No-fault compensation program overdue, experts say

No-fault compensation program overdue, experts say

CMAJ

Canada
NEWS
February 15, 2011

Canada and Russia are the only G8 nations without national no-fault compensations programs for people injured from vaccines, and according to Canadian vaccine experts, it is high time Canada make its exit from that short but inglorious list.

Canada needs a federal no-fault vaccine-injury compensation program to protect the unfortunate few who suffer adverse reactions to vaccines, according to a new report, Designing a No-Fault Vaccine-Injury Compensation Programme for Canada: Lessons Learned from an International Analysis of Programmes, from the University of Toronto’s Munk School of Global Affairs (http://webapp.mcis.utoronto.ca/resources/munkpapers/keelan_workingpaper_feb2011.pdf).

When such instances occur now (outside of Quebec, the only province with a no-fault program), injured parties must seek compensation — for lost wages, uninsured medical expenses and rehabilitation services — through legal action. The problem is, they always lose, because vaccine manufactures and health care providers can’t be held at fault if they follow best practices.

“If people have an unfortunate reaction to the vaccine, causing permanent or serious injury, they shouldn’t have to rely on civil litigation to get compensation,” says lead author Jennifer Keelan, assistant professor at the University of Toronto’s Dalla Lana School of Public Health in Ontario. “These injuries will occur despite best practices, and you can’t predict the rare people who will have these adverse events.”

Not only would a no-fault program benefit individuals who suffer harm, it could help the public in general, says Keelan. The transmission of pathogens in communities drops significantly when vaccinations rates hit a certain threshold. This is known as herd immunity. People waffling about whether to get a vaccine would be more likely to get immunized, says Keelan, if they knew an adverse reaction wouldn’t cost them financially.

People’s bank accounts shouldn’t suffer, she says, if they make decisions that contribute to public health. “Ethically, it’s unacceptable. Many people don’t get vaccinated just for themselves; they do it for the good of the community” says Keelan. “Support for immunization is broad in Canada but it is very shallow. It doesn’t take very much to unnerve parents who will then choose not to expose their children to vaccines.”

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