IN the 1950s, polio was said to be "second only the atomic bomb" as the thing Americans dreaded the most.
Summer outbreaks of the viral infection left hundreds - mostly children - paralysed or dead, and many more disabled for life.
In 1952 alone, there were 58,000 new cases of polio and 3,000 deaths from the disease in the US.
Against this backdrop, a vaccine to prevent the disease was a holy grail for medical science.
The first - an inactivated polio vaccine - was invented by New York virologist Jonas Salk in 1953, turning him into an overnight celebrity.
A large-scale trial got underway in 1954, with initial positive results reported in April 1955.
Tragically, a few weeks later reports began to surface of children being paralysed after being vaccinated with batches from Cutter Laboratories, a family-owned pharmaceutical company in California.
The doses had contained a virulent live strain of poliovirus.
The 'Cutter Incident' ultimately caused 200 cases of paralysis and ten deaths, but these were not its only consequences.
Salk's vaccine was substituted for an oral, attenuated polio vaccine developed by his rival Albert Sabin, which ironically could be re-activated by passage through the gut.
This resulted in occasional cases of polio. As recently as the 1980s, six to eight children a year in the US were being paralysed by the vaccine before a modified Salk version was introduced.
However, the Cutter Incident also led for the first time to effective federal regulation of vaccines and, separately, to a court ruling that Cutter - though not found to be negligent in its production - was liable to pay compensation to the victims.
This opened the floodgates for financially crippling litigation and significant emotional burden for families still required to sue for damages.
Vaccines, despite their overwhelming safety and benefit, also became the first medical products almost eliminated by lawsuits.
This led the US, in 1986, to set up the National Vaccine Injury Compensation Program to protect vaccine manufacturers from litigation on a scale that threatened the continuing production of vaccines. The 'no fault' system can pay out up to $250,000 for disability or death.
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Which brings me to the UK's own equivalent, the Vaccine Damage Payment Act (VDPA), first introduced in 1979 amid unfounded public concerns about the new diphtheria, pertussis, and tetanus combination vaccine.
By May 2019, it had paid out £74.7 million in relation to 941 claims.
Recipients are awarded a one-off, tax-free lump sum of £120,000, but only if they have suffered "60 per cent disability" (this can be difficult to define but might be 60% loss of vision, severe narcolepsy or requiring their leg amputated below the knee).
There must of course be agreement that their injury was caused by the vaccine.
To be clear, this does not cover 'adverse events' reported through the yellow card scheme. Contrary to social media claims, the Covid-19 vaccines have not caused 460 deaths; only that 460 deaths were reported between December 9 and February 21 this year among people who had received the vaccine.
But this would cover everything from heart attacks and strokes, which happen routinely anyway, to someone hit by a bus two weeks after they were inoculated.
What we do know is that there have been 19 deaths in the UK and a further 60 people sickened by rare blood clots which are probably, but not definitely, linked to the AstraZeneca vaccine.
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Prior to the vaccine rollout, the UK Government added the Covid vaccines to the VDPA but took the unusual step of legislating to, in effect, grant pharmaceutical companies immunity from legal action.
Under normal circumstances, someone disabled by, for example, the flu vaccine could sue for higher damages if the £120,000 is insufficient for their injury. This option is now not available to those injured by Covid vaccines.
The Government argues this was necessary to encourage investment in vaccine development given the pandemic crisis, but critics question why - in the interests of fairness - the Government did not offer indemnity instead (meaning that the government’s insurers would cover the cost).
A second curiosity, given this week's publicity around the Neil Astles case, is what happens if someone dies? It is a question which has been raised by solicitor Peter Todd, who has decades of experience fighting for vaccine-related compensation for patients.
Seeking clarity from the Department for Work and Pensions this week he was told that it was "not as simple as saying death in itself constitutes 60% disability", even where causation is clearly established, and that a "key consideration" would be whether they were severely disabled prior to death.
Speaking to the Herald, Mr Todd, said: "I think the position is the DWP can make a payment if satisfied about causation. However, they seem to be reserving the right to refuse a claim if not satisfied on causation and the death was sudden [i.e.] no period of being severely disabled.
"This could apply to blot clot cases where the death is pretty immediate.
"I suspect however, in a case where causation is admitted, they may not dare refuse it on the grounds of the death [being] too sudden as this would be pretty shocking.
"Death is the ultimate disability."
In Japan, families receive 44,200,000 yen (£293,500) and 209,000 yen (£1,390) for funeral costs if their next of kin dies as a result of the Covid-19 vaccine. That seems fairer.
None of this is to detract from vaccines, which are among the safest medical products ever created and singularly responsible for saving millions of lives - from polio to Covid.
But capping compensation at £120,000 while, potentially, suggesting that death might not count seems at the very least misguided, if not outright unfair, when public trust is so vital.
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