COVID-19 vaccine claims scheme
The Australian Government is developing a claims scheme to reimburse people who suffer a moderate to significant impact following an adverse reaction to an approved COVID-19 vaccine.
About the scheme
Vaccination against COVID-19 is one of the most effective ways to reduce severe illness and death from infection.
There are 3 COVID-19 vaccines currently in use in Australia – Vaxzevria (AstraZeneca), Comirnaty (Pfizer), and Spikevax (Moderna). Like all medicines, vaccines can have side effects (also known as adverse events). Almost all of these are mild and resolve within a few days.
The Therapeutic Goods Administration (TGA) closely monitor adverse events for suspected side effects, and often find they are not caused by the vaccine itself.
The Australian Government is implementing a claims scheme for people who suffer a moderate to significant impact following an adverse reaction to a TGA approved COVID-19 vaccine.
The scheme will provide a simple, streamlined process to reimburse/compensate eligible people for their injuries without the need for complex legal proceedings.
The scheme will cover the costs of injuries $1,000 and above due to administration of a TGA approved COVID-19 vaccine or due to an adverse event that is considered to be caused by a COVID-19 vaccination. The list of adverse effects for claims purposes under the scheme include the following clinical conditions that are diagnosed by a treating doctors and are included in the approved product information for the specific vaccine:
- anaphylactic reaction
- thrombosis with Thrombocytopenia Syndrome
- capillary leak syndrome
- demyelinating disorders including Guillain Barre Syndrome (GBS)
- Thrombocytopenia, including immune Thrombocytopenia, identified as a final diagnosis.
Harm not covered by the scheme includes:
- psychological and psychiatric conditions (e.g. shock)
- secondary injuries (e.g. injury suffered when fainting, or a haematoma at the injection site that becomes infected)
- the following other injuries unless they form part of the symptom complex of a clinical condition listed above: headache; fatigue; injection site reaction; muscle or joint pain; dizziness; diarrhoea; pain in extremity; fever; insomnia; nausea; vomiting; lethargy; hyperhidrosis; chills; decreased appetite; malaise; lymphadenopathy; somnolence; abdominal pain; puritus; urticaria or rash; influenza-like illness; angioedema; anxiety-related reactions such as hyperventilation and fainting.
Specified Administration Related Injuries which are clinically diagnosed will also be covered under the scheme.
For claims between $1,000 and $20,000, claimants need to have been hospitalised for at least one night and provide applicable evidence of:
- the nature of the injury and medical documentation of its likely relationship to a COVID-19 vaccination
- hospitalisation, due to a vaccine-related injury
- medical costs
- lost wages.
The hospitalisation requirement may be waived if outpatient treatment is received and the COVID-19 vaccine recipient was not admitted to hospital, when they otherwise would have been, because:
- of the nature of their clinical condition; or
- the recipient was in a rural or remote area making it difficult to access a hospital.
The evidence requirements for claims $20,000 and over, including death, will shortly be advised as part of additional information to be published on the scheme in November 2021. Claims relating to a death will not require evidence of hospitalisation.
Register your interest in making a claim
If you consider you have been moderately to significantly impacted and may want to make a claim under the proposed scheme, let us know now.
The Australian Government is developing a portal to submit claims and documentation and will contact you once this has been established and you are able to submit a formal claim. You do not need to provide any evidence now, that will be needed later.
Once you register, we will tell you when and how you can submit a claim online when the application process is open.
You will need to:
- meet the relevant criteria
- provide evidence to support your claim.
Registering your interest in the scheme does not mean that a claim that is subsequently submitted will be successful.