Kristine R. Bell v. HHS - Hepatitis B, acute disseminated encephalomyelitis (ADEM) (2017)

Kristine Bell, born in 1975, received the second dose of the Hepatitis B vaccine on January 16, 2012. Fifteen days later, she experienced blurred vision, burning, tearing, and photophobia, which resolved with treatment.

Approximately five weeks after the vaccination, she developed left-sided weakness, which progressed over a couple of weeks. Her initial medical evaluations and imaging suggested possibilities including demyelinating disease, neoplasm, or ischemia.

Over the following months, her symptoms evolved, including increased stiffness, movement impairment, diplopia, and hearing loss. Various specialists considered diagnoses such as multiple sclerosis, extrapyramidal disorder, autoimmune encephalitis, mitochondrial disorder, and eventually, acute disseminated encephalomyelitis (ADEM).

Despite extensive testing and consultations, including at the Mayo Clinic and the University of Iowa, a definitive diagnosis remained elusive, with many providers noting the absence of clear inflammatory markers or a clear link to the vaccine. Petitioner's experts proposed ADEM caused by the Hepatitis B vaccine through molecular mimicry, while respondent's experts argued that her condition did not fit the typical profile of ADEM, lacked evidence of inflammation, and was likely of idiopathic origin.

The Special Master found that Petitioner failed to carry her burden of establishing causation, concluding that the medical evidence did not support a diagnosis of ADEM and that the Hepatitis B vaccine was not the cause of her condition. Therefore, entitlement to compensation was denied.