabetes. The study found some notable exceptions in which children developed allergies or inflammation, and another study documented some cases in which neurological lesions had been diagnosed in children after being vaccinated against whooping cough. But such cases are extremely rare and it is very difficult to prove that the culprit is the culprit.
These abnormalities are better understood in the broader context of vaccine safety. The vast majority of vaccines work as promised and cause no serious or permanent side effects. As stated in the 1991 document, "apart from drinking water, no intervention has had such a profound effect on reducing infant mortality as the widespread introduction of vaccines".
Nevertheless, the financial impact of the TPD prosecutions in the 1970s and 1980s resulted in a national vaccine shortage and threatened to stop the manufacture of DPT vaccines. In a short time, doctors, public health experts and pharmaceutical companies began to lobby the federal government to do something against the rising costs of litigation.
Jonas Salk, who invented the first polio vaccine, was one of the experts who testified before lawmakers. Prior to the widespread use of its vaccine in 1955, polio outbreaks caused more than 15,000 cases of paralysis in the United States each year.
"The current live polio vaccine is the cause of more than two cases a year of vaccine-related paralysis," Salk told the legislator. "Such cases occur in the extent of about 6 to 10 cases a year." He encouraged vaccine manufacturers to focus on administering a larger number of killed polio vaccines, which did not cause any paralysis.
"In the case of vaccination-related injuries, it is clear that it would be much more desirable to avoid them," Salk said. "In the event that compensation is necessary, it seems to me that the type of legislation you are proposing would be desirable."
Two years later, the House pbaded the National Bipartite Act of 1986 on Childhood Vaccine Injuries. Senator Edward Kennedy then incorporated his provisions into a larger health bill already pbaded by the upper house. President Ronald Reagan signed the amended bill in November, despite his "mixed feelings" and "reservations" about the possibility that the plan will compensate those who would not have to prove any fault of the manufacturers of vaccines.
This has greatly facilitated the defense of lawyers like Pederson. "They got rid of the cause-and-effect relationship and you do not have to prove your fault," he said. "Overall, I think a lot of people have had compensation that would not have it … Congress has responded" Let's not go to court, let's take care of those kids. " ; "
Today, the special masters intend to complain about alleged injuries from the most common childhood vaccines, as well as influenza vaccine. "It resolves controversies over vaccine-related injuries and prevents them from becoming legal actions that could lead to significant damage in juries, which could threaten the production and availability of vaccines," said Anna. Kirkland, Legal Expert, "The Immunization Tribunal: The Law" said Business Insider in an email.
The Vaccines Court exists, in part, to take into account the fact that the search and prosecution proceed at different speeds. "We know that the pace of science and publishing is often slower than litigation," Kirkland said. "Some of these claims could have become mbadive clbad actions that could have caused manufacturers to leave the vaccine market."
Legitimate scientific studies have never shown any link between vaccines and autism. But it takes a long time to gather and badyze the amount of data required by these studies. The latest study refuting the vaccine-autism link, published in early March by the Annals of Internal Medicine, is based on the medical history of more than 650,000 Danish children over a 14-year period.
At the same time, the scientific authority can be exploited by bad actors. The first peer-reviewed article linking vaccines to autism, published by The Lancet medical journal in 1998, turned out to be a fraudulent study whose main perpetrator had falsified the data. underlying.
Yet it was not until 2010 that The Lancet completely withdrew its newspaper, after the journalist Brian Deer published a lengthy exposé. In the ensuing twelve years, the study caused a drop in vaccination rates in the United States and the United Kingdom and provided a fertile ground for vaccine conspiracy theories.
This dynamic sometimes extends to the court of vaccines itself. Anti-vaccine groups said that its very existence showed that the vaccines were dangerous and proposed payments of $ 4 billion as evidence of widespread harm, even though the majority of the money had been allocated in regulations where the court had not determined the exact cause of the problem. injury of the plaintiff. The relative obscurity of the court and the understandable difficulty of badyzing the legal and medical jargon of its dense procedures probably contribute to the misperception that the federal government views vaccines as a major risk.
The media coverage on vaccines has not always helped either. In 1994, the constitution of Atlanta, the New York Times and the Associated Press all reported that Miss America had become deaf because of a bad reaction to a shot from the DPT. It took the Times more than a week to correct the minutes, pointing out that Queen of Pageant, Heather Whitestone, was deaf to a case of meningitis. We now have a vaccine against this virus (which is ironic).
Pharmaceutical companies may not manufacture vaccines if they themselves have to sue for injuries
Drug manufacturers do not manufacture the most cost-effective vaccines: estimates suggest that developing a vaccine can cost between $ 135 and $ 500 million, and sometimes it takes several months (in the case of an annual vaccine against influenza) to more than a decade. perfect a vaccine formula. When all is over, most vaccines are given only once or twice, thus offering lifetime protection against debilitating and deadly diseases at a typical price of about $ 30 per dose (without insurance) .
Not to vaccinate can be fatal. It can also be expensive. An unvaccinated six year old child in Oregon recently caught tetanus after being cut off at a farm game and had to be flown to the hospital. His final medical bill amounted to nearly a million dollars. Tetanus vaccines, on the other hand, usually cost less than $ 30 (without any insurance) and have been around for almost 100 years.
Vaccines are intended to alert our body by triggering immune responses against weakened and killed versions of the diseases they protect. But in extremely rare cases, people can develop allergic reactions or autoimmune responses to dangerous vaccines. Guillain-Barre syndrome is a rare but temporary disorder that causes the immune system to attack the nervous system, causing mild paralysis to life-threatening paralysis. In rare cases, an influenza vaccine may increase the risk of developing GBS, increasing the risk of developing the syndrome by 1 in 100,000.
One of these cases was Wilma Gundy from Colorado. She told Congress that she had been vaccinated against swine flu on November 26, 1976. "Three weeks later," she said in her testimony, "my feet, legs, arms, hands and left side my body and my tongue started to numb, I felt as if I had injected Novocaine, and besides the numbness I felt extremely exhausted and weak. "
So far this month, the court has ruled on five different cases involving the Guillain-Barre case, all related to the influenza vaccine. One was fired for lack of evidence and the other four received lump sum payments ranging from $ 150,150.58 to $ 255,829.99. The highest compensation ever awarded by the court for all types of suffering, including death, is $ 250,000, but this does not include expenses and loss of income, which means that the highest Total compensation awarded by the court regarding vaccines amounts to $ 9.1 million.
The most common reason why people go to the vaccination court: because someone stole them from the wrong side
According to the Federal Court, most cases of legitimate vaccines do not concern the extremely minimal risks of vaccines. The vast majority of them are solicited by people who have been stuck in the wrong way with a needle. The court calls this a shoulder injury related to the administration of the vaccine (SIRVA), and these claims represent half of the cases that the court sees.
More questionable claims stem from fears that vaccines will cause autism – which at the moment is not true – or people who have been hurt by something other than a money-for-money vaccine.
"These are difficult cases to handle because you are dealing with people who are almost 100% undeniably injured, the problem is precisely what caused this injury," said Vowell.
Recently, the court began cracking down on some of the most egregious complaints. Take autism, for example. Last year, in a decision dismissing an autism-related petition filed in 2002, Special Master Brian Corcoran stated that it "is no longer reasonable that the program's lawyers present such requests .If they do, they certainly should not expect compensation for their work done on them. "
"It took almost fifteen years to settle this case," said Corcoran. "At that time, no non – table allegation that autism was an injury to the vaccine was successful.In the absence of a shocking and unexpected scientific research result that contradicts what I 've seen. we currently understand about the lack of relationship between vaccines and autism, no future. "
Kirkland says the Vaccine Court continues to play a vital role: providing the public and vaccine manufacturers with an extra layer of safety in an unstable and dangerously expensive health care system.
"Otherwise, we do so little for people with disabilities and those who do not have a safety net against injuries and health care costs," Kirkland said. She thinks that the Vaccine Court would not be needed if the United States had a better health care system, because people with disabilities or injuries would simply receive the care they needed, no matter what. the cause of their injury.
"Payments to the courts for vaccines," she said, "are an unusual point of generosity in our otherwise cringe and cruel system."
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