Erwin Casazza v. HHS - Influenza, rheumatoid arthritis (2023)

Erwin Casazza, a 73-year-old man, filed a petition alleging that the influenza vaccine he received on September 3, 2015, caused him to suffer rheumatoid arthritis (RA). He later amended his petition to alternatively allege reactive arthritis.

The case proceeded as an off-Table claim, meaning Mr. Casazza had to prove causation-in-fact.

He presented expert testimony from Dr. M.

Eric Gershwin, who initially opined that the vaccine caused reactive arthritis but later agreed with respondent's experts that Mr. Casazza had RA.

Dr. Gershwin then proposed a theory that the flu vaccine could act as the final trigger for RA in predisposed individuals, citing post-vaccination cytokines and a bystander effect.

Respondent presented expert testimony from rheumatologist Dr. Brendan Antiochos and immunologist Dr.

Penelope Morel, who opined that the flu vaccine does not cause RA and that population studies show the flu vaccine is safe for RA patients. The court reviewed the evidence, including medical records and expert reports.

The court found Dr. Gershwin's theory of causation to be vague and unsupported by substantial evidence, particularly when contrasted with numerous epidemiological studies presented by the respondent that indicated no link between the flu vaccine and RA.

The court also noted that Mr. Casazza's treating physicians continued to recommend flu vaccinations, and he received them without incident.

Furthermore, the court found the temporal relationship between the vaccination and the onset of RA to be unclear and not definitively established as proximate. Ultimately, the court concluded that Mr.

Casazza had not met his burden of proof under the Althen test for causation-in-fact. Therefore, the petition was dismissed.