- HHS Secretary Robert F. Kennedy Jr. plans to propose a rule in November 2026 establishing a formal injury table for COVID-19 vaccines, making compensation easier for vaccine-injured individuals.
- The injury table would presume certain injuries were caused by COVID-19 vaccines if they occur within specified time windows, reducing the burden of proof for claimants.
- A lawsuit filed by attorney Ray Flores in May 2026 compelled HHS to create the table, which was legally required under the PREP Act but never implemented.
- The current CICP program has paid only 60 claims total, with a median award of $4,300, drawing widespread criticism from legal experts and patient advocates.
- Legal experts expect myocarditis in young males to receive close consideration, while the proposal could also jumpstart scrutiny of other vaccine harms.
A long-awaited shift in vaccine injury policy
In a move that could reshape how the federal government addresses COVID-19 vaccine injuries, U.S. Health Secretary Robert F. Kennedy Jr. is preparing to launch a rulemaking process that would establish a formal injury table for COVID-19 vaccines. The proposal, expected in November 2026, would identify specific injuries that the government would presume were caused by COVID-19 countermeasures, including vaccines, provided they develop within defined time windows. This action comes after a lawsuit filed in May forced the Department of Health and Human Services to fulfill a legal obligation under the PREP Act that had remained unmet for years. The public comment period is expected to run into early 2027 before any final rule takes effect.
The broken compensation system
The current system for compensating COVID-19 vaccine injuries has drawn broad criticism. The Countermeasures Injury Compensation Program, established under the PREP Act, has paid only 60 claims total, with a median award of $4,300 for death or serious bodily injury. Attorney Ray Flores, who filed the lawsuit compelling HHS to act, described the program as a black hole for injured individuals.
Unlike traditional vaccines covered by the National Vaccine Injury Compensation Program created by Congress in 1986, COVID-19 vaccines were excluded from that system. Instead, claimants faced stricter standards, lower compensation rates and limited appeal opportunities through CICP. More than 1.5 million adverse event reports filed with the Vaccine Adverse Event Reporting System do not qualify for compensation because the program covers only deaths and injuries meeting the government's definition of serious physical injury.
What the injury table would do
The proposed injury table would establish a presumption of causation for listed injuries occurring within specific time frames after vaccination. This approach mirrors the framework used in the VICP for decades, where claimants with listed injuries do not need to prove causation from scratch.
Legal experts expect myocarditis, an inflammation of the heart muscle linked to mRNA COVID-19 vaccines particularly among adolescent and young adult males, to receive close consideration because federal health agencies have already acknowledged the association. The table would require compelling, reliable, valid medical and scientific evidence linking each injury to the vaccine, according to HHS guidance.
Attorney Chad Davenport called the proposal a fantastic start, expressing hope it would lead to expanding coverage for routine childhood vaccines. Attorney Michael Baum added that post-vaccination injuries are real and should be acknowledged and compensated, consistent with the VICP program's purpose.
Evidence behind the policy shift
The proposal follows a 2024 National Academies review commissioned to inform the VICP, which assessed evidence for four COVID-19 vaccines authorized in the U.S. The committee reached 85 conclusions on potential adverse events, finding sufficient evidence for 20 conclusions, including causal relationships between mRNA vaccines and myocarditis and pericarditis, as well as thrombosis with thrombocytopenia syndrome following the Johnson & Johnson vaccine.
A June 2025 FDA safety communication confirmed that FDA required updated warnings in Pfizer and Moderna vaccine labels regarding myocarditis and pericarditis risks. Data showed approximately 8 cases per million doses in individuals 6 months through 64 years of age and approximately 27 cases per million doses in males 12 through 24 years following the 2023-2024 formula.
A longitudinal study published in September 2024 found that among approximately 300 people who developed myocarditis after mRNA COVID-19 vaccination, cardiac MRI abnormalities persisted at five-month follow-up in many patients, though the clinical significance remains unknown.
Historical context and ongoing challenges
The vaccine injury compensation framework dates to 1986, when Congress created the VICP to protect manufacturers from excessive litigation while ensuring legitimate claims received compensation. That system covers routine childhood vaccines but explicitly excluded COVID-19 vaccines, leaving injured individuals with the more restrictive CICP.
The PREP Act, enacted in 2005, required HHS to create a Countermeasures Injury Table for public health emergencies, but the agency never implemented one for COVID-19. The current proposal would finally fulfill that mandate.
Researcher Wayne Rohde, author of two books on federal vaccine injury compensation, expressed concern that Congress may fail to allocate the estimated $3 billion needed for compensating the vaccine-injured, warning that inaction during this pandemic would worsen outcomes in future health emergencies.
A watershed moment for vaccine accountability
The proposed COVID-19 vaccine injury table represents a potential turning point for thousands of Americans who believe they were injured by the vaccines. If implemented, the table would shift the burden of proof from claimants to the government for listed injuries, offering a more efficient path to compensation than the current broken system. However, significant challenges remain, including adequate funding, Congressional action and the risk that political pressures could influence which injuries make the list. For the millions who have filed VAERS reports and the tens of thousands who have experienced serious adverse events, the November proposal offers a long-overdue opportunity for accountability — and a critical test of whether the federal system can fulfill its promise to those harmed in the name of public health.
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