The VICP excise tax per dose is $0.75 for each disease component in the shot. A vaccine that targets one disease is taxed $0.75 per dose; a combination vaccine is taxed $0.75 for each taxable component it contains, so a three-disease shot carries $2.25 and a four-disease shot carries $3.00. The money flows into the Vaccine Injury Compensation Trust Fund, which pays claims under the federal no-fault system for vaccine injuries.
How the Per-Component Rate Stacks
Federal law imposes a flat 75-cent excise tax on every dose of a taxable vaccine sold by its manufacturer, producer, or importer. When a single injection covers diseases that fall into more than one taxable category, the tax stacks: add $0.75 for each category the vaccine touches.1Office of the Law Revision Counsel. 26 U.S. Code 4131 – Imposition of Tax
A few common examples:
- MMR (measles, mumps, rubella): three taxable categories, so $0.75 × 3 = $2.25 per dose.
- DTaP (diphtheria, tetanus, pertussis): also three categories, so $2.25 per dose.
- ProQuad (measles, mumps, rubella, varicella): four categories, so $0.75 × 4 = $3.00 per dose.
- A single-component flu shot: one category, so $0.75.
Because most childhood immunizations protect against several diseases at once, the stacking rule is where the trust fund actually raises meaningful revenue.
Which Vaccines Are Taxed
A vaccine is taxable if it is manufactured in or imported into the United States and falls into one of 16 categories listed in the tax code:2Office of the Law Revision Counsel. 26 USC 4132 – Definitions and Special Rules
- Diphtheria toxoid (including DT, DTaP, Tdap)
- Tetanus toxoid
- Pertussis (whole cell or acellular)
- Measles
- Mumps
- Rubella
- Polio virus
- Haemophilus influenzae type B (HIB)
- Hepatitis A
- Hepatitis B
- Chicken pox (varicella)
- Rotavirus
- Pneumococcal conjugate
- Seasonal influenza
- Meningococcal
- Human papillomavirus (HPV)
For a vaccine to be covered by the VICP compensation program, two things must be true: the CDC must recommend the vaccine for routine use in children or pregnant women, and the vaccine must be subject to the federal excise tax.3Health Resources & Services Administration. Covered Vaccines Adding a new vaccine to the excise tax list requires Congress to amend the tax code. The Secretary of Health and Human Services can modify the Vaccine Injury Table through rulemaking, but cannot unilaterally add a new vaccine to the tax.4Office of the Law Revision Counsel. 42 U.S. Code 300aa-14 – Vaccine Injury Table
COVID-19 and RSV Vaccines Are Not Included
Neither COVID-19 nor RSV vaccines appear on the taxable vaccine list or the VICP covered vaccine list. Injury claims related to COVID-19 vaccines are handled through a separate program, the Countermeasures Injury Compensation Program (CICP), which has different rules and a lower burden of proof for denial.5Health Resources and Services Administration. National Vaccine Injury Compensation Program Until Congress amends the tax code, these vaccines stay outside the VICP system.
Who Pays the Tax
The excise tax falls on the manufacturer, producer, or importer at the point of sale, not on the patient or the clinic administering the shot.6Office of the Law Revision Counsel. 26 USC 4131 – Imposition of Tax It attaches when the vaccine is first sold or used in the United States. Patients never see a separate excise-tax line on a bill; the cost is built into the wholesale price.
Manufacturers report and remit the tax on IRS Form 720, the Quarterly Federal Excise Tax Return. As with other federal excise taxes, missing a payment deadline triggers a penalty of 0.5% of the unpaid amount for each month or partial month the balance remains outstanding, up to a maximum of 25%.7Internal Revenue Service. Failure to Pay Penalty Interest accrues on top of the penalty.
Refunds for Returned or Destroyed Doses
Manufacturers can recover the excise tax if a taxable vaccine is destroyed or returned for reasons other than resale. The deadline is tight: the refund claim has to be filed within six months of the date the vaccine was returned or destroyed.8Internal Revenue Service. Statute of Limitations to File a Claim for Refund of the Vaccine Tax That six-month window is a special rule that overrides the general IRS refund deadlines, so waiting longer forfeits the refund even if the standard three-year period hasn’t expired.
Where the Revenue Goes
Every dollar collected through the vaccine excise tax is deposited into the Vaccine Injury Compensation Trust Fund, a dedicated federal account.9Office of the Law Revision Counsel. 26 USC 9510 – Vaccine Injury Compensation Trust Fund The fund has paid roughly $5.4 billion in compensation since the program began in 1988, across more than 28,991 petitions filed.10Health Resources and Services Administration. VICP Statistics For fiscal year 2026, the fund carried $6 million over from the prior year and received $649 million in new appropriations, giving it about $654 million in spending authority.11USAspending.gov. Vaccine Injury Compensation Trust Fund
The trust fund covers medical expenses, lost earnings, pain and suffering (capped at $250,000), and a $250,000 death benefit for successful claims, along with attorneys’ fees and litigation costs for petitioners.12Office of the Law Revision Counsel. 42 U.S. Code 300aa-15 – Compensation That structure is what the 75-cent-per-component tax is paying for: a no-fault compensation system funded entirely by the vaccines it covers.