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The “vaccine courts” have two methods to determine whether to award compensation: People must either prove the vaccine caused the side effects or show they suffer from specific illnesses that the government has listed among those for which compensation is automatic.

Ms. Bruesewitz’s parents went to the “vaccine court” in 1995 claiming she suffered residual seizure disorder, but the federal government had removed that affliction a month earlier from the list of illnesses for which it would pay compensation. Attorneys for Wyeth said that was because there is no evidence the vaccine causes residual seizure disorder.

The “vaccine court” ultimately determined that the Bruesewitzes did not prove the diphtheria-tetanus-pertussis vaccine she received as a 6-month-old caused her afflictions. Ms. Bruesewitz was healthy before receiving the vaccine, and her symptoms, including major seizures, began hours after her immunization.

The Bruesewitzes then attempted to sue in state court, but a trial court and an appellate court ruled that they couldn’t because doing so would conflict with the 1986 vaccine act. The Supreme Court heard an appeal of those rulings.

The case was closely watched as nearly 6,000 claims linking autism and vaccines have been filed in “vaccine court.” If the court had ruled in favor of the Bruesewitzes, many of those cases could have gone to court.