U.S to introduce COVID-19 vaccine injury table amid calls for fairer compensation

The United States Department of Health and Human Services (HHS) is preparing a major overhaul of its COVID-19 vaccine injury compensation framework, with plans to introduce a formal injury table that could make it easier for individuals who suffer qualifying vaccine-related injuries to obtain federal compensation.

According to the federal regulatory agenda, the proposal—expected to be published in November—would establish a COVID-19 vaccine injury table under the Countermeasures Injury Compensation Program (CICP).

The rule would undergo a public consultation period extending into early 2027 before it can be finalized.

If adopted, the injury table would identify specific medical conditions that the federal government presumes were caused by covered COVID-19 countermeasures, including vaccines, provided the injuries occur within defined timeframes after vaccination.

Such a presumption would significantly reduce the burden of proof for claimants seeking compensation.

The initiative is being championed by U.S. Health Secretary Robert F. Kennedy Jr., whose department says only injuries backed by “compelling, reliable, valid, medical, and scientific evidence” would be included in the table.

Although HHS has not disclosed the conditions under consideration, legal and medical experts expect myocarditis—an inflammation of the heart muscle that has been linked to mRNA COVID-19 vaccines, particularly among adolescent and young adult males—to feature prominently because federal health agencies have previously acknowledged the association.

The proposal comes amid a lawsuit filed in Washington, D.C., seeking to compel HHS to establish the injury table as required under the Public Readiness and Emergency Preparedness (PREP) Act.

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The lawsuit argues that the absence of the table has made it significantly harder for individuals alleging vaccine injuries to receive compensation.

The plaintiff, Erica Samp, claims she developed encephalopathy, hearing and vision loss, and vascular injuries after receiving two doses of Moderna’s COVID-19 vaccine in 2021.

Her compensation claim was rejected in 2024 after federal officials concluded there was insufficient evidence directly linking the vaccine to her medical conditions.

Her attorney, Ray Flores, said creating the injury table would provide a fairer pathway for people seeking compensation through the CICP, which has faced criticism over its strict eligibility requirements, low compensation rates and limited appeal process.

Legal experts also believe the proposal could pave the way for broader recognition of vaccine-related injuries.

Attorney Chad Davenport described the initiative as “a fantastic start,” expressing hope that it could eventually lead to an expanded list of compensable injuries under the longstanding National Vaccine Injury Compensation Program (VICP).

Unlike most routine vaccines, COVID-19 vaccines are not covered by the VICP, the no-fault compensation system established by Congress in 1986. Instead, claims are processed through the CICP, an emergency programme that critics say offers fewer protections and lower payouts.

Scientific evidence on vaccine safety continues to evolve. A 2024 review by the National Academies of Sciences, Engineering, and Medicine found sufficient evidence linking certain COVID-19 vaccines to rare adverse events, including myocarditis and pericarditis following mRNA vaccines, thrombosis with thrombocytopenia syndrome after the Johnson & Johnson vaccine, and anaphylaxis following COVID-19 vaccination.

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The review also found evidence that improper vaccine administration can cause shoulder, bone and nerve injuries.

At the same time, public health authorities continue to maintain that COVID-19 vaccines have undergone extensive clinical trials and post-authorization safety monitoring involving hundreds of millions of administered doses, with serious adverse events remaining uncommon relative to the overall number of vaccinations.

HHS has until July 21 to respond to the pending lawsuit. If the proposed rule is adopted after public consultation, it would mark one of the most significant changes to the federal government’s COVID-19 vaccine injury compensation system since the pandemic began, potentially making it easier for eligible claimants to receive financial support.