Most of my clients had never heard of the Vaccine Court until they needed it.
That is not a knock on them. The National Vaccine Injury Compensation Program (VICP) is one of the most consequential and least known corners of the federal legal system. It has paid out roughly $5.6 billion since 1988, yet it operates quietly out of a single office in Washington, D.C., with no juries, no traditional discovery, and a set of rules that surprises even experienced trial lawyers the first time they encounter it.
I spent years inside the VICP, first as a federal judicial law clerk at the Vaccine Court and later as a lead Trial Attorney with the U.S. Department of Justice (DOJ) on more than 85 vaccine cases. This guide at Jani Law PLLC covers the questions I hear most often: what the VICP is, how it actually works, and what to realistically expect if you file a claim.
1. What Is the VICP?
The VICP is a federal no-fault compensation system created by Congress in 1986 through the National Childhood Vaccine Injury Act, codified at 42 U.S.C. §§ 300aa-1 to -34.
“No-fault” is the key phrase. You do not sue a vaccine manufacturer for your vaccine injury. You do not have to prove that anyone was negligent in your care or that the vaccine itself was defective. A VICP claim is a petition against the federal vaccine injury compensation program itself, and if you establish that a covered vaccine caused your injury, or that your injury fits the criteria of the Vaccine Injury Table, you are compensated from a dedicated trust fund.
A few fundamentals to keep in mind:
- The trust fund is financed by a $0.75 excise tax on every dose of covered vaccine sold in the United States. It currently holds more than $4 billion.
- The purpose of the trust fund at time of establishment was twofold: (1) to give vaccine injured people a faster, less adversarial path to compensation than traditional tort litigation; and (2) to protect the nation’s vaccine supply from the wave of tort lawsuits that drove vaccine manufacturers out of the vaccine market in the 1980s.
- The scale of the trust fund is significant: more than 13,000 claims compensated and roughly $5.6 billion paid since the VICP was established.
2. What Is the “Vaccine Court”?
The Vaccine Court is not a separate courthouse. It is the informal name for the Office of Special Masters within the U.S. Court of Federal Claims, a federal trial court based in Washington, D.C.
Eight special masters (specialized trial judges who decide vaccine injury claims) hear these cases, and they hear nothing else. There is no jury. A special master reviews the medical records, oversees any hearings, weighs the expert testimony, and issues a written decision.
On the other side of every single case is the DOJ, whose trial attorneys represent the Secretary of Health and Human Services (HHS). The DOJ attorneys who defend these cases practice exclusively in the Vaccine Court. Having served as one of them, I can tell you the VICP is “informal” only in its procedures, not in its rigor.
3. How the Vaccine Court Is Different From a Regular Court
If you are picturing a courtroom drama, set that aside. The Vaccine Court departs from ordinary civil litigation in almost every way that matters:
- No jury. A special master decides your case alone, based on the written record and, in some cases, an evidentiary hearing.
- No discovery as a matter of right. There are no depositions or interrogatories unless the special master specifically permits them, which is rare. Your petition and medical records are expected to contain your entire case from day one.
- Relaxed rules of evidence. The Federal Rules of Evidence do not apply. Special masters may consider affidavits, medical literature, and testimony that would never reach a jury in ordinary litigation.
- A hands-on bench. Congress intended special masters to be more actively involved than typical federal court trial judges. They can request additional records, question witnesses directly, and tell the parties candidly what evidence is missing. At what is called a “Rule 5 conference,” a special master may even share a tentative view of the case, a preview you almost never get in regular federal court.
- Bifurcated proceedings. The court first decides whether you are entitled to compensation. Only after entitlement is established or conceded does the case move to a damages phase.
- Public decisions. Decisions are published online. Petitioners have a strictly enforced 14-day window to request redaction of sensitive medical information, a detail that matters to many clients.
4. Which Vaccines Are Covered by the VICP?
The VICP covers vaccines the Centers for Disease Control and Prevention (CDC) recommends for routine administration to children, pregnant women, or adults, where the vaccine is subject to the federal excise tax. The list includes:
- Seasonal influenza (the flu shot)
- Tetanus-containing vaccines (Tdap, DTaP, Td, DT, TT)
- MMR (measles, mumps, rubella)
- Hepatitis A and Hepatitis B
- HPV
- Varicella (chickenpox)
- Pneumococcal conjugate vaccines (Prevnar 7, 13, 20; Vaxneuvance)
- Meningococcal vaccines
- Polio (IPV/OPV), Hib, and rotavirus vaccines
The full list appears in the Vaccine Injury Table, 42 C.F.R. § 100.3.
One important carve-out to keep in mind: COVID-19 vaccine claims are not currently handled by the VICP. They fall under a separate system, the Countermeasures Injury Compensation Program (CICP), which offers more limited compensation, though there have been ongoing efforts to move COVID-19 vaccine claims into the VICP.
5. Table Injuries: When the Law Presumes the Vaccine Caused Your Injury
The Vaccine Injury Table (Table) is the heart of the VICP. It pairs specific vaccines with specific injuries and onset windows. If your injury, your vaccine, and your symptom timing all match the Table, causation is legally presumed. You do not have to prove the vaccine caused your injury. The government bears the burden of proving something else did.
Some of the most commonly litigated and compensated Table injuries are:
- Shoulder Injury Related to Vaccine Administration (SIRVA): shoulder pain and limited motion beginning within 48 hours of an intramuscular vaccine in the upper arm
- Guillain-Barré Syndrome (GBS): onset 3 to 42 days after a seasonal flu vaccine
- Anaphylaxis: occurring within 4 hours of multiple covered vaccines
- Brachial neuritis: 2 to 28 days after a tetanus-containing vaccine
- Intussusception: 1 to 21 days after a rotavirus vaccine
- Idiopathic thrombocytopenic purpura (ITP): 7 to 30 days after MMR
- Encephalitis/encephalopathy: within defined windows after pertussis-containing or MMR vaccines
Timing is everything in a Table case. Precision about when your first symptom appeared, supported by contemporaneous medical records, often determines whether you get the presumption of causation or have to prove causation as an Off-Table injury claim.
6. Off-Table Injuries: Proving Causation Under Althen
Plenty of vaccine injuries do not appear on the Table, or appear with symptoms outside the listed windows on the Table. These “off-Table” claims may be fully compensable, but the burden of proof sits with you.
The controlling standard comes from the U.S. Court of Appeals for the Federal Circuit’s decision in Althen v. Secretary of Health and Human Services, 418 F.3d 1274 (Fed. Cir. 2005). Under this test, you must establish three things by a preponderance of the evidence to prevail in an off-table case:
- A medical theory: a sound and reliable explanation of how the vaccine can cause the type of injury alleged.
- A logical sequence of cause and effect: showing the vaccine caused your injury, not just that it could in theory.
- A medically appropriate temporal relationship: onset within a timeframe consistent with the proposed mechanism of vaccine injury.
You do not need scientific certainty or even a definitive diagnosis. But you do need a theory that holds up under scrutiny. In practice, off-Table cases tend to rise or fall on the quality of the expert report and expert witness testimony, and the strongest of both are built around the Althen factors from the start.
7. Filing Deadlines: Three Years, Strictly Enforced
The Vaccine Act’s limitations periods are short and unforgiving:
- Injury claims: three years from the date of the first symptom. Not the date of diagnosis, and not the date you first suspected the vaccine.
- Death claims: two years from the date of death, and no more than four years from the first symptom of the injury that led to death.
There is no general tolling for the time it takes to figure out what happened to you. Strong cases can be lost to the calendar. If you are even considering a claim, have it evaluated early. Filing preserves your rights, and because the VICP pays attorney’s fees separately from your award, there is no financial reason to wait.
8. How a VICP Claim Actually Proceeds, Step by Step
Here is the realistic arc of a case:
Step 1: Case evaluation and record gathering. Before anything is filed, your attorney obtains certified, complete medical records directly from every relevant provider: pre-vaccination history, the vaccination record itself, and all post-vaccination treatment. The petition must contain your entire case, so this front-end work is where cases are actually built.
Step 2: Filing the petition. The petition is filed with the U.S. Court of Federal Claims. It lays out the vaccine, the injury, the onset timeline, and the supporting records, exhibit by exhibit. Every new petition goes through a Pre-Assignment Review set up by the U.S. Court of Federal Claims, Office of Special Masters, to confirm the record is substantially complete before a special master is assigned.
Step 3: Government review. Attorneys at HHS and the DOJ review your medical records and take a preliminary position: to concede, contest, or negotiate your claim. The government’s formal response, called the Rule 4 report, currently runs 12 to 16 months to complete review. Straightforward Table cases, especially SIRVA and GBS, are often routed to the court’s Special Processing Unit for expedited settlement handling.
Step 4: Resolution. From here, cases follow one of a few paths:
- If the government concedes entitlement, the case moves directly to damages.
- If the government negotiates, the parties work toward a settlement, which is how most compensated cases resolve.
- If the government contests, the case proceeds toward expert reports, a possible Rule 5 conference, and, in the minority of cases, a full evidentiary hearing with competing experts.
Start to finish, most claims take one to three years. Contested off-Table cases can take longer. It is not a fast system, but it is a functional one, and counsel familiar with its friction points can save you months.
9. How Most Cases Resolve, and What the Numbers Show
The government’s own data, published monthly by the Health Resources and Services Administration, tells a story most people find surprising:
- Since 1988, more than 30,000 petitions have been filed, over 13,000 claims compensated, and approximately $5.6 billion paid out.
- For petitions filed from 2006 through 2024, 10,933 of 14,835 adjudicated petitions were compensated, roughly three out of four.
- About 60% of all compensation comes through negotiated settlement, where the government resolves the case without conceding the vaccine caused the injury.
- Set against more than 5 billion vaccine doses distributed over that period, compensated claims work out to roughly one per million doses.
That last number is worth sitting with. Serious vaccine injuries are rare, and filing a claim is not a statement against vaccines. The VICP exists precisely because vaccines are, on the whole, safe and essential, and Congress decided that the rare person seriously injured by one deserves a dedicated and expedited path to compensation.
The settlement figure matters for expectations too. Most successful claims never see a hearing. But settlement value reflects litigation strength, so preparing a case as though it will be contested is what produces a strong settlement posture.
10. What Compensation Can You Recover?
The Vaccine Act, at 42 U.S.C. § 300aa-15, authorizes several categories of damages:
- Past and future unreimbursable medical expenses, including hospital care, therapy, rehabilitation, prescriptions, equipment, and home modifications, often funded through an annuity in catastrophic cases
- Lost earnings, both wages already lost and diminished future earning capacity
- Pain and suffering, actual and projected, capped by statute at $250,000
- A death benefit of $250,000 in vaccine-related death cases, in addition to certain other recoverable damages
The VICP is a secondary payor, so amounts covered by health insurance or other benefit programs are offset. Damages work is document-intensive, and in serious injury cases it involves life care planners and detailed proof of future needs. It deserves the same care as the entitlement phase.
11. What It Costs You to Pursue a VICP Claim: Nothing Out of Pocket
This is the feature of the VICP that people find hardest to believe: your attorney’s fees and costs are paid by the VICP itself, separately from your award, under 42 U.S.C. § 300aa-15(e).
A few points worth knowing:
- Attorneys are prohibited by statute from charging contingency fees or any other fee for VICP representation.
- You keep 100% of any compensation awarded.
Congress built this fee structure intentionally. Injured people should not be deterred from seeking compensation by the cost of legal representation, and exploring whether you have a claim carries no financial risk to you. You can read more about how we approach these cases on our vaccine injury lawyer page.
12. Common Questions About the Vaccine Court
Is the Vaccine Court a real court? Yes. The “Vaccine Court” is the widely used informal name for the Office of Special Masters within the U.S. Court of Federal Claims, a federal court in Washington, D.C. with nationwide and exclusive jurisdiction over vaccine injury claims filed under the VICP. Special masters are federal judicial officers whose decisions determine whether your vaccine injury claim is compensable and, if so, the amount of compensation. Their decisions are reviewable by the judges of the U.S. Court of Federal Claims and, from there, by the U.S. Court of Appeals for the Federal Circuit.
Do I have to go to Washington, D.C.? Usually not. Most cases resolve on the written record or by settlement. When hearings are needed, they can be held near you or conducted by video (if necessary).
Is my medical information made public? Decisions are published, but you have a 14-day window after a decision issues to move for redaction of sensitive medical details, and minors are identified only by initials.
What happens if my claim is denied? A special master’s decision can be appealed to a judge of the U.S. Court of Federal Claims, and from there to the U.S. Court of Appeals for the Federal Circuit. In limited circumstances, you may also exit the VICP and pursue a separate civil action.
Can I file on behalf of a child or a deceased family member? Yes. A parent or legal guardian can file for a minor child, and an estate representative can file on behalf of someone who died from a vaccine-related injury.
What if my injury isn’t on the Vaccine Injury Table? You may still be able to recover. You will proceed under the Althen causation standard described above, which almost always requires a qualified medical expert.
Does filing a claim mean I’m against vaccines? No. Congress designed the VICP as part of the infrastructure that keeps the vaccine supply stable. Seeking compensation for a rare, serious injury is exactly what the system was built for.
13. Have You or Someone You Love Experienced a Vaccine Injury?
After a vaccine injury, you deserve counsel who understands what you are going through and has practiced in the VICP from every angle. As a former DOJ Vaccine Trial Attorney and federal judicial law clerk at the Vaccine Court, I bring in-depth knowledge and compassion to every vaccine injury case.
A vaccine injury is disorienting. Something routine was followed by something no one prepared you for, and compassion is not an add-on to good representation in these cases. It is one of the core values I built Jani Law PLLC on, and it shapes how I handle every case I take.
Contact Jani Law PLLC today for a free, confidential consultation, available by phone, video, or in person, or call 202-899-2711.
I am Dhairya Jani, founder of Jani Law PLLC, a former DOJ Trial Attorney, and a former federal judicial law clerk at the U.S. Court of Federal Claims, Office of Special Masters. I represent individuals and families in vaccine injury claims under the National Vaccine Injury Compensation Program. Learn more about my background.
This article is attorney advertising and is provided for general information only. It is not legal advice, and reading it does not create an attorney-client relationship.