Vaccination insurance

By Alan Cassels, February 2015

A Victoria resident spearheads a national vaccine compensation movement.

Bob Martin is the kind of guy who inspires people to action. Fit, energetic, with a wry smile, a spiky crewcut and sparkling eyes, Martin exudes so much energy you’d think this 77-year-old has never had a health problem in his life. You might have met him in the Oak Bay Rec Centre where he works as a personal trainer, easily passing for someone 20 years his junior. One thing you learn very quickly about Bob is that he’s a man with a mission. 

In October 2010, two weeks after getting his routine annual flu shot, Martin lapsed into a severe case of Guillain-Barré Syndrome, a disorder where the body’s immune system attacks part of the peripheral nervous system. It left him paralyzed for eight months, four of which were spent in intensive care, so weak and disabled he needed a machine to do his breathing for him. 

While Guillain-Barré is a rare but known adverse effect of flu vaccinations, Martin came through this near-death experience neither bitter nor anti-vaccine. Instead he’s got a clear goal: to make a vaccine-injury compensation system an established part of Canada’s health care system. 

If you are injured on the job you’re likely to get some form of worker’s compensation. Injured in a car accident? You’ll likely get some coverage through ICBC or another auto insurer. But if you get injured by a recommended vaccine, perhaps hospitalized for months, or even permanently disabled, what is there to help you and your family financially? Nothing. 

Martin found this out in a shocking, life-altering fashion. While he was incredibly thankful for the medical care he got in Victoria, he found to his surprise that there’s no insurance for this kind of rare event. Only Canada and Russia, out of 20 developed countries, have no system to compensate people who become vaccine-injured. Such a system would not only help people recover medically and financially from the rare accidents related to vaccines, but citizens, manufacturers and governments could save millions of dollars in avoiding costly and messy litigation that often leaves no one satisfied. 

When Martin was in intensive care, at one point the only thing he could move was his eyes. It was emotionally excruciating for his family to watch this man, who makes his living teaching people how to bench press heavy weights, wondering if he’d ever be the same. His recovery was a slow and at times painful ordeal but he’s come through with a sense of optimism and determination to do whatever it takes to plug this gap in Canada’s health care system.


THE UNITED STATES HAS had a vaccine injury compensation system for nearly 30 years. In the early 1980s, after her own son suffered a brain injury due to the Diptheria-Pertussis-Tetanus vaccine, Barbara Loe Fisher started working with parents and Congress to help shape what that system would look like. Through the National Vaccine Information Centre just outside of Washington DC, she’s still working on vaccine safety and trying to improve “informed consent” policies for patients in the US.

With an encyclopedic grasp of the facts, the politics and the law, she tells me in a phone interview how the drug companies producing government-recommended vaccines were on her side of the issue: “In the early 1980s they [the vaccine manufacturers] threatened Congress that they would leave the country without any childhood vaccines if they didn’t get any government protection.” Congress offered parents, pediatricians and drug companies a government compensation program as a no-fault, non-adversarial legal alternative to costly lawsuits. The resulting National Childhood Vaccine Injury Act of 1986, which created the national Vaccine Injury Compensation Program, collects a surcharge of 75 cents on each dose of vaccine recommended by the Center for Disease Control for use by all children.

Today the US compensation program extends to any government-recommended vaccine. The vaccine currently accounting for most of the claims paid under the US’s Vaccine Injury Compensation Program is for adult injuries related to influenza vaccine.

In Canada, Dr Kumanan Wilson, an internist who works at the Ottawa Hospital Research Institute, has extensively studied vaccine compensation programs. In a review of such systems around the world he crystallizes the reasoning for the practice: “[T]he fundamental premise behind a no-fault compensation system is that people receive immunization not only for their own benefit but also for the benefit of the community. Therefore, if in the process of contributing to this public good an individual should be harmed, there is a strong ethical argument that they should be compensated.”

He told me over the phone from his office in Ottawa that “many public health officials support the idea of a compensation process,” arguing that the legal system is not very well set up to address the rare injuries that vaccines can inflict on some people. He agrees that the political will to create one just doesn’t exist in Canada at the moment, and that national authorities tend to give a national immunization registry a much higher priority. 

Quebec does have a compensation system for cases of serious injury or death. Claims are heard by a three-person medical tribunal and decided by a two-thirds majority opinion. 

After his ordeal, Martin found the legal avenues to be futile and expensive; futile because it’s incredibly hard to prove “beyond a reasonable doubt” that someone was harmed by a vaccine, and expensive, he says, because of the legal costs. “You just face a wall, then a wall, then another wall” in trying to get any redress for your injuries. Thankfully, Martin is back in almost “100 percent health,” but the loss of work and the pain faced by the uncertainty of being paralyzed and hospitalized for so long have seared themselves into his life goal to ensure others will be protected if they become vaccine-injured. 

The need for some form of insurance has gained more urgency given that two years ago BC instituted a mandatory “get a flu vaccine or wear a mask” policy for BC’s health workers. While the healthcare system in BC will obviously cover your care if you are hospitalized, what happens if you are unable to continue working? In Dr Kumanan Wilson’s mind, this is the most compelling reason why those who are injured should receive some form of compensation—because they were required to have the vaccine as part of their job. 

In the US, according to Barbara Loe Fisher, “as of December 14, 2014, there have been nearly 112,000 reports of reactions, hospitalizations, injuries and deaths following influenza vaccinations made to the federal Vaccine Adverse Events Reporting System.”

It should be emphasized that these injuries are “associated” with the vaccination, not necessarily caused by it. In fact, since determining cause and effect is so difficult, many advocates, such as Martin, would stress that you don’t have to find out who’s at fault, you just need a less adversarial system than the courts to deal with people presumed to be vaccine injured. 

Fisher would agree, citing problems with the current compensation system in the US, where two-thirds of children filing vaccine injury claims are not compensated. In fact, it has become increasingly adversarial and more difficult to get officials to admit that a vaccine might have been responsible for an injury or death.

How often people are injured by flu vaccines is extremely difficult to assess. A study published just last month by Dr Wilson and his colleagues suggested that seasonal flu vaccines can slightly increase a person’s risk of developing Guillain-Barré Syndrome, though flu itself presents an even greater risk (about 10 times) of a person developing the syndrome. So it’s complicated, and depends on whether the seasonal vaccine is a good match for the viruses in circulation.

This hasn’t been a good year for the flu vaccine with estimates indicating that the current vaccine is less than 20 percent effective. In practical terms, explains Richard Schabas, a former Ontario chief medical officer of health, and Neil Rau, an infectious diseases specialist and medical microbiologist, “this means we had to immunize between 50 and 100 people last fall, before the annual outbreak, to prevent a single case of influenza this winter. By January, when the annual outbreak was already fading, we had to immunize close to 1000 people to prevent a single case.” (Globe & Mail, January 24, 2015).

The same week in January that Dr Wilson’s study appeared, the CBC reported on another Canadian study which found that “people who receive flu vaccines year after year can sometimes show reduced protection”—dropping a bombshell on public health officials who have been aggressively advocating for mass flu vaccinations every fall.

Martin has been following all the latest vaccine news with interest, striving to learn everything he needs to see his mission through, including skills of lobbying, talking to politicians and health officials, and understanding medical data that he hopes will lead to Canada’s own vaccine compensation system. He’s not bitter or angry and wouldn’t tell people not to get a flu shot. He believes the best approach to getting a compensation system is diplomacy and avoiding the internecine struggles that you often see between the pro- or anti-vaccine camps. To find Martin’s petition online, search for “Create a no-fault vaccine compensation program for Canadians.”

“It’s about helping those people who are unfortunately hurt by vaccines,” he says, admitting it’s going to be a long slog. Still, he’s optimistic we’ll eventually end up with a functional system that will help people recover medically and financially after a personal vaccine disaster.

Alan Cassels is a pharmaceutical policy researcher in Victoria and the author of Seeking Sickness: Medical Screening and the Misguided Hunt for Disease (Greystone, 2012).