Internationally, many countries have developed vaccine injury compensation programs as a means to provide quick, no-fault relief to individuals harmed by rare adverse effects of vaccines.1 These programs began emerging in the latter half of the 20th century, especially after high-profile vaccine injury lawsuits and the recognition that a no-fault model better serves both public health and justice. By the 1980s, the United States and several European nations had established such mechanisms, and as of the 2010s, at least 19 countries had no-fault vaccine compensation schemes in place. Only a few countries in Asia (notably Japan and Taiwan) historically had formal vaccine compensation provisions, but many high-income countries in North America and Europe implemented programs decades ago.
Key examples of international practices include:
· United States: The US instituted the National Vaccine Injury Compensation Program (VICP) in 1986 (effective 1988) via the National Childhood Vaccine Injury Act. The VICP covers a list of routine vaccines (mainly pediatric vaccines) and is a no-fault alternative to the traditional tort system. Claims are handled by a specialized tribunal (U.S. Court of Federal Claims) rather than civil courts. Funding comes from a small excise tax on each dose of vaccine; for example, $0.75 per dose is collected into a federal Vaccine Injury Compensation Trust Fund. If a person is injured by a covered vaccine, they can petition for compensation for medical costs, lost income, pain and suffering (capped), and even a death benefit, without needing to prove manufacturer negligence – they only need to show a likely causal link as per a table of known vaccine injuries or through medical evidence. It is notable that COVID-19 vaccines in the US were not initially covered under VICP because they were new and distributed under emergency use authorization. Instead, COVID-19 vaccine injuries fall under a different mechanism called the Countermeasures Injury Compensation Program (CICP). The CICP, created under the PREP Act for public health emergencies, also provides no-fault compensation but has been criticized for being less transparent and compensating far fewer claims than VICP. Regardless, the existence of these programs in the U.S. reflects a policy decision to balance robust vaccination programs with a safety net for the few harmed by vaccines, thereby also protecting vaccine manufacturers from direct lawsuits in most cases.
· United Kingdom: The UK operates the Vaccine Damage Payment Scheme (VDPS). Under this scheme, individuals (or their families) who suffer a severe disablement (at least 60% disability) or death due to certain vaccines can receive a one-time lump sum payment. The payment is a tax-free benefit, fixed by law at £120,000 (approximately ₹1.2 crore) for each qualified claim. COVID-19 vaccines have been added to the list of covered vaccines under this scheme. While the VDPS payout is relatively modest (and doesn’t cover lesser injuries below the 60% disability threshold), it is meant to provide quick financial support without the need to litigate fault. The UK scheme is funded by general taxation (i.e., government funds) and is administered by the Department for Work and Pensions. It has existed since 1979 and was one of the earlier such programs globally.
· Europe & Other Countries: Several European nations have their own no-fault vaccine injury compensation arrangements. For example, Germany and France have government-funded schemes that compensate proven vaccine injuries (Germany’s dates back to the 1960s). Nordic countries like Sweden, Finland, Denmark, and Norway use a slightly different model: typically an insurance or pharmaceutical industry-funded pool that provides compensation, sometimes administered by the government or through insurers. In Finland and Sweden, for instance, a consortium of vaccine manufacturers funds a common insurance that pays out claims – essentially a manufacturers’ levy finances the compensation. Canada historically left vaccine injury to litigation except for the province of Quebec, which had its own program, but in the wake of COVID-19, Canada announced a national Vaccine Injury Support Program in 2021 to cover COVID vaccine injuries across provinces. New Zealand covers vaccine injuries under its broader no-fault Accident Compensation Corporation (ACC) scheme, which treats treatment injuries (including from vaccines) as compensable without fault, funded by a mix of levies and government funds. Overall, the elements of compensation in these countries often include reimbursement of medical expenses, disability pensions, compensation for pain and suffering, lost wages, and death benefits. Eligibility criteria (such as degree of disability, time limit to file, etc.) and coverage (which vaccines and circumstances are included) vary by country.
· Global COVID-19 Vaccine Program (COVAX): Recognizing the importance of addressing vaccine injuries worldwide, especially in countries without existing schemes, the World Health Organization (WHO), Gavi, and other partners launched a COVAX No-Fault Compensation Program during the COVID pandemic. This program is unprecedented as the first ever international vaccine injury compensation mechanism. It is designed to cover the 92 low- and middle-income countries that are eligible for vaccines through the COVAX Facility (which includes India). Under this scheme, individuals in those countries who suffer serious adverse events from COVID-19 vaccines distributed via COVAX can apply for compensation without needing to litigate in court. The program provides for a lump-sum payout in full and final settlement of any claims. It is funded by a small levy on each vaccine dose procured through COVAX and administered by a third-party insurer (ESIS Inc, a subsidiary of Chubb, as per the WHO agreement). For India, which primarily used domestically produced vaccines, the COVAX program’s relevance may be limited (India received some COVAX doses early on, but not a large portion of its supply). Nonetheless, the existence of the COVAX compensation fund highlights a global consensus that no-fault compensation is a critical component of mass vaccination campaigns during a pandemic, as it builds confidence and provides recourse in the rare cases of harm.
The rationale behind these international practices is largely to ensure justice and maintain public trust in vaccination programs. By providing a no-fault, non-adversarial route to compensation, governments can assure citizens that if they are “doing their part” by getting vaccinated, they will not be left uncompensated in the unlikely event of a serious adverse reaction. It also protects vaccine manufacturers and healthcare providers from crippling liability, which in turn encourages them to participate in vaccine development and distribution without fear of endless lawsuits (this was a key motivation for the U.S. VICP’s creation in the 1980s when vaccine makers were exiting the market due to litigation risk). Moreover, studies have shown that litigation is an expensive and slow avenue for those injured by vaccines, and a no-fault scheme can more efficiently provide relief. Such schemes effectively shift the burden of rare vaccine harm onto society or manufacturers collectively, rather than on the unlucky individual or family.
In contrast, India has thus far lacked a similar mechanism, which is why the Supreme Court’s prompting of the government is significant. Indian policymakers can draw on these international models in considering how to structure a compensation policy. Key questions would include: Should it be funded by the government or via a levy on vaccine doses (a “vaccine tax” as in the US and Taiwan)? What conditions and evidentiary standards will be used to determine if a death or injury is vaccine-related (many countries use a table of known adverse events to simplify causation determinations)? What would be the amount and form of compensation (lump sum vs. periodic, fixed amount vs. case-by-case assessment of damages)? The global experience offers multiple viable frameworks that balance efficiency and fairness, and the Supreme Court’s reference to “global best practices” during arguments suggests an expectation that India at least consider those examples.
