Current situation of vaccine injury compensation program and a future perspective in light of COVID-19 and emerging viral diseases

Background: Vaccines have had a great impact on disease prevention and reducing mortality. Very rarely, vaccines also can result in serious adverse effects. In consideration of this fact, vaccine injury compensation programs have been implemented in many countries to compensate a vaccinee for associated adverse effects. The existing vaccine injury compensation system addresses routine immunization schemes. However, there are rising concerns about the compensation for adverse effects caused by new vaccines such as those developed for coronavirus disease 2019 (COVID-19). This review focuses on vaccine injury compensation programs and highlights the necessity to include all upcoming new vaccines for COVID-19 and other emerging viral diseases in the compensation schemes. Methods: Published articles relating to vaccine compensation injury programs, vaccines, injuries, disabilities, illnesses, and deaths resulting from vaccination were searched in data bases. Through a careful review of the abstracts, 25 relevant articles were selected for analysis. Results: We identified 27 countries on four continents with vaccine injury compensation schemes: 17 countries in Europe, 7 countries in Asia, the United States, a Canadian Province and New Zealand. No programs were identified in Africa and in South America. Program design, funding, and eligibility for compensation vary vastly between countries. We identified 17 countries operating well-established vaccine injury compensation programs. However, minimal information is available on numerous other countries. Conclusion: We conclude that the vaccine injury compensation programs are available in limited number of countries across four continents - mostly in Europe. Lack of standard approach and scope of injury prevention and compensation programs across the countries exists. Some important limitations include limited scientific material, which hindered our research. Therefore, additional data concerning payout for each type of injury and the number of claimants related to a specific vaccine injury worldwide could provide a more comprehensive analysis.

The Impact of the COVID-19 Pandemic on Physician Visits in Japan

Background: Emerging from the coronavirus disease 2019 (COVID-19) scenario, fears of social distancing and contagion have led to a decline in the number of physician visits in Japan, placing severe financial strain on most hospitals and clinics. In this context, this study examined the impact of the spread of COVID-19 on the utilization of outpatient services.Methods: This study used monthly data drawn from the monthly statistics report of the social insurance medical fee payment fund in Japan and estimated fixed-effects models.Results: The results showed that the decline in the number of physician visits because of the first state of emergency declaration in Japan was greater than that caused by COVID-19's spread during the same period. However, there was a decline in the impact of the declaration over time. After the second state of emergency declaration, the decline in the number of physician visits caused by the spread reduced by almost half. The nationwide preschool closure under the declaration of the first state of emergency also adversely impacted the number of physician visits. The reduced healthcare per capita costs of preschool children were greater among prefectures taking specific precautions. The results showed non-negligible regional differences in physician visits of preschool children during the sample period.Conclusions: The findings imply that we should not overestimate the negative impacts of the state of emergency declaration without lockdown on physician visits. To restore the number of physician visits to its pre-pandemic level, it is crucial to facilitate a smooth transition of COVID-19 patients between hospitals and an effective compensation program for hospitals with COVID-19 patients.

“First do no Harm”. No-Fault Compensation Program for COVID-19 Vaccines as Feasibility and Wisdom of a Policy Instrument to Mitigate Vaccine Hesitancy

Vaccines are so far proven to be safe, although related adverse events cannot be excluded. The urgency for COVID-19 vaccines determined a dilution of the general expectations of safety and efficacy of vaccination (from safe and effective to safe and effective enough). In many countries, a no-fault program was established to compensate individuals who experienced serious vaccine-related injuries. The impressive number of administrations worldwide and the legal indemnity afforded to manufacturers of approved vaccines that cannot be pursued for compensation fed the debate about the availability of a compensation model for COVID-19 vaccine-related injuries. Several European countries have long introduced a system, Vaccine Injury Compensation Programs, to compensate people who suffer physical harm because of vaccination. In Europe, COVID-19 vaccination is strongly recommended for the general population and in many states is declared mandatory for healthcare workers. In 1992, Italy edited Law no. 210 providing legal protection for individuals who reported injuries after mandatory and recommended vaccinations as a no-fault alternative to the traditional tort system. Despite its recommended nature, COVID-19 vaccination is excluded from the no-fault model in several European states, and the Italian government is called to provide clear and firm instructions for the management of the many requests for compensation. The authors provide an overview of the existing compensation models in Europe and analyse available legislative proposals.

Mahakal Blessed My Crop: Community Dynamics and Religious Beliefs Influence Efficacy of a Wildlife Compensation Program

Conservation conflicts or human-wildlife conflicts present one of the foremost challenges to wildlife conservation globally. The challenges of reconciling human safety and food security with the conservation of large-bodied wildlife are further compounded in the developing nations with a high spatial overlap of wildlife with people. Therefore, conservation models are required to offset losses faced by affected communities while at the same time ensuring the long-term conservation of wildlife species in shared spaces. Ex-gratia payment is one such widely used conflict mitigation instrument that aims to reduce losses and increase tolerance toward damage-causing wildlife species. However, the efficacy of such programs is rarely investigated and the complex interplay of local beliefs, traditions, and community dynamics are rarely incorporated in the compensation programs. This paper aimed to study an ex-gratia payment program for crop losses in India using ecological, economic, and social lenses. In this study, we used 119 interview surveys across 30 villages. Linear models and thematic analysis were used to understand the sources of crop losses, the propensity to claim ex-gratia payments, and the reasons for claiming or not claiming. We find that even though wildlife is the major cause of crop loss in the region, especially to elephants, the majority of the respondents (53%) did not claim compensation for the losses. The reasons varied from procedural failures to a negative evaluation of the process or the agency involved but the most recurrent reason for not claiming was a deep religious belief in certain communities on the elephant God, “Mahakal.” Our work indicates that the cultural reverence toward the species is enabling the acceptance of losses. We propose that such complex cultural beliefs and local traditions should be considered when designing schemes that aim to garner conservation support toward damage-causing wildlife species.

Conflicts in Implementing Environmental Flows for Small-Scale Hydropower Projects and Their Potential Solutions—A Case from Fujian Province, China

Releasing environmental flows is a valuable strategy for mitigating negative impacts of small-scale hydropower projects on river and riparian ecosystems. However, maintaining environmental flows has faced considerable resistance from different stakeholders, and previous studies have failed to appropriately investigate solutions. Here, online questionnaires and interviews were conducted among small-scale hydropower project owners, government administrators, and the public in Fujian Province, China. The results showed that the major hindrance to implementing environmental flows was the potential economic loss resulting from reductions in electricity production, stakeholders’ skepticism, technical difficulties, and a lack of the government supervision. Diversion-type projects pose the largest losses of electricity production after the release of environmental flows, and by adopting a 10% of mean annual flow as minimum target, most small-scale hydropower projects obtain low marginal profits without compensation. Here, we proposed an appropriate payment for ecosystem services by introducing an economic compensation program for different types of small-scale hydropower projects scaled by potential losses in electricity generation. Under such a scheme, economic losses from a reduction in electricity production are covered by the government, hydropower project owners, and electricity consumers. Our study offers recommendations for policymakers, officials, and researchers for conflict mitigation when implementing environmental flows.

Current situation of vaccine injury compensation program and a future perspective in light of COVID-19 and emerging viral diseases

Background: Vaccines have had a great impact on disease prevention and mortality reduction. Very rarely, vaccines also can result in serious adverse effects. In consideration of this fact, vaccine injury compensation programs have been implemented in many countries to compensate a vaccinee for associated adverse effects. The existing vaccine injury compensation system addresses routine immunization schemes. However, there are rising concerns about the compensation for adverse effects caused by new vaccines such as those developed for coronavirus disease 2019 (COVID-19). The objective of this article is to review the existing vaccine injury compensation programs in different countries. The review also highlights the necessity to include all upcoming new vaccines for COVID-19 and other emerging viral diseases in the compensation schemes. Methods: Published articles relating to vaccine compensation injury programs, vaccines, injuries, disabilities, illnesses, and deaths resulting from vaccination were searched in data bases. Through a careful review of the abstracts, 25 relevant articles were selected for analysis. Results: We identified 27 countries on four continents with vaccine injury compensation schemes: 17 countries in Europe, 7 countries in Asia, the United States, a Canadian Province and New Zealand. No programs were identified in Africa and in South America. Program design, funding, and eligibility for compensation vary vastly between countries. We identified 17 countries operating well-established vaccine injury compensation programs. However, minimal information is available on numerous other countries. Conclusion: We have identified 27 countries operating vaccine injury compensation programs. In Canada, Quebec is the only province with a scheme; however, discussions are ongoing in Canada for nationwide implementation in light of COVID 19. Study limitations include limited scientific material, which hindered our research. Additional data concerning payout for each type of injury and the number of claimants related to a specific vaccine injury worldwide could provide a more comprehensive analysis.