Vaccine court
The VICP covers all vaccines listed on the Vaccine Injury Table maintained by the Secretary of Health and Human Services; in 2007 the list included vaccines against diphtheria, tetanus, pertussis (whooping cough), measles, mumps, rubella (German measles), polio, hepatitis B, varicella (chicken pox), "Haemophilus influenzae" type b, rotavirus, and pneumonia. From 1988 until 8 January 2008, 5,263 claims relating to autism, and 2,865 non-autism claims, were made to the VICP. 925 of these claims, one autism-related (see previous rulings), were compensated, with 1,158 non-autism and 350 autism claims dismissed; awards (including attorney's fees) totaled $847 million. The VICP also applies to claims for injuries suffered before 1988; there were 4,264 of these claims of which 1,189 were compensated with awards totaling $903 million.
Exotoxin
Exotoxins have been used to produce vaccines. This process involves inactivating the toxin, creating a toxoid that does not induce toxin-related illness and is well-tolerated. A widely used toxoid vaccine is the DPT vaccine, which is usually administered in multiple doses throughout childhood with adjuvants and boosters for long-term immunity. DPT vaccine protects against pertussis, tetanus and diphtheria infections, caused by the exotoxin-producing "Bordetella pertussis", "Clostridium tetani" and "Corynebacterium diphtheriae" respectively. Vaccination with the toxoids generates antibodies against the exotoxins, forming immunological memory as protection against subsequent infections. The DPT vaccination may cause adverse side effects, such as swelling, redness and fever, and is contraindicated in some populations. Effective vaccination schedules have reduced rates of mortality linked to pertussis, tetanus and diphtheria but formal controlled trials to test the efficacy of the vaccine have not been conducted. Additionally, pertussis persists endemically and is one of the most common causes of vaccine-preventable deaths.