Martin Cowles v. HHS - Influenza, vestibular migraines (2023)

Martin Cowles, a 44-year-old pilot, received a FluMist influenza vaccine on October 17, 2013. Within days, he began experiencing dizziness and nausea, which he reported as vertigo.

His treating physicians considered diagnoses including viral labyrinthitis and viral neuronitis. Over time, the consensus among his treating physicians and respondent's experts leaned towards vestibular migraines, with some contribution from a cervical spine issue.

Mr. Cowles and his expert, Dr.

Hicks, maintained that he suffered from vestibular neuritis, theorizing that the FluMist vaccine triggered a stress response that reactivated latent Herpes Simplex Virus-1 (HSV-1), leading to inflammation and damage to the vestibular nerve. Respondent's experts, Drs.

Bigelow and Collins, along with Mr. Cowles's treating physicians, argued against this theory, citing anatomical implausibility, lack of evidence for vaccine-induced HSV-1 reactivation, and the ineffectiveness of antiviral treatments for vestibular neuritis.

They also pointed to Mr. Cowles's prior history of vertigo-like symptoms in 2006 and 2011, and his partial response to amitriptyline, a medication used for migraines, as evidence supporting vestibular migraines.

The court found that Mr. Cowles failed to establish a diagnosis of vestibular neuritis and did not present a sound and reliable medical theory of causation linking the FluMist vaccine to his condition.

Furthermore, the court found that his chronic symptoms began after an upper respiratory infection in February 2014, which was too remote from the vaccination to establish a causal link. Consequently, the petition was dismissed.