C.P. v. HHS - Influenza, polymyalgia rheumatica and/or seronegative rheumatoid arthritis (2019)

C.P., a 55-year-old male, filed a petition alleging he developed polymyalgia rheumatica (PMR) and/or seronegative rheumatoid arthritis (RA) as a result of an influenza vaccine received on October 14, 2011. The petitioner had a complex medical history, including a significant knee injury and surgery in 2011, which led to ongoing pain and inability to work.

He presented with various symptoms, including leg pain, numbness, and burning, around the time of his vaccination. His PMR symptoms were reported to have begun in mid-December 2011, with a diagnosis in January 2012.

Seronegative RA was suspected in March 2012 and diagnosed in July 2012. The petitioner's experts, Dr.

Kristin Gowin and Dr. Michael Gurish, proposed that the flu vaccine triggered his conditions through mechanisms like molecular mimicry.

However, they could not identify specific antigens involved or provide definitive links, especially for seronegative RA and PMR, which have unknown causes and autoantibodies. Respondent's expert, Dr.

Mehrdad Matloubian, a rheumatologist and immunologist, testified that there is no established biological link between the influenza vaccine or virus and PMR or RA, particularly seronegative RA. He argued that the petitioner's symptoms were more likely due to his pre-existing knee issues, other medical conditions, or were coincidental given the prevalence of these diseases.

The court found that the petitioner failed to establish a plausible medical theory, a logical sequence of cause and effect, or an appropriate temporal relationship between the vaccine and his alleged injuries. The court noted inconsistencies between the petitioner's testimony and medical records regarding symptom onset and attributed his inability to work primarily to his knee injury.

Ultimately, the court dismissed the petition, finding that the petitioner did not meet his burden of proof for an off-Table claim.