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President clinton’s fiscal 1998 budget, which was not declared "dead on arrival" by the Congress, recommends the adoption of a flat excise tax of $.51/dose on all vaccines currently recommended for school entry. This is a significant tax decrease because since October 1, 1988, federal excise taxes have been imposed to cover the awards paid from the Vaccine Injury Compensation Trust Fund on the following vaccines: DPT or any Pertussis containing combination: $4.56/dose; D or T: $0.06/per dose; MMR, MM, MR, M, or R: $4.44/per dose; and Polio: $0.29/per dose.
Because most of the cases of post-vaccine related injury covered under the eight year retroactivity clause of the Vaccine Compensation Law (PL-103-66) have been adjudicated, it has been determined that the Trust Fund can remain self-sustaining on a lower excise tax base. Excise taxes currently are passed on to the purchasers (including state governments) by the manufacturers; the manufacturers, in turn, submit these taxes to the Trust Fund.
On February 20, 1997, the Secretary of DHHS, issued the final rule on the National Vaccine Injury Compensation Program which incorporated three new vaccines: hepatitis B, Hemophilus influenza b, and varicella. Congressional action is needed both to reduce the excise taxes on the previous vaccines and to add the tax to the more newly approved vaccines. Considering the current congressional zeal to cut taxes, this action seems very likely to occur. Physicians should keep their eyes on vaccine costs, and insist that the saving should be passed on to the consumer.
The Vaccine Injury Compensation Program is the first federally-enacted no-fault system. This initiative was championed by the American Academy of Pediatrics. By all accounts, this has been very successful. To date, 2242 awards (out of 5093 filed petitions) have been paid to families and no physicians have been sued. (Department of Government Liaison, American Academy of Pediatrics, Washington, DC.)