{"package_id":"USCOURTS-cofc-1_17-vv-00714","decision_granule_id":"USCOURTS-cofc-1_17-vv-00714-1","petitioner_identifier":"Zacharia Farag","is_minor":1,"age_at_vaccination":12.25,"age_unit_raw":"years","vaccine_type":"HPV","vaccination_date":"2016-05-16","condition_raw":"alopecia areata totalis","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2023-11-01","extraction_version":"gemini-v2","extracted_at":"2026-04-30T02:51:59.053448+00:00","number_of_concurrent_vaccines":1,"dose_number":null,"time_to_onset_days":14,"theory_of_causation":"Petitioner alleged that the HPV vaccine administered on May 16, 2016, caused Zacharia Farag to develop alopecia areata totalis (AA) through a theory of molecular mimicry. Petitioner's expert, Dr. M. Eric Gershwin, proposed that the vaccine produced cytotoxic T cells that cross-reacted with hair follicles, leading to AA. Dr. Gershwin cited the mouse model of AA and the presence of CD8+ T cells in affected follicles as support. He acknowledged that the HPV vaccine is not designed to produce CD8 T cells but argued it was theoretically possible for Petitioner to be a rare individual who experienced such a response. Dr. Gershwin also submitted case reports and studies linking various vaccines and viral infections (including HPV infection) to hair loss and AA, but acknowledged limitations in these studies and the difficulty in proving molecular mimicry. Respondent's expert, Dr. Mehrdad Matloubian, countered that there is no scientific literature supporting the HPV vaccine's ability to induce cytotoxic T cells or a link between the HPV vaccine and AA. Dr. Matloubian emphasized the strong genetic component of AA, the lack of established environmental triggers, and the implausibility of molecular mimicry with HPV vaccine components given the differences between HPV and the vaccine's antigens. He suggested alternative causes like stress or microbiome changes. The Special Master found that Petitioner failed to provide preponderant evidence that the HPV vaccine can induce cytotoxic T cells or that it caused AA via molecular mimicry, thus failing Althen Prong One. The Special Master also found Petitioner failed to establish a logical sequence of cause and effect (Althen Prong Two), relying solely on temporal proximity. The proximate temporal relationship (Althen Prong Three) was met, with symptoms appearing approximately two weeks post-vaccination. Ultimately, the petition was denied because Petitioner did not prove causation by a preponderance of the evidence.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-05-31","case_summary":"On May 31, 2017, Lynn Farag filed a petition for compensation on behalf of her son, Zacharia Farag, alleging that the human papillomavirus (HPV) vaccine administered on May 16, 2016, caused him to develop alopecia areata totalis. Zacharia Farag was 12 years old at the time of vaccination. His mother reported that he first noticed hair loss around Memorial Day weekend of 2016, approximately two weeks after the vaccination, and that his condition progressed to total hair loss by November 2016. The petition detailed Zacharia's medical history, including a diagnosis of autism and strep throat prior to vaccination. Following the vaccination, he presented with complaints of hair loss, initially diagnosed as tinea barbae and tinea capitis, but later assessed as alopecia areata (AA) by a dermatologist. His condition worsened over time, leading to complete loss of scalp, brow, lash, and body hair by November 2016. Various treatments were attempted, including topical corticosteroids, sulfasalazine, and later immunotherapy with SADBE and diphenylcyclopropenone (DPCP), with limited success and some adverse effects like anemia and behavioral changes. Petitioner's expert, M. Eric Gershwin, M.D., proposed a theory of molecular mimicry, suggesting the HPV vaccine triggered cytotoxic T cells that attacked hair follicles. Respondent's expert, Mehrdad Matloubian, M.D., Ph.D., argued that the link between the HPV vaccine and alopecia areata is speculative and not supported by scientific literature, pointing to genetics and other potential triggers like stress or microbiome changes. The Special Master, Herbrina Sanders, reviewed the evidence, including medical records, affidavits, and expert testimony. The court found that Petitioner failed to establish a medical theory causally connecting the vaccine to the injury (Althen Prong One) or a logical sequence of cause and effect (Althen Prong Two). While a proximate temporal relationship was met (Althen Prong Three), the overall claim was denied because Petitioner did not prove by a preponderance of the evidence that the HPV vaccine caused his alopecia areata totalis. The petition was dismissed. Petitioner was represented by Mark T. Sadaka of the Law Offices of Sadaka Associates, LLC, and Respondent was represented by Dorian Hurley of the United States Department of Justice.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Herbrina Sanders Young","petitioner_identifier_original":null,"caption_petitioner_name":"Zacharia Farag","petitioner_attorney_name":"Mark T. Sadaka","petitioner_attorney_firm":"Law Offices of Sadaka Associates, LLC","petitioner_attorney_location":"Englewood, NJ","adjudicator_name":null,"caption_people_backfilled_at":"2026-05-05 23:44:13","attorney_canonical_keys":"|mark-sadaka|","firm_canonical_key":"law-offices-of-sadaka-associates","package_title":"FARAG v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00714","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00714.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-00714.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-00714-0","title":"FARAG v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 06/28/2021) regarding 52 DECISION of Special Master - Interim Attorney's Fees Signed by Special Master Herbrina Sanders. (kp) Service on parties made.","date_issued":"2021-07-20","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"},{"granule_id":"USCOURTS-cofc-1_17-vv-00714-1","title":"FARAG v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 09/29/2023) regarding 86 DECISION of Special Master. Signed by Special Master Herbrina Sanders. (rig) Service on parties made.","date_issued":"2023-11-01","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-00714/granules/USCOURTS-cofc-1_17-vv-00714-1/pdf","pdf_bytes":522582,"triage_decision":"keep","triage_reason":"docketText matches keep keyword 'decision of special master'","download_status":"ok","registry_pdf_url":"https://vicp-registry.org/pdf/USCOURTS-cofc-1_17-vv-00714/USCOURTS-cofc-1_17-vv-00714-1"},{"granule_id":"USCOURTS-cofc-1_17-vv-00714-2","title":"FARAG v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 12/06/2024) regarding 93 DECISION of Special Master - Fees. Signed by Special Master Herbrina D S Young. (kp) Service on parties made.","date_issued":"2025-01-31","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}