Michael Ray v. HHS - tetanus, shoulder injury related to vaccine administration (SIRVA) (2019)

Michael Ray filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging he suffered a shoulder injury related to vaccine administration (SIRVA) as a result of his January 6, 2016 tetanus vaccination. He reported immediate pain and swelling following the injection, which he felt was administered too high.

Although he experienced pain and swelling within 48 hours, he did not seek formal medical treatment for several weeks, eventually seeing an orthopedist on March 29, 2016. His orthopedist diagnosed him with left shoulder pain, AC joint osteoarthritis, and supraspinatus strain, noting the onset was related to the tetanus shot.

Subsequent evaluations revealed bursitis and tendinosis, and he underwent surgery for a labral tear and other shoulder issues about a year and a half after the vaccination. The respondent argued against compensation, primarily citing the delay in seeking treatment and questioning whether the injury began within the 48-hour window required for SIRVA.

The court, however, found that the petitioner met the three prongs of the Althen test for causation-in-fact. The court recognized that SIRVA is now on the Vaccine Injury Table for tetanus vaccines, supporting the medical theory prong.

It found a logical sequence of cause and effect, noting that the petitioner's contemporaneous medical records, including his own intake forms, consistently indicated the onset of pain on the date of vaccination, despite the delay in treatment. The court also found a proximate temporal relationship, as the pain began within 48 hours of the vaccination.

The respondent did not present evidence of any alternative cause. Therefore, the court granted the petitioner's motion and found him entitled to compensation for his SIRVA, with damages to be determined later.