National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (42 U.S.C. §§ 300aa-10 through 300aa-34) — commonly called "Vaccine Court" — is a no-fault federal compensation system for individuals injured by certain childhood vaccines. Created in 1986, the VICP was Congress's solution to a crisis: pharmaceutical companies were abandoning vaccine manufacturing because lawsuits alleging vaccine injuries (whether or not scientifically supported) made liability insurance unaffordable and unpredictable. The program provides a streamlined alternative to traditional tort litigation: injured individuals file claims with the U.S. Court of Federal Claims (decided by special masters, not juries), and compensation is paid from the Vaccine Injury Compensation Trust Fund — funded by a $0.75 excise tax on every dose of covered vaccine. In exchange, vaccine manufacturers receive significant liability protection — claimants must first go through the VICP before suing manufacturers, and manufacturers are generally immune from liability for unavoidable side effects of properly manufactured and labeled vaccines. The Trust Fund holds approximately $4.6 billion and has paid out over $5 billion in compensation since the program's creation.

Current Law (2026)

Legal Authority

• 42 U.S.C. § 300aa-10 — Establishment of program (creates the VICP as a federal no-fault compensation system for vaccine injuries)
• 42 U.S.C. § 300aa-11 — Petitions for compensation (individuals alleging vaccine injury must file a petition with the U.S. Court of Federal Claims; sets filing deadlines and procedural requirements)
• 42 U.S.C. § 300aa-12 — Court of Federal Claims jurisdiction (grants the Court jurisdiction over VICP petitions; petitions are decided by special masters)
• 42 U.S.C. § 300aa-13 — Determination of eligibility and compensation (special master must determine whether the injury was caused by the vaccine, using the Vaccine Injury Table and scientific evidence)
• 42 U.S.C. § 300aa-14 — Vaccine Injury Table (lists specific injuries associated with specific vaccines and the timeframes within which injury must occur to create a presumption of causation)
• 42 U.S.C. § 300aa-15 — Compensation (specifies what can be awarded: medical expenses, rehabilitation, lost earnings, pain and suffering capped at $250,000, and death benefits of $250,000)
• 42 U.S.C. § 300aa-22 — Standards of responsibility (vaccine manufacturers are not liable for unavoidable adverse side effects if the vaccine was properly prepared and accompanied by proper warnings)

How It Works

The program's centerpiece is the Vaccine Injury Table (42 U.S.C. § 300aa-14) — a list maintained by HHS that pairs specific vaccines with specific injuries and timeframes. If your injury matches a Table entry (for example, anaphylaxis within 4 hours of vaccination), causation is presumed: you don't need to prove the vaccine caused the injury, and the government must prove it didn't. Table injuries account for roughly half of compensated claims. For off-Table injuries (not listed, or outside the specified timeframe), the petitioner must prove by a preponderance of evidence that the vaccine was a substantial factor in causing the injury — a higher but still achievable burden. The VICP is entirely no-fault: you don't need to show the manufacturer was negligent or the vaccine was defective, only that a Table injury occurred or that causation is more likely than not, which dramatically simplifies the process compared to traditional product liability litigation.

Claims are filed with the U.S. Court of Federal Claims and assigned to a special master — a judicial officer with expertise in vaccine cases — who reviews medical records, expert testimony, and scientific evidence and issues a decision without a jury (§ 300aa-12). Most cases resolve in 2–3 years; either party can appeal to a Court of Federal Claims judge, then to the Federal Circuit. Successful petitioners can receive actual medical expenses past and future (not covered by insurance), rehabilitation costs, lost earnings (or projected future earnings for a child), pain and suffering capped at $250,000, and a $250,000 death benefit in fatal cases (§ 300aa-15). Attorney's fees are paid from the Trust Fund even if the claim is unsuccessful, as long as the petition was brought in good faith with a reasonable basis. In exchange for the VICP system, Congress gave vaccine manufacturers significant liability protection under § 300aa-22: claimants must exhaust the VICP before suing in civil court, and manufacturers are immune from liability for unavoidable adverse effects of properly manufactured and warned vaccines — a protection the Supreme Court confirmed in Bruesewitz v. Wyeth (2011).

How It Affects You

If you or your child experienced a serious reaction after a covered vaccine: The VICP is a no-fault compensation program — you do not need to prove the vaccine manufacturer was negligent or that the vaccine was defective. You need to show that your injury is either on the Vaccine Injury Table (creating a presumption of causation) or that the vaccine was a "substantial contributing factor" to your injury. Covered vaccines include DTaP, MMR, flu, hepatitis A and B, HPV, meningococcal, polio, rotavirus, varicella, and others on the childhood immunization schedule — the full list is at hrsa.gov/vaccine-compensation. Critically important: the filing deadline is 3 years from the first symptom for injury claims, or 2 years from the date of death for wrongful death claims with no more than 4 years between vaccination and death. Missing these deadlines is almost always fatal to the claim, with no exceptions. The petition is filed with the U.S. Court of Federal Claims, and the process is handled by a Special Master (a specialized judicial officer). You need an attorney — find one at the VICP's attorney listing at hrsa.gov/vaccine-compensation or through the law firm directories at vaccineinjury.com. Attorney's fees are paid from the Trust Fund (not by you) even if you lose, as long as your claim was filed in good faith — meaning the financial barrier to representation is very low. Compensation can cover all past and future medical costs not covered by insurance, pain and suffering up to $250,000, lost wages, and rehabilitation. If compensation is offered and you accept it, you waive the right to later sue in civil court.

If you're concerned about whether to report a vaccine adverse event or file a VICP claim: VAERS (Vaccine Adverse Event Reporting System) and VICP are different systems with different purposes. VAERS (vaers.hhs.gov) is a voluntary surveillance system — healthcare providers and the public report suspected adverse events to help detect safety signals. Filing a VAERS report does not start a compensation claim, does not require proving causation, and is not a legal proceeding. VICP is the legal compensation program. A VAERS report doesn't automatically generate a VICP petition, and a VICP petition doesn't require a prior VAERS report. If you experienced a serious reaction, you can do both: report to VAERS for surveillance purposes, and separately file a VICP petition for compensation. An important limitation: COVID-19 vaccines are NOT covered by the VICP. COVID vaccines are covered by the separate Countermeasures Injury Compensation Program (CICP) administered by HRSA — which has significantly narrower eligibility, no special masters, no attorney fee award, and lower compensation limits. Find CICP at hrsa.gov/cicp.

If you're a healthcare provider administering covered vaccines: Federal law under the National Childhood Vaccine Injury Act requires you to: (1) give patients (or parents) the appropriate Vaccine Information Statement (VIS) before administering each covered vaccine — VIS documents are produced by CDC and must be current; (2) record each vaccination in the patient's permanent record (vaccine name, manufacturer, lot number, date administered, your name and address); and (3) report certain adverse events to VAERS — for events listed as requiring reporting, you must file, not just consider it. The list of reportable events by vaccine is published at vaers.hhs.gov/docs/VAERS_Table_of_Reportable_Events_Following_Vaccination.pdf. Failure to provide VIS or record vaccination data is a civil violation. The VICP does not affect your practice directly — it channels claims away from malpractice suits — but accurate documentation creates the medical record that will support or undermine any future VICP petition.

State Variations

The VICP is exclusively federal, preempting most state tort claims:

• State tort claims against vaccine manufacturers for design defects are preempted (Bruesewitz v. Wyeth, 2011)
• State manufacturing defect and failure-to-warn claims may survive VICP preemption in limited circumstances
• State vaccine mandate laws (for school entry) interact with the VICP — states that require vaccines create the context for potential injuries that the VICP compensates
• Some states have created additional vaccine injury compensation or assistance programs

Implementing Regulations

• 42 CFR Part 100 — Vaccine Injury Compensation regulations. Key provisions:

  • § 100.1 — Applicability: this Part applies to the National Vaccine Injury Compensation Program (VICP) under subtitle 2 of title XXI of the Public Health Service Act (42 U.S.C. §§ 300aa-1 through 300aa-34)
  • § 100.2 — Average cost of a health insurance policy: for purposes of calculating the lost earnings component of VICP compensation under 42 U.S.C. § 300aa-15(a)(3)(B), certain claimants' awards are reduced by the average cost of a health insurance policy (the amount the government estimates the award would otherwise need to replace in future insurance costs); HHS publishes the applicable average premium figure used in these calculations
  • § 100.3 — Vaccine Injury Table: the central operative provision — a table matching each covered vaccine to specific adverse events (injuries, disabilities, illnesses, conditions, and deaths) and the time period within which the first symptom must appear post-vaccination to trigger the presumption of causation; examples: anaphylaxis or anaphylactic shock within 4 hours of DTaP, DTP, or Td vaccines; encephalopathy or encephalitis within 72 hours of pertussis-containing vaccines; intussusception within 1–100 days of rotavirus vaccine; shoulder injury related to vaccine administration (SIRVA) within 48 hours for any intramuscular vaccine; vasovagal syncope within 1 hour for any intramuscular vaccine; if the petitioner's injury matches a Table entry within the specified timeframe, causation is presumed — the burden shifts to the government to rebut; Table entries are updated by HHS rulemaking as scientific understanding evolves

  The Vaccine Injury Table in § 100.3 is the fulcrum of the entire VICP system. Table injuries receive presumed causation — the most claimant-favorable posture in the VICP — while off-Table claims require the petitioner to prove causation by preponderance of evidence. HHS can add, remove, or modify Table injuries through rulemaking under 42 U.S.C. § 300aa-14(c); the table has been amended numerous times since 1986, including additions for SIRVA (a shoulder condition from improper vaccine injection technique) and COVID-19 vaccine injuries added to the Countermeasures Injury Compensation Program (CICP, a separate program). The timeframe columns are critical: the same injury within vs. outside the specified window determines whether causation is presumed or must be proven from scratch.

• 42 CFR Part 110 — Countermeasures Injury Compensation Program (CICP) — compensation for injuries from pandemic/biodefense countermeasures under the PREP Act

• HRSA Division of Injury Compensation Programs — administers VICP through the U.S. Court of Federal Claims (Special Masters process, petition requirements, attorney fees, settlements)

Pending Legislation

No standalone VICP reform bills have been introduced in the 119th Congress. Vaccine policy provisions appear in broader public health legislation — see FDA Drug Approval for the vaccine approval process.

Recent Developments

COVID-19 vaccines are NOT covered by the VICP — they are covered by the separate Countermeasures Injury Compensation Program (CICP) under the PREP Act, which provides more limited compensation with no judicial review. Advocates have pushed to move COVID vaccines into the VICP, which provides more generous compensation and procedural protections. The Vaccine Injury Table was last updated in 2017, and HRSA has proposed adding shoulder injury related to vaccine administration (SIRVA) and other conditions. The Trust Fund balance remains healthy at approximately $4.6 billion. Influenza vaccine claims (primarily SIRVA — shoulder injuries from improper injection technique) have become the most common petition type, raising questions about whether injection-technique injuries are truly "vaccine injuries."

• RFK Kennedy/MAHA and vaccine skepticism — VICP under scrutiny (2025): HHS Secretary Kennedy's appointment introduced significant vaccine policy uncertainty. Kennedy has long criticized the National Childhood Vaccine Injury Act's liability shield for vaccine manufacturers and the VICP's compensation process. The Trump administration's MAHA initiative includes a vaccine safety review; HRSA's administration of VICP has been scrutinized for whether the Injury Table adequately compensates injured parties and whether the no-fault system is biased toward manufacturers. Congress has received proposals to expand VICP coverage to COVID vaccines and reform the compensation process.
• COVID-19 CICP claims — minimal compensation: The Countermeasures Injury Compensation Program (CICP), which covers COVID-19 vaccine injuries, has compensated only a small fraction of filed claims. As of 2025, CICP has received approximately 10,000+ claims for COVID vaccine injuries; approved compensation has gone to approximately 1-2% of claimants. CICP's limitations compared to VICP — no attorney fee compensation, no pain and suffering damages, shorter limitations period, administrative review only (no judicial appeal) — have led advocates to call for COVID vaccines to be added to the VICP coverage table. HRSA has the administrative authority to add COVID vaccines to the VICP table; HHS Secretary Kennedy has signaled interest in reviewing this.
• SIRVA claims and VICP efficiency: Shoulder Injury Related to Vaccine Administration (SIRVA) — where improper injection technique causes rotator cuff damage, shoulder pain, and limited range of motion — has become the most common VICP petition type, accounting for approximately 70% of new petitions. SIRVA is preventable through proper injection technique; the surge of SIRVA claims (primarily from influenza vaccines given at pharmacies) reflects the rapid expansion of non-medical-professional vaccine administration (pharmacists, pharmacy technicians). HRSA has worked with CDC and pharmacy associations to improve injection technique training; SIRVA claim rates per million doses have declined modestly but remain high.
• VICP attorney fees and access to compensation: The VICP provides attorney fee compensation regardless of case outcome — meaning petitioners who file in good faith but don't prevail can still have their attorney fees paid from the Trust Fund. This provision was designed to ensure that vaccine injury claimants have legal representation regardless of their financial resources. However, it has also attracted some attorneys who file marginal claims knowing they will be compensated for their time even without prevailing on the merits. The Court of Federal Claims' Special Masters review fee petitions for reasonableness; fee award disputes are a significant portion of VICP administrative activity.