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Hepatitis A

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Serious side effects of the Hep-A vaccine include a serious allergic reaction, within a few minutes to a few hours of the shot. If this happened to you, you should contact a lawyer about pursuing your rights under the National Vaccine Injury Compensation Program.

Hepatitis A Claims Filing Deadlines: What are the deadlines for filing hepatitis A claims under the VICP? Individuals found to be injured by the hepatitis A vaccine are eligible for compensation from the National Vaccine Injury Compensation (VICP) as of December 1, 2004. This coverage permits individuals who think that they have been injured by this vaccine to file a claim for compensation.

To be eligible for compensation, claims must be filed:

• within 3 years after the first symptom of the vaccine injury; or
• within 2 years of the vaccine-related death and not more than 4 years after the start of the first symptom of the vaccine-related injury from which the death occurred; or
• 2 years from the date the vaccine is covered for injuries or deaths that occurred up to 8 years before the date the vaccine is covered. For example, hepatitis A was covered by the VICP as of December 1, 2004, and claims have to be filed by December 1, 2006 for injuries or deaths that occurred on or after December 1, 1996.

For individuals filing a claim, the appropriate filing deadline is the one above that provides them with the most time to file their injury or death claims. You should consult a lawyer for any questions about the important deadlines and how they apply to the facts of your case.

Do I Qualify for the National Vaccine Compensation Program? PERSONAL INFORMATION
First Name:
Last Name:
E-mail Address:
Address:
City:
State:	-Please Select- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Zipcode:
Phone:	() - ext.
INJURED PERSON INFORMATION
Date of Birth:	MM January February March April May June July August September October November December DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902
For whom are you inquiring about?	PLEASE SELECT Minor Self Other
If you are NOT inquiring on your own behalf, what is your relationship?
Is the person deceased?	Yes No
If deceased, the cause of death as stated on the death certificate:
Date of Death:	MM January February March April May June July August September October November December DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902
Was there an autopsy performed?	Yes No
INJURY INFORMATION
Has person had any of the following injuries within 48 hours of recieving the vaccination:
Encephalopathy Stroke Heart Attack Brain Injury Death Seizure Guillian-Barre Syndrome
DRUG INFORMATION
Has person had any of the following vaccinations:
Tetanus Pertussis Measles Mumps Chicken Pox (Varicella) MMR Rubella Polio Hepatitis B Rotavirus (Rotashield) Flu Shot DTaP DPT
Other:
Dates that Vaccine(s) were given?
Did behavior regress after receiving vaccines?	Yes No
If yes, please describe regressive behavior:
Other Information: