Theodore A. Bryan v. HHS - Influenza, chronic fatigue syndrome (2020)

Theodore Bryan, a 42-year-old adult, received an influenza vaccine on October 10, 2011. Within two days, he developed symptoms including joint pain, swelling, and fatigue, which he and his treating physicians believed progressed into chronic fatigue syndrome (CFS).

Mr. Bryan presented with a severe reaction to the vaccine, including inability to move, joint swelling, and pain, which lasted for at least five months.

His condition was initially treated as a possible reaction to the flu shot or serum sickness, but his symptoms persisted and evolved. Over time, his symptoms included significant fatigue, cognitive difficulties, muscle weakness, pain, and sleep disturbances.

He sought treatment from multiple physicians, including his primary care doctor, a rheumatologist, a neurologist, and specialists in sleep and neuropsychology. His treating physician, Dr.

Regina Smith, opined that the flu vaccine triggered his CFS. Expert witnesses for both sides testified, with Dr.

Charles Lapp supporting Mr. Bryan's claim and arguing that the vaccine caused immune dysregulation leading to CFS.

Respondent's expert, Dr. Kenneth Fife, initially questioned the diagnosis and causation but ultimately conceded that Mr.

Bryan met the diagnostic criteria for CFS and that his fatigue predated the vaccine. The court found that Mr.

Bryan met the criteria for an off-Table claim, establishing a plausible medical theory connecting the flu vaccine to CFS through immune dysregulation, a logical sequence of cause and effect supported by his medical records and treating physician's opinion, and a medically acceptable temporal relationship of two days between vaccination and symptom onset. The court ruled that Mr.

Bryan is entitled to compensation, with damages to be determined later.