A.B. v. HHS - MMR, afebrile seizure disorder or focal epilepsy (2024)

Filed 2015-08-21Decided 2024-01-30Vaccine MMR
deniedcognitive/developmental

Case summary [AI summaries can sometimes make mistakes]

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 January 30, 2024.

Theory of causation

Petitioner alleged that the MMR vaccine administered on August 27, 2012, caused A.B. to develop an afebrile seizure disorder or focal epilepsy. Petitioner's experts, Drs. Kinsbourne and Gershwin, theorized 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 cited studies suggesting that cytokines can cause seizures independent of fever and that the innate immune system responds rapidly. Respondent's experts, Drs. Wirrell and MacGinnitie, countered that the MMR vaccine, being a live-attenuated virus, requires replication time and typically causes inflammatory responses, including febrile seizures, 5-15 days post-vaccination, not within 24 hours. They argued that the medical literature does not support a rapid cytokine response to the MMR vaccine within 24 hours and that A.B.'s clinical presentation (afebrile, no encephalopathy, normal MRIs, seizure freedom 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 the medical literature did not support such a rapid response for live-attenuated vaccines and that A.B.'s clinical course was not consistent with vaccine-induced neuroinflammation. The petition was denied. Attorneys for petitioner were Mark T. Sadaka and attorneys for respondent were Mary E. Holmes. Special Master Thomas L. Gowen issued the decision on January 30, 2024.

Source PDFs 3 total · 1 downloaded