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Feature Communicable Disease

UK doctors re-examine case for mandatory vaccination

BMJ 2017; 358 doi: (Published 18 July 2017) Cite this as: BMJ 2017;358:j3414

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Re: UK doctors re-examine case for mandatory vaccination

Dear Mr Moberly

I note your recent article in the BMJ, “UK doctors re examine case for mandatory vaccination” with great interest. In particular I note the opening sentence “arguments over the best way to persuade all parents to protect their children from preventable disease”.

One aspect which seldom comes under scrutiny when considering how best to persuade parents to vaccinate their children, is the historical performance of the Vaccine Damage Payment Scheme in acknowledging damage and providing financial assistance to families following an adverse reaction which results in a permanent disablement.

A robust, easily accessible, responsive scheme to assist with a financial payment in times when vaccination has gone wrong, is something of a must to instill confidence in parents that help will be forthcoming in the event that vaccination results in a lasting disability for their child. In this way, parents might view vaccination more favourably.

Unfortunately, far from conveying the message of a scheme which is receptive and responsive in providing monetary assistance to affected children and their families, the statistics paint a picture of a scheme which more times than not, refuses applications from vaccine damaged individuals.

Since its inception, a total of 6,026 have been submitted under the Vaccine Damage Payments Act 1979 with only a mere 931 awards being made.

Additionally, it is not immediately apparent to applicants how significant the requirement to satisfy the 60% disablement threshold is. It is the case that applicants can and have been acknowledged as vaccine damaged, but are still refused a payment on the grounds that they are not, in the opinion of the assessors, damaged enough. It follows that the UK supports a scheme which does not address all acknowledged claims of injury caused through vaccination but only those which cause a greater than 60% level of disablement. Currently parents whose children are vaccine damaged and acknowledged as such, but who do not meet the 60% disablement threshold, are left to shoulder the financial burden through some other means with no payment from the VDPU. In short, it is incredibly difficult to secure a payment under the Vaccine Damage Payments Act 1979.

A recent revelation in the press may go some way to explaining why it is so very difficult to satisfy the 60% disablement threshold and the shockingly low level of payments awarded by comparison to the number of claims submitted.

In February 2017 the Court of Appeal ruled, following consideration of the provisions in the 1979 Act, that the assessment of disablement, had to include assessment in respect of the individual’s future burdens. Clearly it is a serious omission that claimants have not had assessment of their future burdens included in their overall assessment and there is no way of knowing how the exclusion of the future burdens might have impacted on the number of payments made down through the years.

Back in 1982 Lord Mischon highlighted the advantages of vaccination but was also mindful of the burden on the “legislators” to address a duty of care in respect of the children who sustained disablement as a result.

“But there is no doubt that immunisation is an advantageous step to take and an advantageous step to promote. What we must obviously do—and this is very much the lawyers' concern—is to ensure that the proper social duty we owe to those children who unfortunately suffer damage is carried out by us as legislators.”

Sadly, the numbers of claims refused by the VDPS, the fact that claims are being refused on the basis that the individual is not disabled enough, (even when acknowledged as vaccine damaged), and the failure since 1979 to include an individuals future burdens as part of an assessment, are not evidence of a society which has fully embraced a social duty owed to vaccine damaged children.

Whilst an award under the Vaccine Damage Payments Act 1979 will never replace the loss sustained by the applicant, it can assist with the many difficulties an injured person and their families will have to face throughout their lives as a result of a vaccine induced disability.

Those considering vaccination might just feel more inclined to think favourably towards the process if they were reassured that in the event that their child suffers a permanent and lasting adverse effect, there will, at the very least, be help available to assist with the financial burden.

In a recent comment Peter Todd, a solicitor at Hodge Jones and Allen sums it up perfectly when he stated that ……

“The uptake of vaccines is likely to increase where consumers can be confident that not only is disablement exceedingly rare but. in the extremely unlikely event that it occurs, that there is a safety net.”

The reality is, irrespective of how the role of the Vaccine Damage Payment Unit is portrayed in NHS vaccination advertising campaign leaflets, it is incredibly difficult and time consuming to secure a payment in respect of vaccine damage. Conveying a message that financial assistance swiftly follows in the wake of vaccine damage could not be further from the truth and as the statistics show, more times than not, the parents are burdened with not only a disabled child and the additional difficulties that introduces into family life, but also the financial burden the disability brings with it.

Creating a society which more readily addresses the plight of all recognised vaccine injured individuals might just, as suggested by Peter Todd, increase the uptake in vaccination. Will the BMJ include a suggestion to re examine the vaccine damage payment scheme in any discussions involving a proposal for mandatory vaccination as a viable means of increasing confidence in vaccination and vaccine uptake levels?

Yours sincerely

Wendy Stephen

(Mother of the young woman in The Times article)

Competing interests: No competing interests

07 August 2017
Retired nurse