Wed, December 01, 2021

in-focus

Fairness and peoples safety: Our priority in the Covid-19 vaccination programme


Along with the international community, Thailand is implementing a mass vaccination programme to create herd immunity and end the Covid-19 pandemic.

The programme's success depends mainly on the speed of vaccine distribution and the assurance of people's safety after the vaccination. All vaccines are authorised for emergency use only. There is a chance that some vaccine recipients may experience adverse events.

To protect them from adverse effects after the vaccination, on May 3, the National Health Security Board introduced a no-fault compensation programme for individuals who find undesired outcomes after the vaccination.

Not only 49 million people whose health is insured under the Universal Coverage Scheme (UCS) will benefit from this programme, but another 17 million people from the Social Security Scheme and Civil Servant Medical Benefits Scheme will also be compensated for adverse events.

This covers everyone who receives the Covid-19 vaccine administered under the government's national vaccination programme. However, those who have vaccinations provided by a private party aren't entitled to compensation.

It will not just bring the people's confidence in the Thai government's vaccination campaign, it will also protect their healthcare rights from the uncertainty of the pandemic.

The no-fault compensation programme for Covid-19 vaccination is the first and only national-level programme of its kind ever implemented in Thailand.

This same approach is also implemented globally. For example, in February, the World Health Organisation (WHO) announced a programme to compensate eligible individuals in 92 low- and middle-income countries for finding adverse effects after receiving Covax-distributed vaccines.

Thailand is among 25 member states of WHO that implements a no-fault compensation programme for medical errors, even before the arrival of the Covid-19 pandemic.

But only UCS beneficiaries benefit from the existing programme initiated by the NHSO. The programme was introduced by doctors, patient groups, and policymakers who understand the hardship of patients when medical errors happen.

Most of the victims stay silent, because they don't want to have a conflict with physicians and medical staff or because they can't afford to file lawsuits against doctors. The suits can take years to settle. The damages of medical errors on the patients, physically and mentally, can worsen during those years.

Therefore, a no-fault compensation programme was introduced and backed up by Section 41 of the National Health Security Act, to ensure that patients will receive quick and fair compensations when they experience medical errors. It also provides a channel for claiming compensation through the NHSO's sub-committee instituted in its 13 regional offices.

As much as giving a challenge, the Covid-19 vaccination programme also shows the Thai government the opportunity to expand the no-fault compensation programme to a national level.

As the NHSO has many years of experience running such a programme, it is assigned to lead this new national move.

We have issued the guideline and criteria for paying preliminary financial compensation to Covid-19 vaccine recipients suffering side effects. They can submit their complaints at every public hospital, Provincial Public Health Office, and the NHSO's Regional Office within two years from the day the side effects are detected.

The NHSO has also tasked its existing regional sub-committee to handle these complaints by examining and deciding on the compensation requests. The compensation will be paid within five days after the subcommittee’s approval.

A maximum of 400,000 baht will be paid in compensation for a death, a permanent and severe disability, or a chronic disease requiring treatment for the rest of the patient's life that occurs after the Covid-19 vaccination. A maximum of 240,000 baht will be paid in compensation for loss of organs or a disability and no more than 100,000 baht for less serious chronic injuries or illnesses.

At the end of May, around 260 complaints were submitted to the NHSO, six of which were deaths. The most common side effects of the vaccination are numbness and fever. More than 160 cases have been compensated so far. The rest are under the subcommittee's scrutiny.

To bring more confidence to the Covid-19 vaccination campaign, the NHS board has recently introduced laboratory testing and medication for treating Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT) in the UCS benefits package.

VITT is a prothrombotic syndrome observed in a small number of people who received adenoviral vector-based vaccines. The exact incidence of VITT appears to be rare. However, the symptoms may show up in individuals within four to 30 days after vaccination.

The NHSO will keep monitoring adverse events of the Covid-19 vaccination closely. If any new studies concerning the negative effects arise, we may consider implementing a new programme or a provision.

Fairness and people's safety are our priority.

Published : June 18, 2021

By : Jadej Thammathat-Aree National Health Security Office (NHSO), secretary-general