For most patients seeking damages for an injury related to flu, measles, polio and other public health vaccines, the process is well-established and transparent. The process also keeps manufacturers out of legal processes and puts the lawsuits in the hands of special federal vaccine courts. But for more than 10,000 Americans who filed a claim due to a potential COVID vaccine-related injury, the process is slow, secretive and handled by a little-known agency that had only four employees when claims began arriving in 2021.