B.C.L. v. HHS - Influenza, autism spectrum disorder (ASD) / pervasive developmental disorder-not otherwise specified (PDD-NOS) (2015)

On November 4, 2008, Brian and Kimberly Long, as parents and natural guardians of their minor son B.C.L., filed a petition for vaccine compensation. They alleged that B.C.L. developed autism spectrum disorder (ASD) and/or pervasive developmental disorder-not otherwise specified (PDD-NOS) due to recommended childhood vaccinations.

Specifically, they claimed that an influenza vaccine administered on November 21, 2005, significantly aggravated B.C.L.'s pre-existing condition. The petition sought compensation for this alleged aggravation, not for the initial onset of the disorder.

B.C.L. was born on September 7, 1998. His early medical records indicated concerns about delayed speech, and he underwent speech therapy.

Evaluations in 2003 suggested probable Attention Deficit-Hyperactivity Disorder (ADHD), leading to medication treatment. A neurologist in March 2004 found findings suggestive of mild PDD or an autistic spectrum disorder.

Comprehensive evaluations in June 2004 revealed ongoing attention and impulse control issues, with a full-scale IQ of 60. In the summer of 2005, the family moved to Texas, and B.C.L. enrolled in a new school.

His mother noted that after a hurricane evacuation in the fall of 2005, his condition "progressively became worse." Medical notes from November 10 and November 15, 2005, predating the vaccination, documented teachers reporting behavioral changes, including running out of the classroom and not paying attention. On November 21, 2005, B.C.L., then over seven years old, received an influenza vaccine containing 25 micrograms of thimerosal.

Pediatric records from the following month noted only "a little bit of progress" and no abrupt behavioral change. Throughout the 2005-2006 school year, B.C.L. continued to experience problems, with frequent medication adjustments.

In March 2006, he was documented to have mild hallucinations and high anxiety. His mother, in a May 2006 questionnaire, attributed his difficulties to "anxiety depression and dealing with new environment and a lot of changes" and the hurricane, making no mention of the vaccination.

A neurologist in July 2006 observed "regression in the last 6-9 months," noting it could be a normal manifestation of his pervasive developmental disorder. The petitioners' expert, Dr.

Mary Megson, proposed a two-part theory: first, that B.C.L. had an MTHFR gene variant (C677T) making him susceptible to mercury, and second, that the thimerosal in the flu vaccine caused oxidative stress, damaging his brain and worsening his autism. Respondent's experts, Dr.

Stephen Cederbaum (genetics) and Dr. Bennett Leventhal (child psychiatry), refuted this theory.

Dr. Cederbaum explained that the MTHFR C677T variant is common and not associated with increased disease risk.

Dr. Leventhal testified that there is no scientific evidence that influenza vaccines aggravate autism and that B.C.L.'s regression was likely due to the ordinary course of autism, exacerbated by environmental factors like the family's move and hurricane evacuation, which predated the vaccination.

Special Master George L. Hastings denied the petition on February 9, 2015.

He found Dr. Megson unconvincing and Respondent's experts persuasive.

He concluded that B.C.L.'s downturn predated the vaccination and that the mother attributed the difficulties to environmental changes, not the vaccine. The Special Master found that the petitioners failed to establish the necessary prongs of the Loving significant aggravation test, specifically that the flu vaccine could aggravate autism, that it did so in BCL's case, and that a proximate temporal relationship existed.

He noted the case was "not a close case." In a separate decision on interim attorneys' fees and costs dated July 28, 2014, Special Master Hastings awarded Petitioners $109,500.00 in attorneys' fees and $1000.82 in costs, payable jointly to Petitioners and counsel Sheila A. Bjorklund, finding the petition was brought in good faith and upon a reasonable basis.

The final decision denied entitlement without compensation.