AVAT Covid Vaccine NFCS
Introduction
AVAT NFCS is a multi-jurisdiction compensation scheme for COVID-19 vaccine injuries received in any of the participating African Union (AU) or CARICOM States from vaccines deliver through the African Vaccine Acquisition Trust (AVAT) framework.
AVAT Countries:
AU States - Benin, Botswana, Burkina Faso, Cameroon, Central African Republic, Cote d’Ivoire, Dem. Rep. of Congo (DRC), Egypt, Eswatini, Gabon, Gambia, Ghana. Guinea, The Republic of, Guinea-Bissau, Kenya, Lesotho, Malawi, Mauritania, Mauritius, Mozambique, Namibia, Rwanda, São Tomé & Principe, Sierra Leone, Sudan, Togo, Tunisia, Uganda, Zambia, Zimbabwe
CARICOM States - Antigua & Barbuda, Belize, Guyana, Jamaica, Trinidad & Tobago
This scheme is a non-statutory scheme, governed by a Program Protocol.
It is administered by ESIS, Inc., who are a private body (private provider of managed claim services).
The funding for the scheme comes from financial reserves established out of an ad hoc fund based on a per dose levy charged on each covered vaccine procured or made available through the AVAT Facility for use in participating member States.
Vaccines Covered
This NFCS covers COVID-19 vaccines received in any Participating Member State through AVAT framework that:-
i) ‘either (A) has licensure or authorization from a stringent (“functional”) regulatory authority or (B) has received WHO prequalification, following licensure or authorization from a stringent (“functional”) regulatory authority, or (C) has been issued authorization for emergency use based on licensure or authorization by a stringent (“functional”) regulatory authority; and
ii) is included in Schedule 1, as updated from time to time; and
iii) has received all required approvals and authorizations for importation, distribution and use in the relevant Participating Member State; and
iv) has not reached its Scope of Coverage Endpoint.
As at February 2023 Schedule 1 includes just one vaccine, the Janssen Pharmaceutica NV vaccine.
For the Scope of Coverage endpoint see the Time Limits section below.
Injuries Covered
This NFCS only covers permanent injuries.
Under this NFCS only eligible injuries are covered. Eligible injuries are serious bodily injuries or illness that require hospitalisation and result in permanent total or partial impairment; or congenital birth injury resulting in permanent total or partial impairment; or injuries/illness resulting in death.
Charges for making a claim
There is no charge for making a claim under this scheme.
Claimants
Under this scheme the following categories of individuals are permitted to make a claim.
- Vaccine recipients (see the definition of Claimant in the Program Protocol)
- an individual who is duly authorized to represent the vaccine recipient, in the event the vaccine recipient is a child, or is disabled or otherwise lacks the legal capacity to submit an Application for himself
- a duly authorised legal heir if the vaccine recipient has died
The Patient needs to have sustained an Injury which, ‘in the opinion of a Registered Health Professional, is deemed to have resulted from a Vaccine or its administration’.
Under this scheme the claimant is allowed to nominate a legal representative to make their claim.
It is not known whether funding for legal representation is provided by the scheme.
Losses covered
This scheme pays the following
| Live Vaccine Recipient | Dependants of Vaccine Recipient | Legal Heir of a Deceased Vaccine Recipient |
|
Compensation payments are for general categories and are not broken down into economic and non-economic losses. |
No Compensation is provided specifically for Dependants | Compensation payments are for general categories and are not broken down into economic and non-economic losses. |
Payments consist of a lump sum payment
It is not specified in the Program Protocol whether Funeral expenses are available under this NFCS.
Compensation under this scheme calculated on an individual basis using tariffs/guidelines to assist with quantification.
The amount that can be paid under this NFCS depends on the GDP per capita of the relevant country and the specific harm factor linked to the injury suffered by the vaccinee (GDP per capita of relevant country x 12 x harm factor) (see Program Protocol 9.a).
The following harm factors are specified in the Protocol:-
| Harm Factor | Impairment following vaccination |
| 1.0 | Death |
| 1.5 | Impairment equal to or greater than 75% |
| 1.0 | Impairment equal to or greater than 50% but below 75% |
| 0.5 | Impairment equal to or greater than 25% but below 50% |
| 0.25 | Impairment equal to or greater than 10% but below 25% |
| 0.1 | Impairment below 10% |
| 1.5 | Congenital injury/illness causing Impairment equal to or greater than 75% |
| 1.0 | Congenital injury/illness causing Impairment equal to or greater than 50% but below 75% |
| 0.5 | Congenital injury/illness causing Impairment equal to or greater than 25% but below 50% |
| 0.25 | Congenital injury/illness causing Impairment equal to or greater than 10% but below 25% |
| 0.1 | Congenital injury/illness causing Impairment below 10% |
Hospital payments of $100/day can also be awarded for a maximum of 60 days.
Time limits for claims
The scheme does not set a time limit between vaccination and the adverse event occurring. There is a minimum of 30 days between vaccination and making a claim, but no waiting time if the vaccinee is deceased.
Vaccine Administration. To be eligible for compensation the vaccine must have been administered before the ‘Scope of Coverage Endpoint’. The 'Scope of Coverage Endpoint' is listed in Schedule 1 for each Vaccine; it is the date which is 36 months after the date on which a Vaccine was first put into circulation by the manufacturer within the AVAT Framework.
Reporting a Claim. To be eligible under the scheme a claim must also be brought within the ‘Reporting Period’ for that vaccine. The Reporting Period starts from the date on which the vaccine was first put into circulation by the manufacturer and terminates 36 calendar months after the 'Scope of Coverage Endpoint' listed in Schedule 1.
Schedule 7 Provides a schematic of the time limits for making a claim.
Evaluating claims – standard of proof required
The standard of proof required by the scheme is the 'most probable cause': the most likely cause (based on the balance of probabilities) that a vaccine or its administration resulted in a claimed Injury.
Claims are reviewed by a review panel of at least 5 nurses. Their work is informed by a Scientific Advisory Committee. This is an expert panel who review the evolving literature and provide the Administrator, Review Panel and Appeals Panel with advice to guide the claims determination process, including, but not limited to, advice on which, if any, types of injuries that manifest after vaccination are likely to have been caused by a Vaccine and the characteristics of those injuries.
Appeals and the right to litigate
Use of the scheme and litigation are mutually exclusive and a claimant must choose which one they take. By making a claim under the NFCS a claimant agrees not to make any other claim for compensation for the injury while their application is pending with the NFCS.
In the Protocol under the definition of ‘claimant’ it states that claimant may not use this NFCS if they have a pending lawsuit or if they have received any prior payment from any other source, including, court awards, settlements and insurance payments, as compensation for the Injury. If a claimant is eligible for compensation for the injury from other source(s) they are required to disclose the nature and extent of their eligibility.
There is an internal appeals process where the NFCS itself reviews the decision. A claimant can file a Notice of Appeal and the claim is then examined by a three-person Appeals Panel consisting of 2 doctors and a nurse who determine whether the denial of the claim should be upheld or reversed.
Useful information and links
It is not known whether the scheme produces an annual report including data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc).
Link of the scheme website: Home - AVAT No-Fault Compensation Scheme (avatclaims.com)
AVAT Compensation Program Protocol
Schedule 1 - AVAT Compensation Program Vaccine List
Schedule 7 - AVAT Compensation Program Illustrative Diagram of the Reporting Period