A.B. v. HHS - MMR, afebrile seizure disorder or focal epilepsy (2023)

On August 21, 2015, Craig Burchianti, on behalf of his minor child A.B., filed a petition alleging that the measles-mumps-rubella (MMR) vaccine administered on August 27, 2012, caused A.B. to develop an afebrile seizure disorder or focal epilepsy. A.B. was nearly five years old at the time of the vaccination.

Petitioner presented expert testimony from Dr. Marcel Kinsbourne and Dr.

Eric Gershwin, who opined that the MMR vaccine triggered A.B.'s innate immune system, releasing pro-inflammatory cytokines that stimulated a hyperexcitable region in her brain, leading to afebrile seizures within 24 hours. They argued that this rapid inflammatory response, even without fever, could cause seizures.

Respondent, through experts Dr. Elaine Wirrell and Dr.

Andrew MacGinnitie, argued that the MMR vaccine, being a live-attenuated virus, does not cause a rapid inflammatory response within 24 hours and that the medical literature primarily links the MMR vaccine to febrile seizures occurring 5-15 days post-vaccination. They contended that A.B.'s clinical presentation, including the absence of fever, encephalopathy, and normal MRIs, along with her eventual seizure freedom and normal development off medication, was more consistent with new-onset focal epilepsy of unknown cause.

The Special Master found that petitioner failed to establish a sound and reliable medical theory connecting the MMR vaccine to A.B.'s afebrile seizures within 24 hours, noting that the medical literature did not support such a rapid response for live-attenuated vaccines like MMR. The court also found that A.B.'s clinical course was not consistent with vaccine-induced neuroinflammation.

Consequently, the petition was denied for failure to prove causation. The decision was issued by Special Master Thomas L.

Gowen on April 11, 2023.