James Lagle v. HHS - Influenza, Shoulder Pain and Dysfunction (SIRVA) (2022)

James Lagle, a 59-year-old adult, received an intradermal influenza vaccine on October 20, 2015. Within hours, he began experiencing soreness in his right shoulder, which progressed to significant pain over the next two days.

He was diagnosed with bursitis and later a rotator cuff tear, leading to surgery. Mr.

Lagle alleged that the vaccine caused his shoulder injury, a Shoulder Injury Related to Vaccine Administration (SIRVA). He presented testimony from himself, his fiancée, and his sisters, along with medical records and expert opinions from Drs.

Shaer, Srikumaran, and Bodor. These experts opined that the intradermal vaccine, even with its short needle, could have been injected too deeply due to technique or tissue compressibility, causing an inflammatory response that aggravated a pre-existing, asymptomatic rotator cuff tear.

Respondent argued that the vaccine's needle was too short to reach the shoulder structures and that Mr. Lagle's pain was due to the natural progression of a pre-existing, asymptomatic rotator cuff tear, unrelated to the vaccine.

Respondent's experts, Drs. Schroeder and Cagle, believed the pain onset was too delayed and not causally linked to the vaccine.

The Special Master found that Mr. Lagle established by a preponderance of the evidence that his shoulder pain and dysfunction began within 48 hours of vaccination and that the vaccine initiated an immune-mediated inflammatory response that caused his pre-existing condition to become symptomatic.

Therefore, entitlement to compensation was granted, pending a damages decision.