Y.Q. v. HHS - MMR, MMR-associated febrile seizure with seizure disorder/epilepsy, sensory integration disorder, and behavioral changes as sequelae (2020)

Petitioners alleged that the MMR vaccine administered on March 28, 2008, to Y.Q., then approximately 15 months old, caused a febrile seizure on April 1, 2008, approximately 4.5 days later, which led to subsequent seizure disorder, sensory integration disorder, and behavioral changes. Petitioners' expert, Dr. Yuval Shafrir, a pediatric neurologist and clinical neurophysiologist, advanced theories of immune-mediated injury, including chronic autoimmune encephalopathy, molecular mimicry, bystander activation, and epitope spreading. Special Master Christian J. Moran found that the MMR vaccine can cause febrile seizures, as supported by the Institute of Medicine and the respondent's admission. The Special Master determined that the 4.5-day interval between vaccination and the first seizure was medically acceptable, citing epidemiologic studies and the Vaccine Injury Table's encephalopathy interval. Dr. Shafrir's opinion that the MMR vaccine caused Y.Q.'s first febrile seizure was credited. The Special Master also found that Y.Q. suffered lasting neurological and behavioral sequelae for more than six months, despite some treating neurologists finding her neurologically intact at discharge and the evidence being described as relatively thin. Respondent's expert, Dr. Gregory Holmes, a pediatric neurologist and epilepsy specialist, disputed the autoimmune encephalopathy diagnosis, citing a lack of supporting clinical and laboratory findings, and argued that the proposed immune mechanisms were unproven and the timing too short. He also contended that Y.Q.'s later seizures and behavioral problems were not shown to be sequelae of the first febrile seizure. Special Master Moran ultimately ruled in favor of entitlement on September 4, 2019, and awarded damages on December 2, 2020, totaling $1,954,724.43 in lump sums plus an annuity for future life care. Attorneys for petitioners were Ramon Rodriguez III of Sands Anderson PC, and for respondent was Christine M. Becer.