G.J.B. v. HHS - MMR, afebrile seizures/epilepsy with stuttering, headache, altered mental status allegations, and developmental/motor concerns (2023)

On July 26, 2016, Alex and Tess Bechel filed a petition on behalf of their minor son, G.J.B., alleging that childhood vaccines administered on July 29, 2013, caused encephalopathy, epilepsy, seizures, delirium, confusion, altered mental state, and related injuries. The vaccines administered were Kinrix (containing diphtheria-tetanus-acellular pertussis and inactivated polio components), measles-mumps-rubella (MMR), and varicella.

The respondent opposed entitlement, and the case was decided on the written record. G.J.B. was born in May 2009.

Prior to vaccination, medical records noted speech development concerns, including an articulation delay identified in October 2012, for which speech therapy was recommended. Following the July 29, 2013 vaccinations, G.J.B.'s mother reported injection site redness and swelling, and that G.J.B. complained of headaches that evening and intermittently over the next few days.

Five days post-vaccination, on August 3, 2013, G.J.B.'s mother reported to a hospital that he was having difficulty remembering words and did not know his name. The record noted prior stuttering and speech problems but no fever.

The following day, his mother reported he was still stuttering and frustrated, believing the symptoms were related to the vaccines. On August 5, 2013, G.J.B.'s grandmother performed an at-home EEG, which she believed was abnormal.

The next day, G.J.B.'s mother reported the post-vaccination headache and the August 3rd symptoms to a pediatrician, who observed stuttering but found G.J.B. alert and oriented with no focal neurologic deficits. The pediatrician diagnosed stuttering and referred G.J.B. for a neurology consultation.

On August 7, 2013, a 24-hour video EEG at St. Joseph's Hospital revealed epileptiform discharges and 16 events consisting of stuttering or word repetition, suggesting multifocal or generalized epileptogenicity.

Dr. Marissa Vawter diagnosed G.J.B. with epilepsy of unknown etiology and prescribed Keppra.

Over the following months, G.J.B. was evaluated for joint pain, hypermobility, possible Ehlers-Danlos syndrome, motor delays, headaches, and eye findings. Autoimmune and rheumatologic testing was normal.

Subsequent epilepsy monitoring did not capture clinical seizure evidence despite parental reports. By 2016 and 2017, G.J.B.'s seizures were described as well controlled, with improvement in rheumatology follow-up.

Petitioners' experts were pediatric neurologist Dr. Marcel Kinsbourne and allergist/immunologist Dr.

Vera Byers. Dr.

Kinsbourne argued the MMR vaccine's attenuated measles virus was neurotropic and neuropathic, causing seizures within two weeks of vaccination, and that G.J.B.'s five-day onset was medically acceptable. Dr.

Byers proposed that vaccine-induced proinflammatory cytokines, particularly IL-1 beta, could lower seizure threshold and cause seizures independent of fever, citing G.J.B.'s leg swelling and headache as evidence of a sufficient inflammatory response. Respondent's experts were pediatric epileptologist Dr.

Shlomo Shinnar and immunologist Dr. Andrew MacGinnitie.

Dr. Shinnar agreed G.J.B. had epilepsy but characterized it as idiopathic, stating accepted medical understanding did not support vaccines causing afebrile seizures.

Dr. MacGinnitie disputed the cytokine theory, arguing that inflammatory cytokines are generally associated with febrile seizures and have not been shown to cause afebrile seizures or increase due to vaccination in harmful amounts.

Chief Special Master Brian H. Corcoran denied entitlement on May 22, 2023.

He found the timing of G.J.B.'s first reported neurologic symptoms, approximately five days post-vaccination, was consistent with the petitioners' theory. However, he concluded that petitioners failed to prove a reliable medical theory that the vaccines could cause afebrile seizures through the proposed cytokine mechanism and failed to show a logical sequence of cause and effect.

He noted the absence of fever, lack of testing showing sufficient cytokine levels, and insufficient treater support for vaccine causation. Judge Kathryn C.

Davis denied review on November 20, 2023, finding the special master's analysis was not arbitrary, capricious, an abuse of discretion, or contrary to law. No compensation was awarded.

Petitioner counsel was Isaiah Kalinowski of Bosson Legal Group. Respondent counsel was Colleen Clemons Hartley of the U.S.

Department of Justice.