U.S. Health Secretary Robert F. Kennedy Jr. is preparing a rulemaking, expected in November 2026, that would create a formal injury table for COVID-19 vaccines and establish a presumption of causation for listed conditions occurring within defined time windows after vaccination. The move would reshape how the federal government compensates people harmed by the shots under the Countermeasures Injury Compensation Program (CICP), which has paid only 60 claims to date. A public comment period is expected to extend into early 2027 before any final rule takes effect.
How would the proposed injury table work?
An injury table would establish a presumption of causation for listed conditions occurring within specific time frames after vaccination. Claimants with qualifying injuries would not need to prove causation from scratch. The approach mirrors the National Vaccine Injury Compensation Program (VICP), which has applied a similar structure to routine childhood vaccines for decades.
According to HHS guidance, each listed injury would need to be supported by compelling, reliable, valid medical and scientific evidence linking it to the vaccine.
Why is myocarditis expected to be a focus?
Legal analysts 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 in the proposed table. Federal health agencies have already acknowledged the association between mRNA vaccines and myocarditis and pericarditis.
A June 2025 FDA safety communication required updated warnings on Pfizer and Moderna vaccine labels regarding myocarditis and pericarditis risks. FDA 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 to 2024 formula.
A longitudinal study published in September 2024 followed approximately 300 people who developed myocarditis after mRNA COVID-19 vaccination. Cardiac MRI abnormalities persisted at a five-month follow-up in many patients, though the clinical significance of those findings remains unknown.
What are the limits of the current compensation system?
COVID-19 vaccine injury claims currently go through the Countermeasures Injury Compensation Program (CICP), established under the PREP Act. The program has paid only 60 claims in 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.
COVID-19 vaccines were excluded from the VICP, which Congress created in 1986 to cover routine childhood vaccines while protecting manufacturers from excessive litigation. Claimants under CICP face stricter standards, lower compensation rates, and limited appeal opportunities compared to the traditional VICP pathway.
More than 1.5 million adverse event reports filed with the Vaccine Adverse Event Reporting System (VAERS) do not qualify for compensation, because CICP covers only deaths and injuries meeting the government’s definition of serious physical injury.
What is the legal and legislative background?
The PREP Act, enacted in 2005, required HHS to create a Countermeasures Injury Table for public health emergencies. The agency never implemented one for COVID-19. A lawsuit filed in May 2026 by attorney Ray Flores compelled HHS to fulfill that obligation.
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 and Johnson vaccine.
What concerns remain about funding and scope?
Researcher Wayne Rohde, author of two books on federal vaccine injury compensation, raised concerns that Congress may fail to allocate the estimated $3 billion needed to compensate vaccine-injured individuals. He warned that inaction during the current pandemic would worsen outcomes in future health emergencies.
Attorney Chad Davenport called the proposal a fantastic start, expressing hope that it would lead to expanded 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.
What happens next?
If implemented, the table would shift the burden of proof from claimants to the government for listed injuries, offering a more efficient compensation path than the current framework. Significant questions remain about funding, congressional action, and which specific injuries will ultimately appear on the list. For the thousands who have filed VAERS reports and the tens of thousands who have experienced serious adverse events, the November proposal represents a long-overdue opportunity to test whether the federal system can deliver on its commitment to those harmed during a public health emergency.
FAQ
When will HHS release its proposed COVID-19 vaccine injury table?
The proposal is expected in November 2026, with a public comment period extending into early 2027 before any final rule takes effect.
How would the injury table change compensation for COVID-19 vaccine claims?
It would create a presumption of causation for listed injuries occurring within defined time windows after vaccination, shifting the burden of proof from claimants to the government and mirroring the structure of the VICP.
Why has the CICP drawn criticism from claimants and attorneys?
The CICP has paid only 60 claims with a median award of $4,300, applies stricter standards than the VICP, and excludes the more than 1.5 million adverse event reports filed with VAERS, prompting attorney Ray Flores to call it a black hole for injured individuals.
