文章基本信息

标题：Balancing Vaccine Science and National Policy Objectives: Lessons From the National Vaccine Injury Compensation Program Omnibus Autism Proceedings
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作者：Jennifer Keelan ; Kumanan Wilson
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：101
期号：11
页码：2016-2021
DOI：10.2105/AJPH.2011.300198
语种：English
出版社：American Public Health Association
摘要：The US Court of Federal Claims, which adjudicates cases for the National Vaccine Injury Compensation Program, has been confronted with more than 5000 cases submitted on behalf of children with autism spectrum disorders, seeking to link the condition to vaccination. Through a test case process, the Omnibus Autism Proceedings have in every instance found no association between autism spectrum disorders and vaccines. However, vaccine advocates have criticized the courts for having an overly permissive evidentiary test for causation and for granting credence to insupportable accusations of vaccine harm. In fact, the courts have functioned as intended and have allowed for a fair hearing of vaccine concerns while maintaining confidence in vaccines and providing protection to vaccine manufacturers. ON MARCH 10, 2010, THE US Court of Federal Claims, the court that hears cases for the National Vaccine Injury Compensation Program (NVICP), ruled on the final test case of the US Omnibus Autism Proceedings. The proceedings were created to efficiently adjudicate more than 5000 petitions submitted on behalf of children with autism spectrum disorders. Petitioners alleged that their children's disorders were caused by, or significantly exacerbated by, 1 or more government-recommended vaccinations.^{1 – 3} The vaccine court and the Court of Appeals have unanimously ruled in all cases that the petitioners failed to meet the evidentiary standard required for compensation. These hearings have been the subject of much controversy, and the US Court of Federal Claims has come under criticism from both sides of the vaccine safety controversy. Not surprisingly, those arguing for a link between vaccines and autism spectrum disorders are not satisfied with the decisions and believe that the courts' processes and evidentiary standards favor the opinions of established scientific institutions, their research agendas, and their interests in promoting vaccines.^{4 , 5} More perplexing is the criticism from vaccine advocates, many of whom argue that the courts have provided credibility to antivaccination arguments in what they believe to be a flawed system for entertaining theories of harm.^{6 – 8} They argue that the courts' criteria for establishing a causal link between a vaccine and an injury are too permissive and that the institution operates without concern for the public health impact of its decisions.⁹ These critics argue that the courts have given a hearing to alleged junk science, provided a forum for antivaccination sentiment that would otherwise have been marginalized, and triggered the waste of critical scientific research dollars defending vaccine safety against fringe biological theories of harm.”^{6 , 8 , 10 , 11} To the contrary, the NVICP was successful in its management of these proceedings and met the intent of the original legislation to protect the integrity of the vaccine supply, maintain public confidence in immunization, and provide those injured with a fair hearing. The proceedings allowed for an exhaustive investigation of the concerns of parents of children with autism and at the same time protected the vaccine industry from a multitude of crippling lawsuits.