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Yves here. It appears that the U.S. is under the influence of extreme ideologies aiming to revert societal progress, taking us back to the 19th century with its associated epidemic childhood diseases. Robert F. Kennedy Jr.’s assertion that vaccines cause autism contradicts numerous studies. If he succeeds in classifying autism as a vaccine-related injury, it could undermine the entire vaccination framework in the U.S. The Vaccine Injury Compensation Program (VICP) compensates validated claims, and recognizing autism as a vaccine injury would challenge its financial sustainability. Drug companies have previously threatened to withdraw vaccines when faced with dubious injury claims; their reluctance to do so again is under question.
However, the outcome remains uncertain. The measure Kennedy proposes must undergo a rule-making process that includes public input, making his push troubling in itself.
By Céline Gounder. Originally published at KFF Health News
Secretary of the Department of Health and Human Services (HHS), Robert F. Kennedy Jr., has proposed a significant change: adding autism to the VICP’s list of covered conditions. The VICP allows families to seek compensation for severe vaccine-related side effects. Kennedy has also recommended broadening the definitions of two serious neurological conditions—encephalopathy and encephalitis—to facilitate autism claims.
Experts caution that either change would result in a deluge of claims, jeopardizing the program’s financial stability and equipping vaccine skeptics with a new argument.
According to Richard Hughes, a law partner and instructor at George Washington University, HHS “must undergo notice and comment rulemaking to amend the table,” which lists injuries assumed to be vaccine-related if they occur within a certain timeframe. Autism is not included in this table, as the alleged connection has been thoroughly discredited.
If autism were added, Hughes warned, the VICP could be inundated with “an exorbitant number of claims that would threaten the program’s viabilit
When inquired about possible plans, an HHS spokesperson informed CBS News that the agency refrains from commenting on future or potential policy changes.
Carole Johnson, former head of the Health Resources and Services Administration, which manages the VICP, warned that the system already faces significant burdens. She stated: “The backlog is not merely a management issue; it’s built into the legislation itself, which is vital context for discussions on adding new claim categories.”
Dorit Reiss, law professor at the University of California College of the Law-San Francisco, noted that any such change would be exploited: “This will, and likely will, be used to cast doubt on vaccines.”
Compensation Without Causation
The Vaccine Injury Compensation Program originated during a crisis. Following the airing of the 1982 documentary “Vaccine Roulette,” alleging childhood vaccines caused severe issues, a surge of lawsuits against vaccine manufacturers began.
“This led to a flood of litigation against vaccine makers,” recalled Dr. Paul Offit, a pediatric infectious disease specialist and vaccine creator at the University of Pennsylvania. “The situation became so dire that it drove many of them out of the market… By the mid-1980s, legal claims against these firms reached $3.2 billion.”
Offit emphasized that without VICP, “we would not have vaccines available for American children. It simply wasn’t worth it for companies to continue.”
The National Childhood Vaccine Injury Act of 1986 established a no-fault compensation scheme. Families asserting that a vaccine caused harm could file a claim. If injuries appeared on the established list within the required timeframe, compensation was guaranteed. If not, claimants could provide medical evidence for consideration. This system aimed to offer compensation and ensure vaccine availability.
From the start, the table was not intended to be a scientific document but a legal framework.
“It’s a legal instrument, and certain items may be included for policy reasons even if causation evidence is weak,” said Reiss. She elaborated, “The program is designed to be generous and compensate when doubt exists.”
However, she clarified, “autism does not fall into that category. The science is irrefutable. Including it would be purely political.”
This tension—between law, science, and public perception—has characterized the program for nearly four decades.
What Expansion Would Mean in Practice
Since 1988, federal statistics reveal that over 25,000 petitions to the VICP have been processed; out of these, 12,019 received compensation, while 13,007 were dismissed. Approximately 60% of awarded claims involved negotiated settlements, where HHS made no determination of causation. Over the same period, billions of doses have been safely administered to millions of Americans.
Adding autism to the VICP table would drastically alter this landscape.
Federal projections estimate that up to 48,000 children could instantly qualify under a “profound autism” standard, implying potential payouts averaging $2 million per case, leading to an initial financial burden of nearly $100 billion, followed by approximately $30 billion annually—far exceeding the current $4 billion trust.
“Any case where symptoms arose within the last eight years and parents attribute them to vaccines would qualify,” Reiss explained. “The fund currently has a surplus of over $4 billion. One seriously disabled child’s care can reach millions, so a considerable influx, say 100,000 compensation claims, could deplete it.”
Additionally, with only eight special masters managing cases, the system would be hampered by backlogs.
The inquiries are not solely financial. If the fund topples under the strain of autism claims, vaccine manufacturers may reevaluate whether producing vaccines for the U.S. market is prudent. This scenario could recur, repeating the crisis of the 1980s that spurred the establishment of VICP.
Autism and the Courts
In the late 1990s and early 2000s, Andrew Wakefield’s now-retracted study claiming a connection between the MMR vaccine and autism sparked a spike in VICP claims. By 2002, the VICP was inundated with petitions alleging vaccines were responsible for autism. The court consolidated thousands of these claims into the Omnibus Autism Proceedings, selecting a few test cases to determine the outcome.
After years of hearings and expert testimony, the verdict was clear: vaccines do not cause autism. In 2010, the court ruled against petitioners on every proposed causation theory. The U.S. Court of Federal Claims and the Court of Appeals affirmed this decision.
“That precedent holds significant weight,” said Richard Hughes, a vaccine law expert at George Washington University and former VICP legal advisor. “Autism has been thoroughly litigated and dismissed. This still influences the courts today.”
The Ghost of Hannah Poling
Yet, the vaccine-autism dialogue has never truly diminished. In 2008, the government settled a case concerning Hannah Poling, a girl with a rare mitochondrial disorder who exhibited autism-like symptoms post-vaccination. Officials emphasized that this settlement was specific to her case and did not imply a general link. However, headlines spun it differently: “Family to Receive $1.5 Million in First-Ever Vaccine Autism Court Award.”
This incident has fueled years of misunderstanding.
Autism Science Today
The scientific understanding has never been clearer: autism develops early in pregnancy, not during toddler years when most vaccinations occur.
“Vaccinations… took place around the time families first noticed autism symptoms in their children,” said Catherine Lord, a clinical psychologist at UCLA specializing in autism diagnosis. “Now we recognize that autism actually begins significantly earlier, likely during fetal development, meaning it cannot be attributed to vaccines.”
Peter Hotez, a pediatric infectious disease expert and vaccine researcher at the Baylor College of Medicine, who is also a father of an adult child with autism, emphasizes this point: “Genetics and, in rare instances, environmental factors during pregnancy determine autism, not vaccines. This evidence has been established for decades.”
Sarah Despres, a former legal advisor to the HHS Secretary during the Biden administration, now consulting on immunization policy for nonprofits, insists that many misconstrue the compensation program.
“The original table was established as a political document,” she explained. “The program aims to be responsive, generous, and equitable. There are cases that may not directly result from vaccines but still receive compensation through this table injury scheme, requiring no proof of causation.”
What’s at risk: Harm From the Diseases Themselves
The implications are profound. Measles, one of the most contagious diseases, spreads so effectively that one infected child can pass it to 90% of susceptible individuals. Before mass vaccinations began in the 1960s, measles sickened hundreds of thousands yearly in the U.S., resulting in numerous fatalities and thousands of cases of encephalitis and lifelong disabilities. Complications included pneumonia, brain swelling, and occasionally fatal degenerative brain disorders such as subacute sclerosing panencephalitis (SSPE) that can manifest years later. Recently, a child in Los Angeles County died from SSPE after contracting measles in infancy, before reaching vaccination age.
Mumps was once a common childhood illness. Though often regarded as mild, it can lead to sterility in males, meningitis, and permanent hearing loss. Outbreaks on college campuses, as recently as the 2000s, demonstrated its potential resurgence when vaccination rates drop.
Rubella, commonly referred to as German measles, is usually mild in children but can wreak havoc during pregnancy. Congenital Rubella Syndrome (CRS) resulted in many tragedies before the advent of vaccination: thousands of infants were born each year blind, deaf, or with heart defects and intellectual disabilities. Notably, autism itself is documented in medical literature as one of CRS’s possible outcomes—proof that rubella infection, rather than vaccination, can lead to developmental issues.
Measles, mumps, and rubella “are not trivial,” stated Walt Orenstein, former head of the immunization program at the CDC. “They frequently cause fever, and serious complications are common.”
Despite this, as these diseases fade from collective memory, a contrary narrative has gained traction. On September 29, the nonprofit Physicians for Informed Consent, which disputes the scientific consensus on vaccines, announced it had sent its “Silver Booklet” on vaccine safety to every Congress member, as well as to President Donald Trump and Vice President JD Vance. The booklet asserts that “vaccines are not proven to be safer than the diseases they seek to prevent” and calls for punitive measures against states that impose vaccine exemption restrictions. (The booklet is not complimentary; the organization sells it for $25 on Amazon.)
Scientists argue this perspective misrepresents fundamental risk calculations. “Measles stands among the most critical infectious diseases in human history,” notes “Plotkin’s Vaccines,” the field’s leading textbook. “The widespread application of measles vaccines throughout the late 20th and 21st centuries contributed to a significant decline in measles mortality. Measles vaccination has prevented an estimated 31.7 million deaths from 2000 to 2020.”
Kennedy’s potential move to expand the Vaccine Injury Compensation Program relies on casting doubt—implying that science surrounding vaccines is unsettled, suggesting they may pose greater risks than the diseases themselves.
“One tactic used to advocate for the belief that vaccines cause autism involves referencing compensation outcomes from the National Vaccine Injury Compensation Program,” stated Reiss from UC Law-San Francisco. “Even the cases directly addressing the connection between vaccines and autism do not substantiate the claims made by opponents, and many cited cases are misrepresented and misused.”
Offit emphasizes the danger associated with public perception. “When individuals see the Vaccine Injury Compensation Program, they assume that any awarded funds indicate a vaccine-related injury,” he noted.
Kathryn Edwards, an authority on pediatric infectious diseases and vaccine safety at Vanderbilt University, remarked, “Expanding compensation for issues not clearly linked to vaccines… suggests that these conditions are associated with vaccines when they are not.” She drew a parallel to the removal of thimerosal, a preservative eliminated from most childhood vaccines to alleviate public concerns, despite no evidence supporting its removal. “We continue to face consequences from that decision.”
Public health experts assert that these narratives distort reality. The very diseases downplayed once caused tens of thousands of childhood fatalities or disabilities in the U.S. “A century ago, it was common for families to experience the loss of a child or know someone who succumbed to these diseases,” remarked pediatrician, psychiatrist, and medical historian Howard Markel. “Our battle with germs is ongoing; we never truly eradicate them. Instead, we manage to keep them at bay. This narrative serves as a significant disadvantage against the microbes that thrive on infecting the populace.”
Families and the Future
One of the most poignant voices belongs to families. Parents with autistic children often feel isolated—unsupported by disability services, overwhelmed by caregiving demands, and seeking answers. Kennedy’s rhetoric resonates emotionally rather than scientifically with them.
Reiss noted that these families deserve greater support, yet contends that this should not derive from the VICP.
“The goal of the program is to award compensation to those injured by vaccines,” she asserted. “We require better resources—disability funding and aid. Kennedy’s approach leads HHS in the wrong direction, scaling back services when more are necessary.”
Despres echoed this sentiment: “The program’s intention was to err on the side of compensation when faced with uncertainty. It’s essential to grasp that compensation does not imply actual causation by the vaccine. We’ve seen the statistics from the compensation program misused by those aiming to grow distrust in vaccines, despite the truth being otherwise.”
UCLA’s Lord advocated for a shift in focus. “For the past five decades, scientific inquiry has been centered on understanding the biological origins of autism, yielding substantial advances, particularly in genetics,” she noted. “Kennedy could make a more meaningful contribution by acknowledging scientific validity and emphasizing the necessity of providing comprehensive support to autistic individuals and their families.”
What Comes Next?
If Kennedy proceeds with this initiative, HHS will need to formulate a rule, make it available for public commentary, and subsequently defend the modification in court. The resistance will be formidable: from scientists, public health advocates, and families wary of being misled once more.
The discussion surrounding the inclusion of autism in the Vaccine Injury Table transcends policy. The program was founded on the premise of compensation without causation—a delicate balance meant to maintain both trust and vaccine supply. Including autism could jeopardize that balance entirely.
