Academic journal article Law and Contemporary Problems

Immunizing against Bad Science: The Vaccine Court and the Autism Test Cases

Academic journal article Law and Contemporary Problems

Immunizing against Bad Science: The Vaccine Court and the Autism Test Cases

Article excerpt



Despite assurances from healthcare providers, questions about vaccine safety remain in the media spotlight and public debate, particularly the concern that vaccines cause autism. Since 2002, the federal court that hears vaccine-injury disputes--commonly called the Vaccine Court--has been at the center of a debate about whether vaccines cause autism. (1) The year 2010 marked the conclusion of six cases selected to test the validity of theories about how vaccines cause autism. (2) In August 2010, a final decision was rendered in the last unresolved test case, Cedillo v. Department of Health & Human Services. (3) In Cedillo, the Federal Circuit affirmed the Vaccine Court's finding that the petitioner neither presented a viable theory about how vaccines cause autism, nor proved that the petitioner's vaccination caused her autism.

This decision affects approximately five thousand similar autism claims pending in the Vaccine Court. (4) Many families involved in these claims assert that the test cases satisfied the court's unique standard of proof, whereas the federal government argues that the cases failed to meet even a low standard. (5) In light of the complex, competing scientific claims considered by the court, the autism test case decisions raise significant "science and law" issues. (6) Throughout the autism test cases, there has been an overarching concern that a decision to deny entitlement will result in a flood of autism claims in state courts. But considering current scientific and medical knowledge, the concern over autism cases moving into the civil sphere is likely overstated. Instead, attention should be paid to how these autism claims reflect a broader concern: a loss of public trust in vaccines.

The conclusion of the autism test cases is an opportunity to review the success of the vaccine-injury program and its relationship to U.S. vaccination practices. Part II of this note traces the history of vaccine-injury suits in the United States, the creation of the Vaccine Court, and how vaccine-injury claims are proven in the court. Part III introduces the vaccine-autism controversy and the Vaccine Court's decision to institute an omnibus proceeding to manage the autism claims. Part IV provides an overview of the omnibus autism proceedings, focusing on the Cedillo case. Part V sets forth an argument that the autism test cases demonstrate how the current standard of proof in vaccine cases trends too much toward awarding compensation and away from science. Vaccine Court decisions are unlikely to restore public trust in vaccines, but the decisions can contribute to public misperceptions. Compensating too many undeserving petitioners undermines the integrity of vaccine safety. Accordingly, this threatens to create a public health problem: If the standard of proof in the Vaccine Court is too low, the court implicitly validates public fears about vaccines and impacts public willingness to get vaccinated. To maintain public trust in vaccines, the standard of proof in the Vaccine Court must be clearer and more scientifically rigorous.



A. Vaccine-Injury Lawsuits in the United States

Every state legally requires that children receive certain immunizations before attending school or daycare. (7) Many states provide medical, religious, and even philosophical exemptions to vaccination requirements. (8) Nevertheless, most children in the United States today receive routine immunizations against fourteen diseases. (9) In rare cases, vaccines cause serious and even fatal side effects. (10) These side-effects can occur even if vaccines are produced and administered properly. (11)

In the mid- to late 1980s, there was a significant increase in the number of vaccine-injury suits against vaccine manufacturers, (12) possibly attributable to heightened media coverage at the time about the risks of vaccinations. …

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