The tetanus vaccine is considered so vital that 576 million doses containing it (often along with diphtheria and pertussis) were administered from 2006 through 2017 — and 719 injury claims related to it were compensated, the data shows.

Getting tetanus can be devastating, as a 2017 case in Oregon showed. According to a C.D.C. report on that case, a 6-year-old boy who had not been vaccinated developed tetanus from a cut on the forehead and required 57 days in the hospital. For much of that time, he was in so much pain from muscle spasms that he had to be kept in a darkened room, wearing ear plugs. His care cost more than $800,000. The cost for a five-dose regimen of the tetanus vaccine, which would have prevented his suffering, is about $150 .

In very rare circumstances, vaccines can cause death. A person can go into anaphylactic shock or have a fatal case of Guillain-Barré syndrome. Since 1988, more than half of the 1,300 claims of death were dismissed because the program found insufficient evidence that the vaccine was responsible.

About 90 of the 520 death claims that were compensated involved the flu shot. Nearly half of compensated death claims involved DTP, an early vaccine against diphtheria, tetanus and pertussis (also called whooping cough). The pertussis formulation, known as whole-cell, was replaced in the 1990s with acellular versions contained in the current DTaP and Tdap vaccines.

The vaccine compensation program was created because a flood of lawsuits, especially ones involving DTP, was prompting pharmaceutical companies to abandon the vaccine business. Public health officials and Congress worried there would not be enough manufacturers providing crucial vaccines.

A 1986 law established the compensation fund, financed by a tax paid by vaccine manufacturers of 75 cents per dose . The law acts as a liability shield for drug companies: People claiming injury are required to seek redress first with the vaccine program in the United States Court of Federal Claims and with the Department of Health and Human Services before they can sue a manufacturer.

There is a backlog of about 2,800 cases that need to be resolved, a process that takes an average of two to three years.