Ramona Knorr v. HHS - Influenza, microscopic polyangiitis (“MPA”) (a form of anti-neutrophil cytoplasmic antibody (“ANCA”)-positive vasculitis) with renal failure, and polyneuropathy (2019)

Ramona Knorr filed a petition alleging that she suffered from microscopic polyangiitis (MPA), renal failure, and polyneuropathy as a result of receiving influenza vaccines on November 7, 2012, and October 8, 2013. The court considered her claim as an off-Table injury, requiring proof of causation.

Petitioner's primary theory was that the vaccines caused her MPA, with her expert, Dr. Gershwin, proposing molecular mimicry and bystander activation as potential mechanisms.

Respondent's experts, Drs. Whitton and Oddis, argued that the flu vaccine does not cause vasculitis and that Petitioner's condition was more likely due to other factors, such as a prior Epstein-Barr virus (EBV) infection or chronic ear infections.

The court found that Petitioner did not establish a credible medical theory linking the flu vaccine to MPA, noting that her expert lacked specialized knowledge in vasculitis and that the scientific literature did not strongly support the proposed mechanisms. The court also found that Petitioner's earlier ENT symptoms were not clearly linked to her MPA diagnosis.

While there was a temporal association between the second vaccine and her MPA onset, the court concluded that the evidence did not preponderantly establish that the vaccine caused her injury. Therefore, Petitioner's claim for entitlement to compensation was denied.