Thank you for your request

Request

‘will you please tell me:

1) how many GBS determinations were made within VDPS between 2022 and end 2025 in respect of Covid vaccines? [G1]

2) in how many of these settled G1 determinations did the past Medical Assessor decide “on the balance of probabilities” that GBS had been caused by a Covid vaccine? [G1yes]

3) How many different primary Medical Assessors handled the G1no determinations [where G1no = G1 minus G1yes]? [MAno]

4) How many of these MAno Medical Assessors formally reviewed at least one of their G1no determinations in the light of the December 2025 Green Book correction which explained that Lunn’s paper had been accepted and published online in February 2023?

The above questions identify a further issue that statistics about the performance of VDPS should ideally address, namely balance of probabilities wrt causation per claimed condition on which determination of causation (Step 1) has been reached:

a) How many determinations have been made per condition/syndrome (ie type of claimed VD) on the balance of probabilities?

b) Per condition, show the distribution of “balance of probabilities” for approved causation

c) Per condition, show the distribution of “balance of probabilities” when causation has been rejected.

Finally, may I ask does VDPS routinely inform claimants that, in the interest of pharmacovigilance, MHRA should be informed about each claimed condition/syndrome in respect of which VDPS has received a claim and, accordingly, that VDPS will submit a Yellowcard on the claimant’s behalf as:

i) MHRA is accustomed to dealing with multiple reports about the same case (ie from doctor, patient, pharmacist, other);

ii) MHRA has the pharmacovigilance expertise to recognise new syndromes that might represent a serious adverse event post-vaccination.’

The NHS Business Services Authority (NHSBSA) received your request on 17 March 2026.

On 14 April 2026 you wrote to clarify your request:

‘To make matters more straightforward for FOIREQUESTS, and to speed their response in respect of

. . .  a further issue that statistics about the performance of VDPS should ideally address, namely balance of probabilities wrt causation per claimed condition on which determination of causation (Step 1) has been reached:

a. How many determinations have been made per condition/syndrome (ie type of claimed VD) on the balance of probabilities?

b. Per condition, show the distribution of “balance of probabilities” for approved causation

c. Per condition, show the distribution of “balance of probabilities” when causation has been rejected.

Please will FOIREQUESTS provide the information requested above for TWO conditions ONLY [ie A; B below] for Oxford-AstraZeneca SARS-CoV-2 vaccine:

A. GBS

B. CVST with low platelet count.

I hope that I may expect answers by mid-May 2026 to this limited request: about TWO major forms of damage which are clearly documented as having time-specific attribution to OxAZ vaccine.’

Response

I can confirm that the NHSBSA holds some of the information you have requested. All data is as of 31 December 2025 and relates to Covid-19 claims which received an outcome between 1 January 2022 and 31 December 2025.

Question 1 - how many GBS determinations were made within VDPS between 2022 and end 2025 in respect of Covid vaccines? [G1]

I can confirm that the NHSBSA holds the requested information.

At the medical assessment stage, the medical assessor provides a description of the assessed conditions they have been able to identify from the claimant's medical records. This can sometimes be a mixture of conditions. The condition recorded against each claim may therefore be different to the condition initially stated by the claimant on their original claim form.  There were 272 medical assessment outcomes which contain at least one of the following search terms:

• Guillain Barré syndrome
• GBS

This includes all claims submitted, regardless of if they met the criteria for a Vaccine Damage Payment. Under the Vaccine Damage Payments Act 1979, to qualify for a Vaccine Damage Payment, it must be proved that an eligible vaccine was received and:

• on the balance of probabilities, the vaccine caused the disability
• the resulting disablement is severe

Severely disabled means at least 60% as defined by the principles for assessing the extent of disablement. These are set out in section 103 of the Social Security Contributions and Benefits Act 1992 and the Social Security (General Benefit) Regulations 1982:  https://www.legislation.gov.uk/ukpga/1992/4/contents https://www.legislation.gov.uk/uksi/1982/1408/schedule/2

Question 2 - in how many of these settled G1 determinations did the past Medical Assessor decide “on the balance of probabilities” that GBS had been caused by a Covid vaccine? [G1yes]

I can confirm that the NHSBSA holds the requested information. As mentioned in our response to question 1, there were 272 medical assessment outcomes which contain the search terms:

• Guillain-Barre syndrome
• GBS

This includes all claims submitted, regardless of if they met the criteria for a Vaccine Damage Payment. Under the Vaccine Damage Payments Act 1979, to qualify for a Vaccine Damage Payment, it must be proved that an eligible vaccine was received and:

• on the balance of probabilities, the vaccine caused the disability
• the resulting disablement is severe

Of these 272 medical assessment outcomes, there are 135 claims to the VDPS where causation has been accepted. This includes all claims where causation has been accepted, regardless of if they met the criteria for a Vaccine Damage Payment. For example, where the disablement was not assessed as severe. Severely disabled means at least 60% as defined by the principles for assessing the extent of disablement. These are set out in section 103 of the Social Security Contributions and Benefits Act 1992 and the Social Security (General Benefit) Regulations 1982:  https://www.legislation.gov.uk/ukpga/1992/4/contents https://www.legislation.gov.uk/uksi/1982/1408/schedule/2

Question 3 - How many different primary Medical Assessors handled the G1no determinations [where G1no = G1 minus G1yes]? [MAno]

I can confirm that the NHSBSA holds the requested information. There were 61 different medical assessors who produced outcome reports.

Question 4 - How many of these MAno Medical Assessors formally reviewed at least one of their G1no determinations in the light of the December 2025 Green Book correction which explained that Lunn’s paper had been accepted and published online in February 2023?

I can confirm that the NHSBSA does not hold the requested information. This is because under the government’s rules for the scheme, claims are assessed based on the information available at the time. All relevant information is considered to make a complete and fair assessment. The medical assessor thoroughly considers:

• information given on the claim form
• any further evidence submitted by you
• any pre-existing conditions that are not caused by the vaccine
• medical records (if required)
• clinical research
• epidemiological evidence
• the current consensus of expert medical opinion

The medical assessor will advise if the claimant is entitled to a Vaccine Damage Payment, based on the government’s rules for the scheme. As soon as a claim has been assessed, the claimant will receive a letter telling them the outcome, and a copy of the comprehensive medical report VAD 30 (MA). The medical assessment report is written by the medical assessor and explains how they reached their decision and what information they considered.

If a claim is rejected, the claimant can challenge the medical assessor’s decision by submitting a mandatory reversal. Under the government’s rules for the VDPS, there is no limit on the number of times a claimant can request a mandatory reversal, and there is no time limit. This means the claim will be assessed again based on the most recent available information.

The above questions identify a further issue that statistics about the performance of VDPS should ideally address, namely balance of probabilities wrt causation per claimed condition on which determination of causation (Step 1) has been reached:

Please will FOIREQUESTS provide the information requested above for TWO conditions ONLY [ie A; B below] for Oxford-AstraZeneca SARS-CoV-2 vaccine:

A. GBS

B. CVST with low platelet count.

The NHSBSA may hold some of the requested information; however, we estimate that the cost of compliance with the request would exceed the appropriate limit under section 12 of the FOIA.

We estimate that the cost of complying with your request would exceed the non-central Government limit of £450. The limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and represents the estimated cost of one person spending 18 hours in determining whether the NHSBSA holds the information, and locating, retrieving, extracting and checking the information.

Regarding CVST with low platelet count, it may be recorded in some of the medical records held, however it would require a manual review of each record to locate, retrieve and extract the information.

Undertaking a manual search for CVST with low platelet count claims would take up to 40 to 50 hours. This clearly exceeds the 18 hours which would accrue a cost of £450 or more, triggering the provisions of section 12 of the FOIA.

We have considered each question in your request individually and where you have narrowed the scope of cases to be checked; however, the work needed to locate and extract the information would still exceed the cost limit set out in section 12 of the FOIA. Please see the following link to view the section 12 in full:  https://www.legislation.gov.uk/ukpga/2000/36/section/12 The NHSBSA is, however, able to respond to your questions in relation to GBS. Please note that the information is not held in the format requested. Under the Freedom of Information Act, there is no requirement for a public authority to create new information. We have therefore provided the relevant information in the format in which it is held.

a. How many determinations have been made per condition/syndrome (ie type of claimed VD) on the balance of probabilities?

There are 173 related to GBS and the AstraZeneca vaccine.

b. Per condition, show the distribution of “balance of probabilities” for approved causation

There are 130 related to GBS and the AstraZeneca vaccine.

c. Per condition, show the distribution of “balance of probabilities” when causation has been rejected.

There are 43 related to GBS and the AstraZeneca vaccine.

Finally, may I ask does VDPS routinely inform claimants that, in the interest of pharmacovigilance, MHRA should be informed about each claimed condition/syndrome in respect of which VDPS has received a claim and, accordingly, that VDPS will submit a Yellowcard on the claimant’s behalf as:

Question I - MHRA is accustomed to dealing with multiple reports about the same case (ie from doctor, patient, pharmacist, other);

Question II - MHRA has the pharmacovigilance expertise to recognise new syndromes that might represent a serious adverse event post-vaccination.

The VDPS does not routinely inform claimants that they should inform the MHRA of their claimed condition/syndrome and nor does it submit a Yellow Card on the claimant’s behalf. Data Queries

Please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference if you have any specific questions regarding this response; or, if you feel you may be misunderstanding or misinterpreting the information; or, if you plan on publishing the data.

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The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2026” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.