Documentation Key to Vaccine Injury Claims.

Author/s: Winnie Anne Imperio

KIAWAH ISLAND, S.C. --Don't shrug off the mother calling in the middle of the night about her child having a slight fever after a vaccination. Document it.

That information will be crucial if the mother ends up filing a claim with the National Vaccine Injury Compensation Program, Dr. Robert W. Block said at a pediatric and adolescent medicine update sponsored by the Southern Medical Association.

The compensation program, which was established in 1986 in response to a surge of lawsuits over DTP-related injuries, ensures that individuals who experience an injury or death as a result of a mandated childhood vaccine are provided with fair and efficient compensation.

"The biggest hold-up in the processing of these claims is finding documentation in medical records," he said. "Without the documentation, the patient may not even have a claim."

If a parent calls with a question about a vaccine reaction--even if it's one of those innumerable calls about fever--document the date and the reaction in the patient's chart," said Dr. Block, chair of the Advisory Commission on Childhood Vaccines, the oversight committee for the compensation program.

This documentation shows that the parent made an effort to contact somebody and that they discussed the reaction with a physician.

It's particularly important to note the date of the first reaction because that marks the beginning of a possible vaccine injury, he said. Deadlines for filing claims are based on when first symptoms occur.

If the reaction is serious, notify the Vaccine Adverse Event Reporting System.

It is in physicians' best interest to keep this program working as smoothly as possible because if the claim is settled in the federal daim system, physicians are less likely to be subjected to frivolous civil lawsuits, said Dr. Block, chair of pediatrics at the University of Oklahoma in Tulsa.

Nurses and other staff should also be advised to make a note when a parent calls the office about a vaccine-related reaction. It's also important to inform parents who suspect their child has a vaccine-related injury about the compensation program.

Given the number of physicians and clinics providing immunizations, the chances of having a patient go through this process are slim but if it happens, documentation could be very important, Dr. Block said.

Vaccine Injury Claims

The National Vaccine Injury Compensation Program and the Advisory Commission on Childhood Vaccines were created as a result of the National Childhood Vaccine Injury Act of 1986. Their purpose is to ensure that individuals who experience an injury or death related to a vaccine are given fair and efficient compensation. They also ensure a stable vaccine supply by limiting liability for manufacturers and administrators. Before the program existed, manufacturers were worried about costs associated with DTP lawsuits in the 1980's and threatened to stop vaccine production.

Claims are first reviewed by a physician from the Department of Health and Human Services. If the injury is on the vaccine injury table, a "damages" hearing is convened where compensation is determined. The vaccine injury table includes covered vaccines and related adverse events, which are determined by the Advisory Commission, Covered vaccines include DTP, MMR, polio, hepatitis B, Haemophilus influenzae type b, varicella, and rotavirus.

 If the injury is not in the vaccine injury table, claimants must prove causation in federal court, and cannot file a civil lawsuit unless they have gone through the federal process.