Ringing Out 2025: Battered, But Still Standing
A New Year's Eve dispatch from the nail salon — and a moment to catch our breath
What a year it’s been.
Public health is looking like Rocky Balboa at the end of, well, any of the Rocky movies. Bloodied, battered, eye swollen shut — but still standing. Still fighting.
I considered writing a comprehensive summary of everything that’s happened this year. I started an outline, and it was daunting. It was also, frankly, depressing. So instead, I’ll close out 2025 with a small moment of relief — and a reminder of what we’re still fighting for…
On Monday, the Advisory Commission on Childhood Vaccines (ACCV) met. If you haven’t heard of the ACCV, you’re not alone. It’s a functionally obscure commission housed within Health and Human Services, but it plays a critical role: advising on the National Vaccine Injury Compensation Program (VICP) — including what injuries are on the Vaccine Injury Table, which determines what’s eligible for compensation.
Many of us were quite concerned about what this meeting would hold. Could this be a sneaky, end-of-year attempt to upend the VICP? As we wrote last week, the timing of a holiday meeting raised eyebrows. The ACCV is required by charter to meet four times per year, and this was their first meeting of 2025.
Luckily, the meeting was mostly uneventful.
Delightfully so.
This appeared to be a pro forma check-the-box exercise to meet the four-meetings-per-year requirement. All four “meetings” were crammed into a couple of hours, each announced separately as the 132nd through 135th meeting of the ACCV — distinguished only by a meeting administrator saying, “We will end this recording and start another.” Otherwise, it was essentially a single meeting.
The agenda was posted the morning of. Several of us anxiously messaged each other when it went live, scouring it for any signs of VICP demolition. But no — tame. Career public health folks gave presentations (many of which focused on the history of VICP). It felt like business as usual— a much-welcomed departure from the ACIP rollercoaster. If ACIP has been a stomach-churning ride, this was Dramamine in the best way possible.
I tuned into the meeting while getting my end-of-year mani-pedi. I listened to the ACCV members introduce themselves while I picked out a sparkly polish for my toes. I got a new phone and hadn’t brought the right headphones—the ones with the adapter that fits my phone’s port—so I kept the volume low and propped the phone up against my ear with my bra strap.
The whole scene felt emblematic of a chaotic year. Here I was, tracking federal vaccine policy while getting my nails done, jury-rigging a solution to a problem I hadn’t anticipated. Meanwhile, the nail salon banter around me centered on canceled holiday plans due to the flu or COVID, and where to buy the best face masks. Seems I can’t escape public health anywhere I go!
While mostly uneventful, a couple of things stood out.
One of the public comments came from a parent who said his child experienced neurological changes after receiving the MMRV vaccine. He said his VICP claim had not been successful, in part because of the longstanding scientific and medical consensus that vaccines do not cause autism.
But then he pointed to the change in the HHS website language in November — the one that seemingly opened the door to the possibility that vaccines could cause autism. The new language says “the claim ‘vaccines do not cause autism’ is not an evidence-based claim because studies have not ruled out the possibility that infant vaccines cause autism.”
“Why should I have to prove to the VICP what the CDC and HHS now say can’t be proved?” he asked.
While this meeting did not open any formal discussion of adding autism to the VICP injury table, this whisper of autism in the context of the ACCV was still concerning. It’s a preview of battles to come.
I was also struck by a couple of other public comments — ones that I think convey an important message for the public to hear.
Allison Hill, PharmD, director of professional affairs at the American Pharmacists Association, praised the VICP while calling for “long-overdue updates.” She called for expanding the VICP to include all adult vaccines, moving COVID-19 vaccines from the Countermeasures Injury Compensation Program (CICP) to the VICP, and ensuring timely implementation of excise taxes for newly recommended vaccines.
She also took direct aim at efforts to add autism to the injury table: “Adding this disproven claim to the Vaccine Injury Table would threaten the solvency of the VICP and contradict decades of scientific evidence showing no causal link between vaccines and autism.”
Dorit Reiss, PhD, a vaccine legal expert at UC Law San Francisco, gave a comment that I found particularly compelling. She provided a concise history of why the VICP exists — it was enacted in 1986 when vaccine manufacturers were leaving the market due to mounting lawsuits, and began operating in 1989. The program had two goals: protecting the vaccine supply through defined (but not absolute) liability protection, and making compensation for vaccine injuries easier and faster.
“An important aspect of a well-functioning vaccination program,” Reiss noted, “is compensating the rare cases of vaccine harms quickly and generously: they should not have to alone bear the costs of participating in something that has public benefits.”
She pointed out that since 2014, substantially more than 50% of VICP claims have been compensated — compared to an average of 33% wins in civil courts for product liability claims. In other words, the VICP isn’t a roadblock to compensation. It’s actually a faster, more likely path to it than traditional litigation.
This is why moving COVID-19 vaccines to the VICP matters so much. Currently, COVID vaccines fall under a different program — the Countermeasures Injury Compensation Program (CICP) — which is notoriously difficult to navigate. As Reiss has written elsewhere, since CICP began in 2010, only 29 claims have been compensated out of 499 filings. The statute of limitations is just one year. Legal fees aren’t covered. It serves as a payer of last resort. It’s a program designed for emergencies, not for vaccines that are now part of routine care.
But — and this is important — Reiss also called for improvements to the VICP itself:
Adding more special masters (the administrative lawyers who hear these cases) to expedite review — currently, there are only 8
Updating the caps on compensation, which haven’t been raised since the 1980s
Increasing the statute of limitations to 6 years, or at least extending it to adulthood for children
This echoes conversations I’ve had behind closed doors with colleagues across public health. There is a misconception — one that’s been deliberately amplified — that those of us in public health advocate for blanket immunity for vaccine manufacturers. That we want to shield Big Pharma at all costs.
This could not be further from the truth.
Vaccine injuries, while very rare, are real. And when they occur, those individuals deserve fast and fair compensation. They should not bear the costs alone of participating in something that benefits all of us.
The VICP was designed to do precisely that. It’s not perfect, and as Reiss and Hill both noted, there are real improvements to be made. But the answer is thoughtful reform — not adding scientifically unsupported conditions that would bankrupt the program and destabilize the vaccine supply for everyone.
One thing that struck me about Reiss’s comment was her emphasis on process. She noted that she looks forward to “participating in the lengthy rulemaking process, with the required 180 days, for those changes to be made.” She reminded listeners that “the most important changes the program needs can only be made by Congress.”
This matters. There are rules. There are steps. There are 180-day comment periods and Congressional action and deliberation. These aren’t bureaucratic obstacles — they’re safeguards. They exist so that changes to programs affecting millions of children and families happen through transparent, democratic processes, not through quiet holiday meetings.
As we head into 2026, I remain concerned about what’s coming for the VICP (and public health, in general). But I’m also holding onto the fact that there are dedicated people — clinicians, lawyers, scientists, pharmacists, parents — who showed up to a meeting during the holiday dead zone to put these things on the record.
One thing I wish we could carry into 2026 is a better public understanding that public health stands with the public, not with industry. We want vaccines to be safe. We want injuries to be compensated. We want a system that works for families. These are not competing goals.
So here’s to 2026. May it be a little less Rocky, a little more... I don’t know, a pleasant training montage? Eye of the Tiger playing gently in the background while we all catch our breath?
Let’s get ready to rumble…
Stay Curious,
Unbiased Science
P.S. Enjoy this video compilation of my facial expressions throughout the year, put together by Unbiased Science team member, Veda Bojar. Not much of a poker face, eh?
I know I literally just subscribed, but is it possible to post the video on a non-Meta platform? This was a very enlightening post and I learned a lot, thank you!