Melissa Larson v. HHS - Influenza, Guillain-Barré syndrome (GBS) (2023)

Melissa Larson, a 36-year-old respiratory therapist, received an influenza vaccine on November 6, 2013, as a condition of her employment. Approximately six weeks later, she presented with severe lower back pain, which was initially diagnosed as a sprain.

Shortly thereafter, she developed new symptoms including numbness, facial drooping, shortness of breath, difficulty swallowing, and increasing weakness. A neurologist raised the possibility of Guillain-Barré Syndrome (GBS), and she was hospitalized for monitoring and tests, including a spinal tap which showed slightly elevated protein.

Despite these concerns, she was not treated for GBS and her symptoms largely subsided. Her discharge diagnoses included generalized weakness and possible GBS.

Over the following year, Larson sought treatment from various specialists for recurring symptoms, with physicians increasingly questioning the GBS diagnosis and considering fibromyalgia as a more likely cause. Her worker's compensation claim for a vaccine injury was denied, and a neurologist opined that a clear diagnosis of GBS could not be made.

In October 2014, a neurologist diagnosed her with fibromyalgia, a diagnosis echoed by subsequent medical professionals. Larson was eventually treated for fibromyalgia and returned to work in April 2016.

The Special Master denied entitlement, finding that Larson failed to demonstrate by a preponderance of the evidence that she suffered from GBS, citing inconsistencies with typical GBS presentations, normal EMG/NCS results, and her recovery without GBS-specific treatment. The Court of Federal Claims affirmed this decision, agreeing that Larson did not meet her burden of proof for GBS.

The Court also noted that Larson's claim had evolved from an initial fibromyalgia diagnosis to a GBS-focused claim, with fibromyalgia later presented as a sequela of GBS, and found no basis to remand for consideration of a standalone fibromyalgia claim.