预防接种异常反应的社会保障补偿论

Social Security Compensation for Abnormal Reactions to Vaccination

预防接种异常反应适用无过错补偿制度。2019年出台的《疫苗管理法》调整了国务院《疫苗流通和预防接种管理条例》确立的补偿制度,但多项新规未能完成对行政法规和地方规章的重塑,学理亦未充分阐释预防接种异常反应的本质、无过错补偿的性质及其制度走向。参酌德国、日本、美国等国预防接种异常反应补偿的法理及制度,我国无过错补偿的法理应为国家承担的结果责任,并以基金制作为财务基础,实现国家责任的形式与实质分离,由生产者共同体承担疫苗风险的担保责任。据此,应将现行基于免疫规划疫苗和非免疫规划疫苗分类的“双入口”补偿结构合并为单一补偿机制,纳入社会保障体系,采取补偿项目三级分类制,以年金为基本给付方式,由社保经办机构办理,涵盖疫苗损害本身和受种者持续性保障。

The no-fault compensation system applies to adverse events following immunization(AEFI). The Vaccine Administration Law introduced in 2019 adjusted the structure of compensation system established by the State Council’s Regulations on the Administration of Vaccine Circulation and Vaccination, and a number of new regulations have yet to complete the reshaping of administrative and local regulations.Inaddition, the academic theories failed to adequately explain the essence of AEFI, the nature of nofault compensation and the direction of system reform. By examining and comparing the compensation jurisprudence and systems for AEFI in Germany, Japan and the United States, the jurisprudence of no-fault compensation in China should be the result liability of the state, and the fund should be used as the financial basis to realize the separation of the form and substance of the state’s result liability, and the community of producers should bear the guarantee liability for vaccine risks. Accordingly, the existing “double-entry” compensation structure based on the vaccine classification of immunization program and non-immunization program should be merged into a single compensation mechanism and incorporated into the social security system, with a three-tier classification system of compensation items and annuities as the basic payment method, to be handled by social security agencies, covering both the vaccine damage itself and the continuous protection of the vaccine recipient.