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根据2005年国务院《疫苗流通和预防接种管理条例》的要求,全国(未包括香港、澳门特别行政区和台湾地区,下同)所有的省、自治区、直辖市和新疆生产建设兵团已公开发布相应的补偿办法,对预防接种异常反应给予一次性补偿。其中,补偿测算方法和补偿额度是政府、疫苗生产企业、疫苗受种方等各方关注的核心问题。本研究比较分析了各省份的预防接种异常反应补偿测算方法,并计算了各省份各类损伤的补偿额度。2014年1岁以内婴儿死亡补偿金、残疾生活补助费、其他损伤费用补偿的最高额度中位数分别为28.2万元、5.1万元~46.2万元和2.3万元。研究发现省际间异常反应补偿额度差异过大、同类损伤补偿费用种类不一、补偿费用测算弹性过大、补偿申请与审核程序复杂等问题。建议各省份逐步向总体费用补偿的方向发展,逐步平衡或统一不同省份同一类型损伤的补偿费用类别,进一步明晰测算指标和测算方法,并简化补偿申请手续。对不足以证实或排除的预防接种异常反应,可采取“疑点利益归属于受害人”的原则给予一定补偿。建议国家层面可考虑计算补偿资金需求,针对多方来源进行补偿专项筹资,以对各省份提供支持,推动补偿制度的发展完善和预防接种异常反应风险管理。
According to the State Council’s Regulation on the Regulation of Vaccine Distribution and Vaccination in 2005, all provinces, autonomous regions, municipalities directly under the Central Government and Xinjiang Production and Construction Corps across the country (excluding Hong Kong, Macao Special Administrative Region and Taiwan, the same below) have publicly released the corresponding compensation Approach, give a one-time compensation for the abnormal response to vaccination. Among them, the calculation of compensation method and the amount of compensation are the core issues of concern to all parties, including governments, vaccine manufacturers and vaccines. This study comparatively analyzed the method of calculating the compensation for abnormal response of vaccination in all provinces, and calculated the compensation amount of each kind of injury in each province. In 2014, the median of the maximum amount of compensation for infant death, disability life allowance and other injury expenses within 1 year of age was 282,000 yuan, 51,000 yuan to 462,000 yuan and 23,000 yuan respectively. The study found that there are many problems such as the large differences in compensation rates for anomalous reactions across provinces, the different types of compensation fees for similar injuries, the excessively flexible compensation calculation and the complicated application procedures for compensation and examination. It is suggested that the provinces gradually develop compensation to the overall cost and gradually balance or unify the types of compensation fees for the same type of injury in different provinces so as to further clarify the measurement indexes and calculation methods and simplify the application procedures for compensation. For those who do not have enough evidence to confirm or exclude the abnormal vaccination response, some compensation may be given based on the principle that “doubtful interests belong to the victim”. It is suggested that the national level should consider calculating the demand for compensation funds, providing specific funding for various sources of compensation so as to provide support to all provinces, promoting the development of a compensation system and risk management of abnormal responses to vaccination.