Only a fraction of claims through the coronavirus vaccine injury scheme have been finalised, raising concerns the process may be inaccessible for some genuine claimants.
Of the 3071 claims received by November 9 — 11 months since the scheme was established — only 263 had been determined as payable or not payable, while 1471 applications were waiting on additional information from applicants and 166 were subsequently withdrawn.
The COVID-19 Vaccine Claims Scheme, administered by Services Australia, covers losses or expenses of $1000 and above related to injury resulting in hospitalisation or death from specified reactions to the COVID-19 vaccine.
Earlier this year, Government Services Minister Bill Shorten said the small number of approvals demonstrated the vaccines were overwhelmingly safe.
But, while the vast majority of Australia’s 64 million COVID-19 vaccinations were without incident – the Therapeutic Goods Administration has received reports of 9300 reactions associated with a hospital admission, and stressed this did not mean the vaccine caused the admission – some people who experienced a severe reaction have struggled to claim under the scheme.
Sandra Byron, 59, experienced severe symptoms later diagnosed as Guillain-Barre syndrome and capillary leak syndrome after her first AstraZeneca vaccine in May 2021 and is now housebound with chronic pain and unable to work.
Her husband and now full-time carer, Ashley Russell, emphasised the Sydney family was not against vaccination but believed the claim scheme was a poor fit for exhausted patients with piecemeal medical documentation.
Byron was taken by ambulance to Hornsby Hospital four weeks after her shot with body numbness and swelling. Correspondence from the hospital confirmed her “serious systemic adverse reaction to the AstraZeneca vaccine in the days to weeks after her first dose” had been logged with NSW Health.
Yet her scheme claim, completed by her GP 10 months ago, was returned because it required reports from a neurologist and a haematologist, neither of whom she had seen while in hospital.
After the specialists confirmed it was “likely that she suffered a mild attack of Guillain-Barre syndrome … still has significant ongoing disabilities” and had “clinical features consistent with capillary leak syndrome”, her claim was rejected.
“It’s really humiliating and degrading, having the claim be picked apart by unidentified people who’ve never seen me,” Byron said.
The couple have since spent thousands of dollars seeing additional specialists, including other haematologists and neurologists, as well as a psychologist who assessed Byron as having “extremely severe” depression, to resubmit.
Sydney haematologist Associate Professor Nada Hamad said she had expected stories like Byron’s related to lesser-known vaccine side effects ever since the federal government first announced the compensation scheme.
“Diagnosis was very difficult to make at the time, and there was very little in terms of follow-up of these patients,” she said, adding it was hard to diagnose these reactions after the fact.
“If a patient comes to me, and I have access to the bloods and platelet counts done at the time, and detailed observations in medical records, I can come up with a report saying ‘it is very plausible that …’, but you are cobbling the story together.”
An opinion written in September by the doctor who saw Byron in hospital the previous year, which this masthead has verified with the doctor, stressed “we ought to bear in mind … at the time we were less aware [of] potential vaccine side effects”.
Associate Professor Vivien Chen, from the Thrombosis & Haemostasis society of Australia and New Zealand, said public awareness of thrombosis with thrombocytopenia syndrome following the AstraZeneca vaccine meant those cases would likely already have relevant documentation.
“We definitely tested more people for it than had it,” she said, adding people with the condition were referred to hospital.
Seventy-five claims totalling $3.8 million have been paid under the scheme. The maximum payout is $70,680, paid to estates of the deceased. Fourteen people have died due to COVID-19 vaccination in Australia, 13 after receiving an AstraZeneca shot.
Questions sent to Shorten’s office were answered by the federal Department of Health.
Asked whether the scheme was inaccessible, a spokesperson for the department said the scheme had been developed in consultation with “a range of stakeholders … including the Australian Medical Association and other peak bodies”.
They added the information required would “usually be able to be evidenced from routine hospital discharge summaries or treatingspecialist practitioners’ consultation letters sent back to the [patient’s] regular medical practitioner” and the form could be completed by the patients’ regular medical practitioner.
They said the federal government “recognises adverse reactions, while rare, can be severe and emotionally distressing for patients” but it was appropriate to require claimants to submit evidence demonstrating their condition to receive taxpayer-funded compensation.
The scheme will close in April 2024.