Jamie Rothstein v. HHS - Tdap, significant aggravation of a preexisting, but asymptomatic, demyelinating neurologic disorder which resulted in her development of MS (2024)

Jamie Rothstein filed a petition alleging that a Tdap vaccination on July 12, 2013, caused transverse myelitis (TM), and later amended her petition to allege it caused a significant aggravation of a pre-existing, asymptomatic demyelinating neurologic disorder, resulting in Multiple Sclerosis (MS). The petitioner, a registered nurse, received the Tdap vaccine as required for a new job.

The day after vaccination, she experienced pain and numbness in her feet, which progressed over the following weeks. MRIs revealed lesions consistent with demyelination, and she was initially diagnosed with TM.

Later, she was diagnosed with MS. The parties stipulated that she had pre-existing, asymptomatic MS lesions prior to vaccination and that her symptoms began the day after the vaccine.

The core dispute was whether the Tdap vaccine could trigger an MS relapse in a susceptible individual and whether the rapid onset of symptoms was medically plausible. Petitioner's experts argued that inflammation from the vaccine could trigger latent MS lesions, citing animal studies and literature on immune responses.

Respondent's expert argued that the onset was too rapid for an immune response and that vaccines do not cause MS or its relapses. The Special Master found that the petitioner provided a reputable medical theory and a logical sequence of cause and effect, demonstrating that the Tdap vaccine triggered her pre-existing MS into a clinically symptomatic state within a medically acceptable timeframe.

The court found that the respondent failed to prove an alternative cause unrelated to the vaccine. Therefore, entitlement to compensation was granted, and the case would proceed to damages.