Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said yesterday that he intends to "fix" a government program that compensates people with vaccine injuries.

The Vaccine Injury Compensation Program (VICP) was established by Congress in 1986 to protect vaccine makers from most lawsuits alleging vaccine-related injury, while also giving people who believe they were injured by vaccines an opportunity to have their claims heard and potentially receive compensation from HHS. According to the Health Resources & Services Administration, VICP has paid more than $5.4 billion in awards for harm over the life of the program. 

But in a post yesterday on X, Kennedy said that the structure of the VICP hobbles claimants because HHS (rather than the vaccine makers) is the defendant and that it routinely dismisses meritorious cases or drags them out for years. Kennedy said he is working with US Attorney General Pam Bondi to fix the program.

"The VICP is broken, and I intend to fix it," Kennedy said. "I will not allow the VICP to continue to ignore its mandate and fail its mission of quickly and fairly compensating vaccine-injured individuals."

Kennedy's plans are unclear

Though Kennedy's post did not provide any details on changes he plans to make to the VICP, observers are concerned that it could be an attempt to further reshape US vaccine policy. A longtime critic of vaccines, Kennedy has already overhauled the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, replacing the board's 17 vaccine experts with seven new members, some of whom share his views on vaccines. 

Among the concerns is that Kennedy wants to expand the eligibility for compensation by allowing claimants to sue for adverse events that haven't been shown to be associated with vaccines.

"There are improvements needed to the program, but that’s not what the Secretary wants to do," Dorit Reiss, PhD, a law professor at the University of California Law, San Francisco, wrote on the Skeptical Raptor blog. "He wants to serve the anti-vaccine agenda by making the program compensate cases not caused by the vaccines."

An analysis of data from a large US healthcare system reveals some of the geographic variation in patients with Candida auris infections, researchers reported yesterday in Antimicrobial Stewardship & Healthcare Epidemiology.

For the study, researchers with HCA Healthcare analyzed data on C auris patients treated at 37 of its acute-care facilities across 5 states from January 2021 through September 2022. They were specifically interested in patients in Nevada and Florida, the two states that have seen significant increases in cases of the multidrug-resistant fungal infection. Their aim was to describe patient factors associated with the organism and identify similarities and differences related to geographic location.

A total of 321 patients were included in the study, with 131 in the Western region and 190 in the Eastern region. Hospitals in Nevada treated 118 of the 131 patients in the Western Region, and hospitals in Florida were responsible for 183 of the 190 patients in the Eastern Region. 

The average age of patients in the Western and Eastern regions was 60.1 and 64.4 years, respectively. The average Elixhauser Comorbidity Index score, which assesses the overall disease burden of a patient, was 16 and 16.4, respectively.

Patients characterized by 'significant underlying morbidity'

Clinical outcomes were mostly similar between the two regions. Over one-third of patients required mechanical ventilation at some point during their admission, while greater than half of the total study population received a blood transfusion. 

Approximately 25.2% of all patients received hemodialysis, while 24.3% received total parenteral nutrition during their hospital stay. More than 50% of patients in both regions required admission to the intensive care unit at some point during their stay.

However, the percentage of patients who died or entered hospice at discharge was significantly higher in the Eastern Region than in the Western Region (32.1% vs 19.1%). 

"Patients identified with C. auris were characterized by significant underlying morbidity and disease burden," the authors concluded. "Further studies are warranted to identify infection prevention best practices to reduce transmission and reduce mortality through earlier identification and appropriate antifungal therapy."