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​Duty of care: On vaccine injury compensation programmes

March 13, 2026 5 min read Polity & Governance Social Issues GS Paper 2 (Health Policy Rights-Based Governance Judiciary)
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What Happened

  • The Supreme Court of India, in the case Rachna Gangu v. Union of India (2026 INSC 218), directed the Ministry of Health and Family Welfare to formulate a "no-fault compensation" policy for serious Adverse Events Following Immunisation (AEFI) arising from COVID-19 vaccines administered under the national immunisation programme.
  • The Court noted the absence of any "uniform or structured policy mechanism" to provide redress to individuals who suffered serious adverse effects following COVID-19 vaccination — a gap starkly visible during one of the world's largest vaccination drives.
  • The Court also directed that AEFI-related data be placed in the public domain periodically, improving transparency in India's vaccine surveillance system.
  • The judgment explicitly stated that the formulation of the no-fault framework shall not be construed as an admission of liability or fault by the Union of India — a significant legal qualifier that addresses government concerns about precedent.
  • The editorial framing of this development argues that when the State mandates or strongly incentivises mass vaccination campaigns, it acquires a moral and legal duty to compensate those who suffer rare but severe adverse effects — regardless of negligence.

Static Topic Bridges

No-Fault Compensation Systems in Vaccine Programmes

A no-fault compensation system allows individuals who suffer serious vaccine-related injuries to receive financial compensation without the burden of proving negligence or malice by the government or vaccine manufacturer. This is distinct from tort law, where proving fault/negligence is a prerequisite for compensation.

  • The United States operates the National Childhood Vaccine Injury Act (1986) and the National Vaccine Injury Compensation Program (VICP), which provides compensation for injuries listed in a Vaccine Injury Table — no need to prove negligence
  • Many European countries and the UK have statutory no-fault vaccine injury compensation schemes; the UK pays up to £120,000 for severe disability
  • India previously had no formal no-fault compensation mechanism for vaccine injuries; only ad hoc payments were made in some COVID-19 cases under political pressure
  • AEFI (Adverse Event Following Immunisation): any untoward medical occurrence which follows immunisation and which does not necessarily have a causal relationship with the usage of the vaccine
  • India's AEFI surveillance system: operates through national and state expert committees; serious AEFIs are investigated for causality; data collected but not proactively published

Connection to this news: The Supreme Court's direction to create a no-fault framework represents a shift from an ad-hoc, litigation-dependent approach to a structured, rights-based compensation system. This is directly relevant to UPSC questions on health policy and the state's duty under Article 21 (right to life).

India's Immunisation Programme and Vaccine Policy

India runs the Universal Immunisation Programme (UIP), one of the world's largest public health initiatives, covering vaccines against 12 diseases. COVID-19 vaccination (2021-2023) was one of the most expansive drives globally, covering 220+ crore doses.

  • Universal Immunisation Programme (UIP): launched 1985; covers BCG, OPV, DPT, Hepatitis B, Measles-Rubella, IPV, Rotavirus vaccine, Pneumococcal Conjugate Vaccine (PCV), JE vaccine
  • Mission Indradhanush (2014): intensified catch-up vaccination drive to reach unimmunised and partially immunised children; extended to pregnant women
  • COVID-19 vaccination: Covishield (AstraZeneca, manufactured by SII), Covaxin (Bharat Biotech), ZyCoV-D (Zydus); later Corbevax, Covovax
  • Emergency Use Authorisation (EUA) was granted for COVID vaccines by India's Central Drugs Standard Control Organisation (CDSCO)
  • National Regulatory Authority: CDSCO under DCGI (Drugs Controller General of India)
  • The National Technical Advisory Group on Immunisation (NTAGI) advises the government on vaccine policy

Connection to this news: Because COVID vaccines were mandated in several contexts (travel, jobs, entry to public spaces) and administered under an extraordinary public health emergency, the state's moral obligation to compensate injuries is stronger than for purely voluntary vaccinations. The SC's direction operationalises this principle.

Right to Health and State Duty under Article 21

The Supreme Court has progressively read the right to health as a component of the fundamental right to life and personal liberty under Article 21 of the Constitution, binding the state to ensure accessible, affordable, and safe healthcare.

  • Landmark cases: Paschim Banga Khet Mazdoor Samity v. State of West Bengal (1996) — state obligated to provide emergency medical care; Consumer Education and Research Centre v. Union of India (1995) — right to health is a fundamental right
  • DPSP Article 47: duty of the state to raise the level of nutrition and the standard of living and to improve public health
  • National Health Policy 2017: aims to achieve Universal Health Coverage (UHC); targets health expenditure of 2.5% of GDP by government
  • India's health expenditure as % of GDP: approximately 2.1% (2021-22); OECD average is ~8.8%
  • Right to Health Bill: not yet enacted as a central law; only Rajasthan has a Right to Health Act (2023)

Connection to this news: The Supreme Court's intervention bridges the gap between Article 21's promise and the operational reality of India's immunisation programme. A no-fault compensation framework is a concrete mechanism through which the state discharges its constitutional duty to persons injured in the course of a public health mandate.

Key Facts & Data

  • Supreme Court case: Rachna Gangu v. Union of India (2026 INSC 218)
  • Direction: Ministry of Health and Family Welfare to formulate no-fault AEFI compensation policy
  • India's COVID-19 vaccination: 220+ crore doses administered (one of world's largest drives); vaccines include Covishield, Covaxin, ZyCoV-D
  • Universal Immunisation Programme (UIP): launched 1985; covers 12 diseases
  • Mission Indradhanush: launched 2014; intensified immunisation drive for children and pregnant women
  • AEFI surveillance: national and state-level expert committees; causality assessment; data currently not in public domain
  • US model: National Vaccine Injury Compensation Program (VICP) under NCVIA 1986
  • Constitutional basis for state duty: Article 21 (right to life), Article 47 (DPSP — public health)
  • CDSCO (under DCGI): India's drug and vaccine regulator; granted EUA for COVID vaccines
  • Explicit court qualifier: no-fault framework not an admission of liability by Union of India