Vaccines: an Urgent Matter

A group of experts has made two constructive proposals to try to correct the “threat to the public’s health” that is inherent in the “precarious” supply of vaccines in the United States: There is an urgent need for a national commission to develop “an effective and socially responsible” vaccine policy, and there is a need to provide a better means of handling compensation for vaccine-related injury and death.

These conclusions emerged from a two-year study by the Institute of Medicine of the National Academy of Sciences. The urgency of the matter became apparent last December when the nation came close to running out of one vital vaccine, DTP, used to protect children from the risks of diphtheria, tetanus and pertussis (whooping cough). The shortage was caused by the termination of production by one of three manufacturers and technical problems encountered by another of the companies. A factor behind production cuts was the increasing difficulty in obtaining liability insurance to protect the manufacturers from an increasing number of damage suits. The shortage was ultimately relieved when one of the companies resumed production.

“But it brought home just how precarious our vaccine supply is,” Dr. Jay P. Sanford, chairman of the committee, said.

The present system of reliance on suits in the courts has had an “erratic and unpredictable” effect, with only a few of the suits reaching settlement, while vast sums of money have gone to lawyers, the committee noted. The nation requires a system for “reasonable compensation in a rapid and equitable manner” that would not protect anyone suspected of misconduct, the committee concluded. Among the options would be a supplementary compensation system in conjunction with the courts, limits on the courts in vaccine cases or, most promising of all, a public-liability insurance program.

The prompt establishment of a national commission could facilitate the action needed to assure the supply.