A federal program has paid out millions of dollars to people injured after having a vaccine they say was given incorrectly, but many patients are finding out, even if they have that same injury, they're not eligible for the program, leaving them few options for any relief.
The Vaccine Injury Compensation Program pays injured patients settlements to prevent them from suing vaccine makers. The News4 I-Team tracked more than $133 million paid to people with a condition called shoulder injury related to vaccine administration (SIRVA). It now makes up more than half of all the new cases filed in the program each year.
"Everybody is starting to become more aware of the incidence of SIRVA. That's why I think that number will keep going up," said Paul Brazil, who specializes in vaccine injury cases.
Brazil has filed hundreds of SIRVA claims for patients around the country. He says they've experienced excruciating pain and limited use of their arm. Any shot given too high in the deltoid muscle can cause SIRVA, no matter which vaccine is in the syringe.
"People have multiple surgeries. They could be missing time from work. They could have out-of-pocket medical expenses," Brazil said. "It can be a pretty substantial monetary payment."
Virginia resident Bob Simmons said he developed SIRVA immediately following a shingles vaccine in April 2018. More than a year later, the 72-year-old triathlete said he can't even use his left arm to hold a dinner plate, let alone pick up his eight grandchildren.
"Compared to the injuries a lot of people have, catastrophic injuries and everything else, it's hard for me to complain too much. But it is an inconvenience; it's tough," Simmons said. "And it doesn't seem to be getting any better."
But even though SIRVA is believed to be caused by how the shot is given, Simmons found you have to have had the right shot to get paid through the program.
Seasonal flu shots are covered. Tetanus shots are covered. Shingles shots are not.
"Any claim where you list the shingles vaccine as the cause of your injury will just be summarily dismissed," Brazil said.
The Vaccine Injury Compensation Program was created decades ago for the childhood vaccines that kids are required get in their first few years of life. If adults get the same version kids get, they're covered, too. In fact, adults now account for most of the cases in the program. But Congress never expanded it to include adults-only versions of vaccines.
The pneumonia vaccine, Prevnar, is covered, but Pneumovax, primarily for adults, is not. The shingles vaccine differs slightly from the childhood vaccine for chicken pox, so injuries from a chicken pox shot are covered, but the same injuries when caused by a shingles shot are not.
Simmons says if SIRVA is a covered injury in the program; it shouldn't matter what kind of shot it was.
"It's ridiculous! Why should it [matter]? It's the administration of the shot, not what's in the shot," he said.
Brazil said it's unfair, but there is an explanation.
"It really comes down to money," he said.
For every vaccine covered by the program, the patient getting the shot pays a 75-cent tax, which helps fund those payouts. So shots that don't collect the tax can't be included.
Brazil said sometimes you can't even tell which shot caused the injury. Seniors often get multiple shots at the same time, in the same arm.
"There are a lot of reasons why it would make sense to just include every vaccine," Brazil said. "If Pharma wanted to change it, if they wanted to be included, they'd be included."
He said the pharmaceutical company Merck could have pushed to get its shingles shot, Zostavax, into the program but didn't. Now the company is facing dozens of lawsuits alleging serious side effects, including death.
But Brazil said SIRVA cases are excluded from that action.
"SIRVA's a little different because we think SIRVA is caused by improper administration. Therefore, the manufacturer wouldn't be on the hook for that," Brazil said.
Plus, the shingles shot Simmons got was from a different vaccine-maker. His only option would be going after the vaccine-giver.
"That would require suing the pharmacy, or wherever he received the vaccine, and trying to prove negligence," Brazil said. "Mr. Simmons is in a tough spot."
Simmons said the Costco pharmacist who gave him the shot was standing while he was sitting down, which the CDC warns against.
“Costco cannot comment on the specifics regarding this particular case, however, all Costco Pharmacists are certified to administer immunizations and have received training through a nationally recognized accredited program,” Costco said in a statement to the I-Team. “Our immunization procedure manual is updated annually and includes information on proper vaccine administration. Additionally, any reported immunization incidents are submitted to the Vaccine Adverse Event Reporting System (VAERS).”
Simmons said Costco did report his injury to the manufacturer and a federal system that tracks vaccine injuries.
It's now been a year since his shot, and he said he's lost 80 percent of his arm's strength.
"I'm not really litigious in nature," Simmons said. "I just want to get my arm fixed. I was in pretty good shape up until that point in time."
Reported by Jodie Fleischer, produced by Rick Yarborough, and shot and edited by Jeff Piper.