Medical-legal aspects of immunization. Policy and practices

The experience in the United States with the vaccine liability crisis demonstrates the vulnerability of public health policy and practice standards to independent developments in the legal arena. Scientific progress in the fields of immunology and molecular biology offer promise for the control of an increasing number of communicable diseases through immunization. Legal protections for pharmaceutical laboratories, manufacturers, and providers are appropriate incentives to continued development, supply, and administration of effective, affordable vaccines. At the same time, potential recourse to litigation in the courts in the event of vaccine-related injury provides society with desirable assurances of enforceable industrial and professional standards, as well as financial support for those who sustain serious adverse reactions to licensed vaccines. The National Childhood Vaccine Injury Act of 1986 is an attempt to construct an equitable solution to this dilemma. Interested physicians and lawyers will have a role to play in the search for an appropriate balance between these important but competing values. Progress in science and the law in the field of public health generally, and vaccine development specifically, should be a collaborative enterprise. Familiarity with, and respect for, the basic principles and theories of both fields will be essential to this endeavor.