Public Health Agency of Canada Vaccine Confidence Webinar Series: Understanding Canada’s Vaccine Injury Support Program

Quick notes

• This webinar is being recorded and a recording will be made available on CANVax.ca and on Canadian Public Health Association's YouTube channel.
  • Slides will also be made available.
• Please complete our post-webinar survey.
• Register with CANVax and subscribe to our newsletter.

Presenters

Speakers

• Stéphanie Parisien, Acting Director, Vaccine Injury Support Program, Public Health Agency of Canada
• Edward Maier, Project Lead and Senior Case Manager, Raymond Chabot Grant Thornton Consulting
• Dr. Jennifer Crichton, MD, CCFP, MBA, MSc, Department of Family Medicine, University of Ottawa

Moderator

• Stephanie Elliott, MPH, CPH, Vaccine Confidence Division, Public Health Agency of Canada

Disclosures

• Stéphanie Parisien has nothing to declare
• Edward Maier has nothing to declare
• Dr. Jennifer Crichton receives consultant fees from Raymond Chabot Grant Thornton Consulting Inc. for her work associated with the Vaccine Injury Support Program
• Stephanie Elliott has nothing to declare

Objectives

At the end of this webinar, health care professionals will be able to:

• explain the Vaccine Injury Support Program (VISP) eligibility criteria and processes
• support individuals who may have suffered a vaccine injury in submitting their claim
• identify their role in supporting the claim process, such as retrieval of medical records

What is a Vaccine Injury Support Program (VISP)?

No fault

Financial support is provided regardless of who is responsible or possibly at fault. For example, the claimant, manufacturer or health professional administering the vaccine.

Non-adversarial

Does not require the claimant to seek legal representation or solicit expert medical review (beyond their attending physician's report).

Fair, timely and equitable

Provides fair, timely and equitable financial compensation to individuals who experience serious vaccine injuries.

Driving factors for the Pan-Canadian VISP

Addresses long-standing gap

Strengthens Canada's immunization system and provides equitable access to financial support.

Demonstrates leadership

Canada joins the international community in offering a national vaccine injury compensation program.

Shows fairness and reciprocity

People who experience a serious and permanent vaccine injury while performing a public good. For example, being immunized should be supported in a fair and timely manner, regardless of responsibility or possible fault.

Pan-Canadian Vaccine Injury Support Program

The Pan-Canadian Vaccine Injury Support Program ensures that all people in Canada who have experienced a serious and permanent injury as a result of receiving a Health Canada authorized vaccine, administered in Canada on or after December 8, 2020, have fair and timely access to financial support.

Quebec is continuing to administer its provincial program with funding from the Public Health Agency of Canada (PHAC) for individuals vaccinated in that province.

Roadmap to the Pan-Canadian Vaccine Injury Support Program

• December 10, 2020: New program announced by the Prime Minister.
• February 2021: Call for proposals launched.
• February 24, 2021: Call for proposals closed.
• March 2021: The Public Health Agency of Canada establishes a Review Committee to review proposals
• March 2021: Raymond Chabot Grant Thornton (or RCGT) Consulting was unanimously selected as third party administrator.
• June 1, 2021: Program launched and administered independently by Rayomond Chabot Grant Thorton Consulting with funding from the Public Health Agency of Canada.

Policy parameters

The Public Health Agency of Canada established the Vaccine Injury Support Program policy parameters. Raymond Chabot Grant Thorton Consulting is responsible for designing and implementing the program within these parameters.

The Vaccine Injury Support Program provides financial support to individuals who experience a serious and permanent injury from a Health Canada-authorized vaccine administered in Canada, on or after December 8, 2020.

Individuals have three years after the date of vaccination, date of death or date when an injury first becomes apparent to submit a claim.

Aligns with Quebec's Vaccine Injury Compensation (VIC) program.

Based on the World Health Organization's accepted practices on the establishment of causality.

Third party responsibilities

Raymond Chabot Grant Thornton Consulting is responsible for designing and implementing:

• intake
• causality assessment
• severity assessment
• compensation and payment
• appeals

PHAC has no involvement in program delivery, including assessing claims or appeals.

Vaccine Injury Support Program responsibilities and process

PHAC has no involvement in program delivery, including assessing claims or appeals. Raymond Chabot Grant Thorton Inc. has responsibility for:

• intake
• casualty assessment
• severity assessment
• compensation and payment
• appeals

Role of health professionals

• Understand eligibility
• Recommend program
• Medical assessment form
• Continue to provide care
• Respond to requests

Eligibility criteria

Authorized vaccine

Any person receiving a Health Canada authorized vaccine.

Time frame

Claims can be filed within 3 years after the date of vaccination, date of date or date when the injury first becomes apparent.

Injury reported

Injury reported to health care provider.

Eligibility date

Date of vaccination was on or after December 8, 2020.

Administered in Canada

The vaccine was administered in Canada. Exceptions and frequently asked questions.

Serious and permanent

The injury is serious and permanent or has resulted in death.

Definition of serious and permanent

"A serious and permanent injury is defined as a severe, life-threatening or life-altering injury that may require in-person hospitalization, or a prolongation of existing hospitalization, and results in persistent or significant disability or incapacity, or where the outcome is a congenital malformation or death."
- World Health Organisation (WHO)

• This definition was developed by the World Health Organization.
• Intended to be permissive and open-ended.
• Used by Quebec's Vaccine Injury Compensation Program.

Causality assessment using WHO model

"Causality assessment usually will not prove or disprove an association between an event and the immunization. It is meant to assist in determining the level of certainty of such an association. A definite causal association or absence of association often cannot be established for an individual event."
- WHO

• Medical Review Board composed of 3 independent physicians (and additional specialists as required).
• Two-thirds majority decision (same as Quebec).
• Injured party remains anonymous throughout the process.
• No patient representative (different than Quebec).

Injury severity assessment

• In order to compensate a claimant, the level of injury must be determined.
• Medical Review Board conducts a severity assessment using medical records.
  • It is based on the Quebec Automobile Insurance Act and determines a percentage of injury.
• Examples of injuries submitted since June 1, 2021:
  • vaccine-inducted thrombotic thrombocytopenia
  • Guillain-Barré syndrome
  • anaphylaxis
  • myocarditis

Challenges with case assessments

• COVID-19 vaccine post-market literature is continuously evolving.
• Decisions are made on the best available evidence available at the time.

Serious and permanent injuries?

Vaccine-inducted thrombotic thrombocytopenia versus non vaccine-inducted thrombotic thrombocytopenia thrombosis.

Financial support

• Financial support will be provided when the majority of the Medical Review Board has determined:
  • balance of probabilities between the vaccine and injury (causality assessment)
  • the injury qualifies as severe and permanent (injury severity assessment)
• Payment following decision will generally cover:
  • lump Sum Injury Indemnity: injury indemnity, death and funeral benefits
  • recurring: list income, medical expenses
  • eligible expenses: Home adaptation, transportation, medical devices, personal support worker

Overview of claims

• Number of claims
  • In the past year, 99% of claims were related to COVID-19 vaccines
  • There have been many different injuries claimed and each is assessed individually
• Timeline
  • Case by case
  • Medical records collection

Statistics for the Vaccine Injury Support Program

What can you do?

As members of the immunization community, Raymond Chabot Grant Thorton Consulting would like to engage you with the following goals in mind:

• feedback: eliciting constructive feedback regarding VISP processes
• increase Awareness: ensuring equitable access to VISP for all Canadians
• best evidence: collaboration between vaccine experts and VISP to ensure sharing of consensus on novel/emerging vaccine associated injuries
• medical record retrieval: we offer both physical and digital reception of data
• recruiting physicians: neurologists, physiatrists, cardiologists and thrombosis specialists

For feedback or further information: info@vaccineinjurysupport.ca or visit the website vaccineinjurysupport.ca.

For more PHAC webinars and videos for healthcare professionals, please visit the Government of Canada website: COVID-19 for health professionals: Training, webinars and webcasts (Canada.ca)

National Collaborating Centre for Infectious Diseases website: NCCID hosts the Public Health Agency of Canada Webinars on COVID-19 Vaccines for Health Care Providers (National Collaborating Centre for Infectious Diseases)

Canadian Vaccination Evidence Resource and Exchange Center website: The Public Health Agency of Canada (PHAC) Vaccine Confidence Webinar Series (CANVax)