Vaccines have long served as a defense against infectious diseases and other public health threats. These measures have combated and offered the prospect of immunity against or minimizing the effects of polio, measles, seasonal flu, hepatitis, and COVID-19, among other infectious illnesses. According to UNICEF, vaccines have saved worldwide 4.4 million lives per year. The World Health Organization touts roughly 154 million lives preserved by vaccinations.
The National Institutes of Health reports that an estimated half a billion Americans obtain vaccines each year. The number of flu vaccine doses in the United States exceeds 150 million annually. Between 2006 and 2022, influenza vaccines accounted for more than 40 percent, or 2.4 billion, of the over five billion doses administered in that period.
Generally, vaccine recipients experience mild side effects, such as brief low-grade fevers or mild soreness or discomfort in the shoulders where the vaccine is administered. Some fatigue may even develop.
More serious illnesses and injuries are considered rare effects of vaccines. However, severe pain, fainting, breathing difficulties, and even death are not beyond possible outcomes of vaccines. Those who suffer these vaccine injuries can seek compensation through the National Vaccine Injury Compensation Program (VICP), a creation of Congress.
Vaccine injury law is generally a niche segment of the legal profession. As we discuss more below, petitions, or claims, for compensation under the Program channel through the United States Court of Federal Claims. As of 2025, the membership directory of the United States Court of Federal Claims Bar Association lists 63 vaccine injury lawyers admitted to practice before the Court of Federal Claims. These are not necessarily all of the attorneys licensed to handle vaccine injury petitions before the Court. The United States Court of Federal Claims also maintains a roster of attorneys willing to represent petitioners alleging vaccine injuries.
The process of becoming a vaccine injury lawyer appears relatively straightforward. Gaining admission to the United States Court of Federal Claims only licenses an attorney to bring and pursue vaccine injury claims under the Program. Those lawyers wanting to enter this field need first an understanding of the National Vaccine Injury Compensation Program and the U.S. Court of Federal Claims.
What is the National Vaccine Injury Compensation Program?
Enacted in 1986, the National Childhood Vaccine Injury Act established a no-fault system to compensate victims of illnesses and injuries caused by vaccines. To obtain the benefits of the Vaccine Injury Compensation Program, claimants need not prove that the vaccine manufacturer or entity giving the vaccine negligently designed, created, or produced the vaccine; failed to warn of its dangers, or, in the case of physicians or other administrators, engaged in medical malpractice.
Excise taxes imposed upon vaccine makers fund the program. From this trust fund comes the payment of medical expenses and lost wages. Claimants can also receive pain and suffering. Those whose claims are paid under the Program may not thereafter sue vaccine makers, vaccine distributors, hospitals, doctors, or clinics in state or federal courts for tort remedies.
The Program began accepting claims in 1988. Since then, petitioners have distributed payments totaling more than $4.5 million. Approximately 9,500 petitioners have received compensation through the Program for vaccine injuries.
Covered Vaccines
To receive compensation under the Program, claimants must show that they suffered injuries or a loved one died as a result of a “covered vaccine.” These vaccines include those that combat:
- Hepatitis: Inflamed or damaged liver
- Seasonal flu: Respiratory illness occurring often in the winter months, featuring symptoms such as fever, cough, chills, weakness, headaches, muscle pain
- Diphtheria: Bacteria causing upper respiratory infections (nose and throat); often contracted from travel outside the United States
- Human papillomavirus: Causing skin warts in various areas of the body and potentially cancer
- Measles: Virus that leads to fever up to 104 degrees Fahrenheit, coughing, runny nose, and rashes
- Mumps: Virus that swells salivary glands and is marked often by puffy cheeks
- Rubella: Also known as the “German measles” or “three-day measles”; characterized by red rashes
- Tetanus: Also called “lockjaw,” bacteria that causes complications such as difficulty breathing and swallowing, blood clots that block lungs, tightening of vocal cords, and fractures
- Rotavirus: Diarrhea and vomiting present especially in children
Proving Causation
Attorneys who handle vaccine petitions should familiarize themselves with the Vaccine Injury Table. It lists for each of the covered vaccines a set of illnesses, injuries, or conditions. If a claimant experiences the first onset of an illness or injury within a given number of hours or days (as stated in the table) of receiving the dose, the claimant enjoys a presumption that the vaccine caused that injury.
For example, a person who experiences a shoulder injury within 48 hours after receiving a seasonal flu shot is presumptively entitled to compensation under the program for that injury.
Seasonal flu vaccines can also cause a neurological disorder known as Guillain-Barre Syndrome, which affects the part of the nervous system responsible for transmitting signals from the brain and spinal cord to extremities, organs, and other areas of the body. Those with this disease can see weakness, loss of muscles, pain, loss of vision, and an inability to walk. The program presumptively affords compensation when the onset of the syndrome occurs at least three days but no more than 42 days after administration of the dose.
Some of the other potential injuries from vaccines as identified by the Vaccine Injury Table include:
- Analphylaxis: A sudden, allergic reaction to a vaccine that can place the body in shock, obstruct airways, and cause shortness of breath, dangerously rapid heart rates, irregular heartbeats, and death.
- Vasovagal Syncope: Fainting that results from a sudden decrease in blood pressure and heart rate
- Encephalopathy: A brain disorder characterized by memory loss, change in personality, or coma.
The Vaccine Injury Table sets forth more comprehensive definitions and criteria for these and other injuries listed in the Table.
Petitioners whose injuries do not fall within the Table can resort to expert opinions, medical records, the diagnosis of physicians treating the petitioner, or a combination of these pieces of evidence. Vaccine attorneys, especially when handling claims not based on the Vaccine Injury Table, must gather and analyze extensive medical records and histories or engage medical experts to render opinions of causation. Pre-existing medical conditions or injuries could complicate a petitioner’s efforts to prove causation.
How Are Vaccine Injury Claims Pursued?
Claimants under the Program must first petition the United States Court of Federal Claims. Created by Congress in 1855 under the name of the United States Court of Common Claims, the Court of Federal Claims hears and decides claims against the United States Government. Those who pursue compensation for vaccine injuries from the Program’s trust fund in effect sue the United States Government.
In addition to claims under the National Vaccine Injury Program, the United States Court of Federal Claims adjudicates matters involving:
- Contracts between the United States (or its agencies and bodies) and their vendors, suppliers, and service providersNative American claims
- Takings (eminent domain) by the United States Government
- Patents and copyrights
- Military and civilian government worker claims
- Tax claims
A petitioner whose claim is denied by the Special Master may seek review by either a motion or by requesting such from a judge of the Court of Federal Claims. If a judge reverses the Special Master’s denial of entitlement to compensation, the case turns to a determination of damages.
During the period from 2006 to 2022, the Court of Federal Claims considered 12,320 petitions for compensation from alleged vaccine injuries, Nearly 73 percent of petitioners, or 8,946, received compensation. However, with over five billion vaccine doses being given in that period, the compensation ratio translates to one claimant for every 1 million doses.
According to the Health Resources and Services Administration, 5,518 petitioners during the period from 2006 to 2022 obtained compensation through settlements rather than a determination that injuries or illness resulted from the vaccine. Favorable rulings from the Court of Federal Claims accounted for only 415 petitions yielding compensation.
Claimants may pursue separate tort-based lawsuits against vaccine manufacturers and administrators in state or federal court only if they appeal the Special Master’s decision or withdraw the claim within a specific period.
Attorneys Fees in the Program
Attorneys who represent vaccine injury victims generally can receive a reasonable fee – even if the petition does not result in an award of compensation. Typically, these fees are on an hourly basis. The Program uses an Attorney’s Forum Hourly Rate Schedule for the Court to judge the reasonableness of fees, based on the attorney’s experience in vaccine injury cases. Attorneys representing clients in the Program may not charge separate contingency fees.
What is the Vaccine Injury Bar?
Becoming Licensed to File Petitions for Vaccine Injury Compensation
There is no specific license to become a vaccine injury lawyer. An attorney must become admitted to practice before the U.S. Court of Federal Claims because petitions under the Vaccine Injury Compensation Program go before that court.
Rule 83.1 of the Rules of the Court of Federal Claims sets the requirements and process to be admitted to practice before the United States Court of Federal Claims. Specifically, a lawyer must be licensed by a state or federal court and must be in “good standing.” This means that the lawyer may not be disbarred or have a suspended law license. Beyond these requirements, Federal Rule 83.1 does not impose any specific educational or experience prerequisites for attorneys to practice vaccine injury law. However, as you will read below, experience factors into the fees a vaccine injury lawyer may receive under the Program.
Lawyers can seek admission either through an oral motion or filing a written application. In the former approach, the lawyer appears in person at the Howard T. Markey National Courts Building in Washington, D.C. The Court of Federal Claims conducts admission sessions once a month, typically on the Thursday of the first full week of the month.
To appear on the calendar, the lawyer must complete and submit a “Form for Admission in Open Court” at least one week before the specific admission session. The applicant must also submit a certificate from the clerk of the state’s highest court (New York Court of Appeals for New York lawyers, the District of Columbia Court of Appeals for D.C. Lawyers, and the highest court in the District the state supreme court for all other states). This document states that the applicant is licensed and in good standing. Certificates more than 30 days before submission to the United States Court of Federal Claims are not acceptable.
In the written application alternative, the lawyer seeking admission completes and submits a verified application using “Form 1” in the Court’s appendix of forms. Along with the certificate of good standing from the clerk of the highest court where the applicant is licensed, attorneys must have two letters or signed statements from those admitted to the Court of Federal Claims or the United States Supreme Court attesting that:
- The attorneys personally know the applicant
- The applicant meets the qualifications for admission
- Based on personal examination, the applicant possesses good character and standing
