No vaccine is 100% safe, so shouldn’t Australia have a compensation scheme?

A COVID-19 vaccine is finally in sight and governments are working out the logistics of vaccinating entire populations.

But no vaccine is 100% safe. Concerns have been raised around how fast the vaccines — which are soon to be distributed worldwide — have been developed. 

Other countries have compensation schemes to pay out people injured by a vaccine — from minor side effects to serious risks –but what happens in Australia if someone gets sick after being vaccinated? 

Vaccine risks are rare, but real

Vaccines throughout history have been problematic, from an early polio vaccine infecting children and causing paralysis and death, to US soldiers developing hepatitis B from a contaminated yellow fever vaccine.

More recently, in 2017 in the Philippines a dengue fever vaccine caused complications and several deaths, and an elderly man died that same year in Australia after being vaccinated for shingles — his immunosuppression medication meant he was at higher risk of complications.

Every vaccine carries a risk of side effects and adverse reactions. Six in every 100,000 infants who get the rotavirus vaccine develop intussusception, a rare bowel blockage. At most, one case in 1 million doses of influenza vaccine can cause Guillain-Barré syndrome, a rare disorder which causes permanent paralysis. 

When it comes to COVID-19 vaccines, we’re looking at new technology — mRNA vaccines have not been commercially viable before. 

Non-mRNA vaccine trials have also been paused twice — AstraZeneca’s after a participant developed symptoms of transverse myelitis. Although an independent panel decided the condition was unrelated to the vaccine, few details about the patient’s condition have been released and there have been calls for greater transparency. 

Some participants have also reported normal but intense side effects from the vaccine, ranging from fever, aches, and swollen injection sites to a “severe hangover” feeling. Most show up within six weeks.

Where’s Australia’s vaccine compensation scheme? 

Vaccine injury compensation schemes covering costs for those who develop serious side effects from a vaccine exist in many other countries and have the backing of the World Health Organization. 

Despite a growing push from academics, the Australian government has refused to implement such a scheme, University of Sydney clinical vaccine specialist Nicholas Wood tells Crikey. 

“Philosophically, if you’re asking people to do something to benefit themselves and the community, and if there’s a feeling the vaccine is mandatory, then there needs to be a safety net,” he said.

The government has given AstraZeneca and the University of Queensland indemnity against liability for rare side effects — meaning it would foot the bill if someone sued the company, although details of what illnesses and how much cash has not been released.

The injured person would still need to hire a lawyer and head to the courts and can apply for funding through the National Disability Insurance Scheme (NDIS), although this applies only to permanent disabilities. 

In contrast, 25 countries have a no-fault compensation scheme which avoids the legal system. In the United States, a table outlines which injuries are covered and what compensation is provided. The schemes are funded in different ways, from vaccine levies to cash from car registration.

The schemes don’t cover administration errors — if the vaccine isn’t given to someone correctly, injured parties have to pursue a case of medical negligence.

Would this send the wrong message?

If the government was to suddenly implement a compensation scheme would it send a message the vaccine is dangerous? 

It might, Professor Julie Leask — a vaccine communication expert at Sydney University’s Susan Wakil School of Nursing and Midwifery — tells Crikey, but only for a small subset of people. 

“There will inevitably be a group of people who use that info to amplify their beliefs that the vaccinations aren’t safe,” she said. 

“But we know even among non-vaccinators the idea that Australia doesn’t look after people injured by a vaccine is one thing wrong with the program.” 

She said research showed Australians supported a compensation scheme and wanted to be informed about risks and side effects.

How do we send the right message? 

Research fellow at the Murdoch Children’s Research Institute’s vaccine uptake group Jessica Kaufman tells Crikey we needed proactive communication around what safeguards are in place. 

“It’s important we really clearly explain the scientific steps that have been taken,” she said.

Although vaccines are being developed much faster than usual, no steps have been skipped — phases are just occurring at the same time rather waiting for one to be complete before starting the next one.

Thousands of participants have also been recruited much faster than usual.

Kaufman says some reservations people may have are because messaging is coming from the government.

“We haven’t done a great job of divorcing the vaccine from politics,” she said. “The people sharing information should be scientists and public health officials … It shouldn’t be about why the government is doing well.” 

Both Leask and Kaufman say people had become more scientifically literate during the pandemic and could handle complicated explanations. 

“A good approach is to be right on the front foot, communicating about what’s known,” Leask said.