Exclusive: Vaccination claims 'to follow US growth trends'

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Exclusive: Vaccination claims 'to follow US growth trends'

The Pharmacists’ Defence Association has told Pharmacy Magazine it expects civil claims against pharmacists relating to vaccination administration to follow a “very similar” growth trend to the US, where it says claims have risen consistently since the 90s.

Speaking at the PDA national conference on March 30, chairman Mark Koziol said there was a growing trend in the UK of patients bringing claims against pharmacists over vaccination administration.

When Pharmacy Magazine recently asked for more information, a PDA spokesperson explained that cases the organisation has dealt with have fallen into a number of categories, including poor injection technique, use of contaminated needles and injection into wrong part of the body (see full list below).

Cases that involve allegations of long-term damage or of livelihoods being affected are “particularly problematic from a claims and regulatory point of view,” the spokesperson said.

They said that “a number of claims” have related to a condition known as SIRVA (shoulder injury related to vaccine administration) caused by vaccines being mistakenly injected into the shoulder joint or bursa.

‘Several cases coming in simultaneously’

The spokesperson told Pharmacy Magazine the first case the PDA had dealt with was in 2012 and had to do with a claim that a flu vaccination had caused keloid scarring.

They declined to say exactly how many cases the organisation had dealt with as this was “information that we feel would be too sensitive,” but commented: “A few years ago, when the [flu] vaccination service started we might have been dealing with just one or two claims per year – we now have several all coming in simultaneously and this is a trend that is increasing. In the last month for example [speaking at the end of April 2019], we have had two more claims notified to us.”

While vaccination claims form a small proportion of the PDA’s overall casework, it expects the current growth trend to continue.

Pharmacists in the UK are "not currently providing vaccinations on anything like the scale that occurs in the US,” where pharmacists began providing immunisations in 1996, the spokesperson said, adding that because of the difference in population size claims are unlikely to ever reach the volume seen in America.

However, “We expect the growth profile of claims increases to be very similar; this has, after all, been seen in civil claims generally”.

The PDA has “supported a number of pharmacists involved in vaccination-associated errors through GPhC investigation processes,” although none of these cases had progressed to a Fitness to Practise hearing, they said.

Meanwhile, the GPhC told Pharmacy Magazine that due to the way it records the concerns it receives, and because cases “can be complex and multi-faceted,” it is not possible to say whether it has dealt with more concerns of this nature in recent years.

“Keep detailed records”

When asked what advice the PDA had for pharmacists concerned about civil claims, the spokesperson recommended keeping records of vaccinations provided and documenting any unusual circumstances.

They added: “Unlike a dispensing error, there is no potential to recover the erroneously administered vaccine once injected, so pharmacists should be extra vigilant when verifying the vaccination is the correct one for the patient and is in date.”

Pharmacists whose employers ask them to write a report of an alleged incident “are likely to need advice on how best to do this,” the spokesperson said, recommending that anyone involved in an incident seek advice “without delay”.

Some of the allegations seen in the PDA’s vaccination casework

  • Poor injection technique leading to temporary or longer-term damage
  • Needle stick incidents where a patient may have been injected with a contaminated needle
  • Injection into the wrong part of the body
  • Erroneous intra articular administration
  • Wrong vaccine administered completely
  • Wrong strain of vaccine used
  • Failure to follow a PGD
  • Administration outside of the PGD
  • Cold chain failures
  • Local reactions to the injection
  • Poor record keeping
  • Providing a vaccination service without the required accreditation.

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