Vaccine Injury Compensation Programs: Rationale and an overview of the Québec program.

Vaccines are among the safest therapeutic agents, and serious adverse events rarely occur. When they do occur, an individual may have to bear some or all of the costs associated with their injuries, seek compensation through litigation or, if available, seek compensation from a publicly-supported Vaccine Injury Compensation Program (VIC Programs). The VIC Programs are "no-fault" compensation schemes in which governments compensate individuals who are harmed by properly manufactured vaccines. There are ethical, legal and practical rationales to support these programs. Worldwide there are 19 countries that have implemented VIC Programs; in the majority of these countries, vaccines are not mandatory. They all have similar processes with respect to process, standard of proof and elements of compensation. In Canada, only the province of Québec has a VIC Program, which has been running successfully since 1985. Concerns with VIC Programs include cost, difficulties assessing causality and concern that such programs may undermine public trust in vaccines; but these concerns can be addressed, especially in high-income countries that can bear the costs and have the capacity to manage the program.