In Reply.—The author did not wish to respond. I have a great deal of interest in this area, however, and thought that a response to Dr Lokietz' letter was important.
I do not agree with his assessment of the National Vaccine Compensation Program and its implementation. Having participated in the defense of physicians and others in vaccine-related litigation, I can attest to the harm that the tort-system handling of these claims has for everyone concerned. In my view, substitution of the compensation method for adjudicating claims of vaccine-induced injuries is a far better method than the adversarial legal method.
Initially, an agreement on what would be included in the Vaccine Injury Table,1 which is the source for determining the applicability of a given claim, was the only way that the system could work. That the table will need refinement in the future is clear. That not everyone accepts
FULGINITI VA. Diphtheria and Tetanus Toxoids and Pertussis Vaccine Litigation-Reply. Am J Dis Child. 1991;145(4):425. doi:10.1001/archpedi.1991.02160040081006