A health problem after a vaccination can leave you with two separate concerns: getting appropriate medical care and determining whether you have any legal options.

Many claims involving covered vaccines go through the federal National Vaccine Injury Compensation Program (VICP). COVID-19 vaccine claims generally fall under the separate Countermeasures Injury Compensation Program (CICP). A civil lawsuit may also be possible in limited circumstances, although federal law restricts many lawsuits involving vaccine injuries.

The correct route depends on the vaccine, the severity and cause of the injury, and when it occurred. Each option also has different deadlines, evidence requirements, and available benefits. Understanding those differences is an important first step for someone considering a vaccine injury claim in New York.

Key Takeaways About Legal Recourse for a Vaccine Injury in New York

• A vaccine injury claim may involve the VICP, CICP, or a civil lawsuit, depending on the vaccine, injury, and circumstances.
• The VICP covers certain vaccines. If your injury appears on the Vaccine Injury Table and meets its requirements, you may not have to prove that the vaccine caused it. If the injury is not listed, you will need evidence connecting it to the vaccine.
• A VICP injury generally must last more than six months, result in inpatient hospitalization and surgery, or result in death.
• COVID-19 vaccine claims generally fall under the CICP, which is limited to serious injuries and deaths.
• VICP injury petitions generally must be filed within three years after the first symptom or manifestation of onset or significant aggravation.
• CICP requests generally must be filed within one year after the covered countermeasure was administered or used.
• Federal vaccine laws can restrict civil lawsuits against vaccine manufacturers, administrators, and other protected parties.
• Do not delay reviewing your options because the applicable federal and state deadlines can be very different.

What Legal Recourse May Be Available for a Vaccine Injury in New York?

New York does not operate a general state vaccine-injury compensation program comparable to the federal VICP. For many claims, the first step is determining whether the vaccine falls within a federal compensation program.

The VICP is a federal no-fault system for people who believe they were injured by certain vaccines. A person of any age may file a petition if they received a covered vaccine and meet the program’s other requirements. Parents and legal guardians may file for eligible children or disabled adults, and the legal representative of a deceased person’s estate may file an eligible death claim.

The VICP currently covers these vaccine categories:

• Diphtheria
• Haemophilus influenzae type b, or Hib
• Hepatitis A and B
• Human papillomavirus, or HPV
• Measles, mumps, and rubella
• Meningococcal
• Pertussis
• Pneumococcal conjugate
• Polio
• Rotavirus
• Seasonal influenza
• Tetanus
• Varicella

Not every vaccine is covered. For example, the shingles vaccine, pneumococcal polysaccharide vaccine, and nonseasonal influenza vaccines are not currently covered by the VICP. The HRSA list of covered vaccines should be checked because coverage can change.

COVID-19 vaccines follow a separate federal route. HRSA states that COVID-19 vaccine claims are handled through the CICP because those vaccines are not currently covered by the VICP.

Civil claims require another level of review. Federal law provides certain protections to manufacturers, vaccine administrators, and other protected parties. A person therefore cannot assume that a traditional negligence, product-liability, or medical-malpractice lawsuit is available simply because an injury followed vaccination.

What Requirements Apply to VICP and CICP Claims?

Receiving a covered vaccine and experiencing a medical problem afterward does not automatically make someone eligible for compensation.

For a VICP petition, the effects of the injury generally must:

• Last for more than six months after vaccination;
• Result in inpatient hospitalization and surgical intervention; or
• Result in death.

The VICP’s Vaccine Injury Table can make causation easier to establish in some cases. If the injury, onset period, and other requirements listed on the Table are satisfied, the vaccine is presumed to have caused the injury unless another cause is shown. A person may also pursue an injury that is not listed on the Table, but medical evidence must establish that the vaccine caused or significantly aggravated the condition.

CICP has different requirements. It provides benefits only for serious injuries or deaths directly resulting from the administration or use of a covered countermeasure. Unless an applicable countermeasure injury table provides a presumption, the claimant must present compelling, reliable, valid medical and scientific evidence of causation. The fact that symptoms appeared after vaccination is not enough by itself.

CICP claims are resolved through an administrative process. A claimant may request reconsideration after an unfavorable decision, but there is no judicial appeal of the program’s determination.

What Evidence Helps Support a Vaccine Injury Claim?

The records surrounding the vaccination and resulting medical condition can help establish what happened and when.

Useful documentation may include:

• Vaccination records showing the date and vaccine received
• Medical records from before vaccination
• Records documenting the first symptoms
• Emergency-room or hospital records
• Diagnostic tests and imaging
• Prescription records
• Treatment and rehabilitation records
• Employment records showing missed work
• Medical bills and insurance statements
• Records of adverse-event reports

The New York State Department of Health directs adverse vaccine events to the federal Vaccine Adverse Event Reporting System, or VAERS. A VAERS report can document that a health event was reported, but it does not establish that the vaccine caused the condition.

The timeline can still be important. A vaccination record may establish when the dose was given, while later medical records can document when symptoms appeared, what doctors found, and how the condition developed.

Complete records may also reveal other relevant information, including a prior medical condition, an earlier diagnosis, or another possible explanation for the symptoms. Keeping the full medical history together can make the claim review more accurate.

How May Medical Records and Expert Opinions Be Used?

A diagnosis after vaccination does not automatically establish legal causation. Medical evidence must be considered alongside the requirements of the applicable federal program.

For a VICP petition, the Vaccine Injury Table may provide a presumption of causation. If a covered vaccine and listed injury satisfy the Table’s definition and onset period, the claimant generally does not need to prove that the vaccine caused the injury unless evidence establishes another cause.

An injury that is not listed on the Table may still qualify, but the claimant must establish a connection between the vaccine and the injury. A medical opinion may address:

• When the condition began
• Whether the diagnosis fits the symptoms
• Whether the timing is medically consistent with the claimed injury
• Whether a preexisting condition was significantly aggravated
• Whether another cause better explains the condition

Medical malpractice may become relevant if the allegation concerns negligent administration or other medical care. However, calling a claim medical malpractice does not automatically remove it from federal vaccine laws.

What Deadlines May Apply to Vaccine Injury Claims?

The federal programs have different filing deadlines. The applicable deadline may be based on the date of vaccination, the first symptom, the date of death, or a later change to an injury table.

General VICP deadlines include:

• Injury petition: Within three years after the first symptom or manifestation of onset or significant aggravation
• Death petition: Within two years after the death and within four years after the first symptom or manifestation of the injury that resulted in death
• Certain Vaccine Injury Table changes: Within two years after the change for qualifying injuries or deaths that occurred up to eight years before the change

A court may apply equitable tolling to a VICP deadline only in very limited circumstances.

For CICP, a request generally must be filed within one year after the covered countermeasure was administered or used. A person can submit a letter of intent to help meet that deadline, but the required request forms must still be completed. Special rules may apply when a countermeasure injury table is created or amended.

New York’s ordinary statutes of limitations do not replace these federal deadlines. However, a New York deadline may still matter if a viable state-law claim remains. Identifying the correct legal route early is important because waiting for a diagnosis or complete medical recovery may not extend the applicable filing period.

When Might a Civil Lawsuit Be Possible?

Federal vaccine law can restrict a civil action involving a covered vaccine injury. A New York appellate decision demonstrates how those restrictions may apply even when a claim is presented as medical malpractice.

In Santana v. Patel, 228 A.D.3d 540 (1st Dep’t 2024), the plaintiff alleged shoulder injuries after receiving a flu vaccine. She argued that the injury resulted from improper administration of the injection rather than from the vaccine itself.

The First Department concluded that the alleged condition fell within the Vaccine Injury Table’s definition of Shoulder Injury Related to Vaccine Administration, or SIRVA. Because the claim involved a vaccine-related injury covered by the federal program, the plaintiff was required to pursue the VICP process before bringing a civil action seeking more than $1,000. The court affirmed dismissal of the lawsuit.

For New York residents, Santana provides an important lesson: describing a claim as medical malpractice does not necessarily place it outside the federal vaccine-injury system.

For covered VICP claims seeking more than $1,000 from a vaccine manufacturer or administrator, the claimant generally must complete the required VICP process first. Depending on how that process ends, the claimant may be able to reject the VICP judgment or withdraw the petition under specified circumstances and pursue a civil action. Other federal liability restrictions may still apply.

COVID-19 vaccine cases are governed by different protections under the Public Readiness and Emergency Preparedness Act, or PREP Act. That law generally provides broad immunity to covered people and entities for claims arising from covered countermeasures. Its narrow exception permits a federal action for death or serious physical injury caused by willful misconduct, which is a more demanding standard than negligence or recklessness. Before filing that type of lawsuit, a covered individual generally must first exhaust the remedies available through CICP. The lawsuit must be filed in the U.S. District Court for the District of Columbia.

A civil lawsuit may therefore remain possible in limited circumstances, but the vaccine, injury, defendant, timing, and alleged conduct must all be examined before relying on a traditional New York claim.

What Compensation May Be Available for a Vaccine Injury?

The available compensation depends on the program and the losses supported by the evidence.

VICP compensation may include:

• Reasonable and necessary medical and rehabilitative expenses not covered by insurance or another qualifying source
• Qualifying future medical and care expenses
• Actual and anticipated lost earnings
• Pain, suffering, and emotional distress, up to $250,000
• A $250,000 estate award for a vaccine-related death
• Reasonable attorney fees and legal costs when the statutory requirements are met

Reasonable attorney fees and costs may be available even when a VICP petition is unsuccessful if the petition was filed in good faith and had a reasonable basis. An attorney may not charge the petitioner an additional fee for services connected with the VICP petition.

VICP compensation data also requires context. HRSA reports that approximately 60% of compensation awarded through the program results from negotiated settlements in which the Department of Health and Human Services did not conclude that the vaccine caused the alleged injury. A compensation award should therefore not automatically be described as a government finding of causation.

CICP benefits are narrower and may include:

• Qualifying medical expenses not reimbursed by insurance or another source
• Lost employment income when the claimant was unable to work for more than five days
• Survivor benefits in qualifying death claims

CICP does not provide compensation for pain and suffering, and it does not reimburse attorney fees. The program is considered a payer of last resort, meaning that payments from health insurance and other third parties can affect the amount available.

Eligibility for either program does not mean that every claimed expense will be paid. The medical evidence, supporting financial records, program limits, and other sources of reimbursement all affect the final determination.

How Can a New York Vaccine Injury Lawyer Help?

The practical challenge is often determining where the claim belongs before spending time pursuing the wrong remedy.

A lawyer can identify the vaccine, review the diagnosis, and determine whether the claim may fall under VICP, CICP, or another legal route. Counsel can also examine the filing deadline, injury requirements, medical history, Vaccine Injury Table, and any federal restriction on a civil lawsuit.

A VICP petition is filed in the U.S. Court of Federal Claims. A person may file without a lawyer, although HRSA reports that most petitioners use counsel. Reasonable attorney fees and costs may be available when the petition satisfies the program’s requirements.

CICP works differently. A claimant may use an attorney or another representative, but the program does not pay the representative’s fees.

Seeking legal help may be especially useful when:

• The diagnosis is serious or disputed
• The injury does not clearly satisfy the Vaccine Injury Table
• The filing deadline is approaching
• Medical causation is contested
• Federal law may restrict a civil claim
• The potential financial losses are substantial

A careful review can help clarify which route applies, what evidence may matter, and whether pursuing the claim makes sense.

Frequently Asked Questions

Can I file a vaccine injury claim if I had a preexisting medical condition?

A preexisting condition does not automatically rule out compensation. Medical evidence may need to show that the vaccine significantly aggravated the condition rather than the symptoms resulting solely from its ordinary progression or another cause.

What if I do not know whether my vaccine is covered by the VICP?

Check the vaccine type and date of administration against the current federal Vaccine Injury Table and HRSA’s covered-vaccine guidance. Not every vaccine is included.

Can I receive health insurance benefits and VICP compensation for the same medical bills?

VICP generally does not pay for an item or service to the extent that insurance or another qualifying source has paid or can reasonably be expected to pay for it. The program may compensate eligible unreimbursed expenses without duplicating an insurance payment.

Can a family member file a vaccine injury claim for someone who cannot file personally?

A parent or legal guardian may file for an eligible child or disabled adult. The legal representative of a deceased person’s estate may file an eligible death claim.

Can I report a vaccine reaction to VAERS and still pursue compensation?

Yes. Reporting an adverse event to VAERS is separate from seeking compensation through VICP or CICP. A VAERS report documents that an event was reported but does not establish that the vaccine caused it.

Understanding Your Vaccine Injury Options in New York

Sometimes the hardest part is figuring out where to start. You may have a diagnosis, medical records, and a clear memory of when you received the vaccine but still not know which compensation system applies.

Brandon J. Broderick, Attorney at Law can review the circumstances and help you understand the available legal route, its deadline, and the evidence that may be needed.

If you are unsure what options may be available, contact us today to schedule a free legal review.