Backlogged: Few cases finished after millions spent investigating COVID vaccine claims

CHARLESTON, S.C. (InvestigateTV) — On the extremely rare occasions that a vaccine meant to protect public health harms a patient, the federal government has programs to provide compensation for proven injuries.

The reason is because the government wanted to protect manufacturers from litigation that might dissuade them from creating and manufacturing vaccines – including during a pandemic.

For most patients seeking damages for an injury related to flu, measles, polio and other public health vaccines, the process is well-established and transparent. The process also keeps manufacturers out of legal processes and puts the lawsuits in the hands of special federal vaccine courts.

“Instead of suing the pharmaceutical agencies or even the vaccine administrator, the doctor or the pharmacy, or whatever… all those claims would funnel into vaccine court, and the vaccine administrators and manufacturers would have immunity from liability. So this was a win-win for everyone, really,” said Anne Toale, an attorney who handles vaccine cases on behalf of patients and their families.

But for more than 10,000 Americans who filed a claim due to a potential COVID vaccine-related injury, the process is slow, secretive and handled by a little-known agency that had only four employees when claims began arriving in 2021.

At its present pace, the Countermeasures Injury Compensation Program would take more than a decade to clear the backlog of COVID vaccine cases while piling up millions of taxpayer dollars in administrative costs.

“People got COVID vaccines. They followed the directions. They did the right thing. They did, you know, protect themselves, their loved ones, their communities - and people had to get these vaccines. So all these people who did what they’re supposed to do and did the right thing, now, they’re being told, ‘Oh, sorry, you’re in a queue,’” Toale said.

Since the COVID-19 pandemic hit through March 2024, the program has spent more than $26 million in administrative costs while paying out only $42,125 to 11 patients who had a substantiated reaction to the vaccine, according to an InvestigateTV analysis of federal data.

The federal government also has signed contracts worth millions of dollars to outside medical professionals to review COVID claims cases.

According to government records analyzed by InvestigateTV, the government contracted several doctors $25,000 each to review cases.

Many of those doctors and nurse practitioners told InvestigateTV that the task of reviewing these cases is daunting and can take weeks for a single case.

Public health doctors, lawyers, patients and even members of Congress have raised concerns about the program.

“I think it’s been very sluggish to act,” said Dr. Brobson Lutz, a former public health director for the city of New Orleans. “We know there have been thousands of adverse effects. Fortunately, most of them minor. But some of them do deserve compensation and it’s very unfortunate . . . they’re not receiving anything.”

Commander George Reed Grimes, who oversees both vaccine programs for the U.S. Health Resources and Services Administration declined InvestigateTV’s request for an interview.

The countermeasures program was created by Congress in 2010 to evaluate claims by patients who had an adverse reaction to a vaccine created in a public health emergency.

But critics argue that rather than create a new federal bureaucracy, Congress should have expanded the authority of an existing, decades old program known as the Vaccine Injury Compensation Program to handle pandemic-type vaccines. There now is a bipartisan push to move COVID cases into the vaccine program.

But even that effort has proved difficult.

In the meantime, Americans such as Laura Murray continue to wait for a resolution.

She calls month after month. Month after month she receives the same response, “It’s in the queue.”

Murray has been waiting three years.

A waiting game

Shortly before receiving a COVID vaccine in early 2021, Murray’s mother, Debra Richardson, had routine blood work done and results came back normal.

In February, she received the first dose of a COVID vaccine. Within two weeks, the 69-year-old from Summerville, South Carolina was fighting for her life.

“She called me and said, “I’m feeling a little dizzy, and I think you need to take me to the hospital,’” Murray said. “They did some tests on her and found out that she was extremely low on her platelets and that she was anemic.”

As her condition worsened, doctors diagnosed her with a life-threatening blood disorder where clots developed in her brain.

In her medical records reviewed by InvestigateTV, one doctor noted that Richardson’s case “should be reported as a possible vaccine-related adverse event.”

Doctors hoped that plasma infusions would cure her. But help came too late. Richardson died on March 19, 2021.

Her case is one of more than 670 claims for compensation related to a COVID vaccine death, federal records show.

“I want other people to know that this can be a potential side effect,” Murray said of her efforts to both report the adverse reaction to the federal government and file for compensation.

Murray filed the claim on her mother’s behalf and gathered her medical records. And then she began waiting and calling.

“You just want to know, you know, do you have my information? Is someone going to review the information? Are you going to deny my claim because you seem like you’re stalling or not wanting to go through the process,” Murray said. “It’s very, very frustrating.”

She started doing more research and found the number of Anne Toale, the attorney who handles vaccine injury cases.

During her 20 years in practice, Toale has represented patients who were injured by flu, measles, diphtheria and other routine public health vaccines.

Toale told Murray that there likely wasn’t much she could do to help.

“Sadly,” Toale said, “there’s not a role for lawyers in the CICP,” the program where the COVID cases are handled.

COVID case reviews are time-consuming and expensive

The countermeasures program has now increased its staff to 34, Commander Grimes told members of Congress during a recent hearing on the government’s response to COVID.

It also has contracted with 30 medical professionals to review cases, according to InvestigateTV’s analysis of data from USASpending.gov.

Between Jan. 4, 2021 and March 1, 2024, the COVID program awarded 110 contracts to 30 medical professionals to review claims cases. Those contracts are worth nearly $2.5 million.

An additional $136,998 was earmarked for six medical professionals to serve as expert witnesses. Five of the six also serve as case reviewers.

As of March 1, the agency had sent just 450 injury and/or death claims for review to those 30 doctors, nurse practitioners, physician assistants and others with advanced medical degrees.

One contract was given to a lawyer, who used to be a practicing nurse 40 years ago. She was paid nearly $90,000 to review nine cases and serve as an expert witness in four others.

One doctor received $24,000 to review a single case, another received $13,000 for a single review.

Though the program only has compensated 11 patients it has cleared about 2,000 cases because the patients either did not supply medical records, had no proof that their injury was caused by the vaccine, or they missed filing deadline of one year after vaccination.

Even so, without more reviewers and an infusion of millions of dollars from the federal government, the cases will continue to backlog, critics said.

“It boils down to leadership,” said Dr. Lutz, the public health doctor from New Orleans. “I don’t think effective leadership has been there.”

Injuries caused by COVID vaccines handled differently

Since 1986, the Vaccine Injury Compensation Program has reviewed claims related to reactions from flu, measles, polio and other routine public health vaccines.

Congress created the program after civil lawsuits against vaccine makers and healthcare providers threatened to cause vaccine shortages and reduce vaccination rates, according to the U.S. Health Resources and Services Administration, which oversees both compensation agencies.

Since 1988 when the first claims were processed, the federal government has compensated more than 6,000 people who had adverse reactions to a flu vaccine, 111 who were injured by a tetanus vaccine and one person with a bad reaction to the mumps shot, HRSA data shows.

All told, the program has paid out more than $5.1 billion to nearly 10,500 adults and children injured by a vaccine, federal data shows.

The program is fully funded from administrative costs to compensation payments through a trust fund that collects a 75-cent excise tax on every vaccine given.

Unlike the COVID program, it doesn’t rely on any tax dollars. And that’s not the only difference, according to HRSA. In vaccine court:

· Patients who were injured by a vaccine have up to three years to file a claim or two years after a death. COVID cases only have one year after injection.

· The vaccine program compensates for documented “injuries with effects lasting for more than six months after the vaccine was given or resulted in inpatient hospitalization or surgery.” COVID compensates for “serious physical injuries.”

· The U.S. Department of Health and Services makes the determinations on COVID claims. In the vaccine program, those decisions are made by judges, called special masters, with the U.S. Federal Court of Claims.

· Lawyers, such as Toale, cannot recoup any fees for representing a patient with a COVID claim.

Toale said the current system is unfair to COVID patients because that vaccine now has become part of a regularly administered drug and should be treated the same as the seasonal flu.

There is a bipartisan bill pending in Congress to transfer the COVID cases into the vaccine program, but it has largely stalled.

In the meantime, Laura Murray continues to make her regular and seemingly futile calls, asking for an update on her case.

The spending data includes the case numbers of the claims assigned to the contracted medical professionals. Her case is not among them.

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