Changes made to COVID Vaccine Claims Scheme

Filip Vukasin

6/04/2023 5:31:25 PM

The Department of Health and Aged Care has removed and added certain conditions that can be claimed in relation to COVID vaccine adverse reactions.

Man with potential vaccine injury
The COVID-19 Vaccine Claims Scheme had received a total of 3071 claims by November 2022.

The Vaccine Claims Scheme (VCS) has been updated by the Department of Health and Aged Care (DoH).
Established in 2021, the VCS was implemented to cover losses or expenses over $1000 for people who suffer moderate-to-severe impact following an adverse reaction to Therapeutic Goods Administration-approved COVID vaccines.
Earlier this week on 3 April, the DoH added the following conditions to the VCS: 

  • Transverse myelitis (AstraZeneca)
  • Cerebral venous sinus thrombosis without thrombocytopaenia (AstraZeneca)
  • Erythema multiforme – major (Moderna and Pfizer).
Myocarditis and pericarditis have also been added as claimable clinical conditions for the Novavax vaccine.
A DoH spokesperson told newsGP all new claimable clinical conditions have been added to the COVID Vaccine Claims Scheme based on advice from the Therapeutic Goods Administration (TGA).
‘The changes to clinical conditions and vaccines accepted under the scheme can be claimed retrospectively in respect of eligible conditions arising from vaccines administered from the start of the vaccine rollout on 22 February 2021,’ they said.
‘We will continue to proactively respond to the available medical evidence regarding serious adverse events linked to COVID-19 vaccines.’
As a result, new clinical conditions may be added to the scheme in future.
Meanwhile, the DoH has also made a clarification to the treatment of demyelinating disorders, particularly noting that Guillain Barre Syndrome and Transverse Myelitis are covered for AstraZeneca. However, other demyelinating disorders are no longer eligible.
Claims already submitted for these conditions prior to 3 April will continue to be assessed.

A spokesperson for MDA National told newsGP they are communicating these changes with their members.
‘[Doctors] may advise their patients who present with the listed conditions, potentially linked to a COVID-19 vaccination, about the support they can seek from the Australian Government,’ they said.
‘We are unable to provide information around our experience with doctors or claimants around the scheme as this is commercial in confidence.
‘For any GPs requiring advice, we would always recommend contacting their relevant medical defence organisation.’
Up to November 2022, the DoH had received 3071 claims through the scheme with only 263 determined as payable or not payable, while 1471 applications were waiting on additional information and 166 had been withdrawn.
According to the most recent TGA vaccine safety report, from the more than 65.3 million COVID vaccine doses administered up to 19 March 2023, 137,970 adverse events had been reported.
Pfizer has had the most reports (81,298) followed by AstraZeneca (48,721) and Moderna (7477).
The full list of clinical conditions that are applicable under the Vaccine Claims Scheme are:
  • anaphylaxis (AstraZeneca, Pfizer, Moderna, Novavax)
  • thrombosis with thrombocytopaenia syndrome (AstraZeneca)
  • myocarditis (Pfizer, Moderna, Novavax)
  • pericarditis (Pfizer, Moderna, Novavax)
  • capillary leak syndrome (AstraZeneca)
  • Guillain Barre syndrome (AstraZeneca)
  • thrombocytopaenia, including immune thrombocytopaenia, identified as a final diagnosis (AstraZeneca)
  • erythema multiforme – major (Moderna, Pfizer)
  • central venous sinus thrombosis without thrombocytopenia (AstraZeneca)
  • transverse myelitis (AstraZeneca)
Other harms related to the administration of COVID vaccines include:
  • shoulder injury
  • other moderate-to-significant physical injury giving rise to permanent impairment or the need for an extended period of medical treatment.
The entire Vaccine Claims Scheme document and responses to Frequently Asked Questions can be found on the DoH website.
Applications to the Vaccine Claims Scheme can be made on the Services Australia website.
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