{"package_id":"USCOURTS-cofc-1_17-vv-01282","decision_granule_id":"USCOURTS-cofc-1_17-vv-01282-0","petitioner_identifier":"Adrian Cordova, IV","is_minor":1,"age_at_vaccination":13.0,"age_unit_raw":"years","vaccine_type":"HPV","vaccination_date":"2016-07-22","condition_raw":"alopecia areata","condition_category":"other","autism_spectrum_adjacent":0,"outcome":"denied","award_amount_usd":null,"decision_date":"2021-08-02","extraction_version":"gemini-v2","extracted_at":"2026-04-30T02:52:43.939298+00:00","number_of_concurrent_vaccines":1,"dose_number":1,"time_to_onset_days":42,"theory_of_causation":"Petitioner Adrian Cordova, IV, a minor at the time of vaccination, received his first dose of the HPV vaccine on July 22, 2016, and a second dose on October 12, 2016. He alleged that the HPV vaccine caused or significantly aggravated alopecia areata (AA). This was an off-Table claim requiring proof of causation. Petitioner's expert, Dr. M. Eric Gershwin, opined that the HPV vaccine could trigger an autoimmune response via molecular mimicry, leading to T cell attacks on hair follicles. Respondent's expert, Dr. Andrew MacGinnitie, disputed this, stating the HPV vaccine's intended response is antibody-mediated (B cells), not T cell-mediated, and that no reliable evidence links the HPV vaccine to AA. The Special Master found that Petitioner failed to establish a reputable medical theory that the HPV vaccine can cause AA, as the evidence did not sufficiently support the claim that the vaccine could instigate or trigger AA, and the cited studies were small-scale and did not definitively show an increase in the specific T cells responsible for AA. The Special Master also found that Petitioner did not establish a logical sequence of cause and effect, as no treating physician linked the vaccine to the AA, and the temporal association alone was insufficient. The claim for significant aggravation also failed because the vaccine's ability to worsen AA was not established. The petition was denied. Attorneys involved were Amy Senerth for Petitioner and Camille Collett for Respondent. Chief Special Master Brian H. Corcoran issued the decision on August 2, 2021.","is_death":0,"date_of_death":null,"petition_filed_date":"2017-09-18","case_summary":"On September 18, 2017, Erika Hicks, as parent and natural guardian of Adrian Cordova, IV, a minor, filed a petition seeking compensation under the National Vaccine and Injury Compensation Program. The petition alleged that Adrian Cordova, IV suffered from alopecia areata (AA) attributable to a human papillomavirus (HPV) vaccine received on July 22, 2016, or that a second HPV dose received on October 12, 2016, significantly aggravated his condition. The caption was later amended when Mr. Cordova turned 18. The case was resolved on the record by Chief Special Master Brian H. Corcoran.\n\nMr. Cordova, then thirteen years old, received his first dose of the HPV vaccine on July 22, 2016. Approximately six weeks later, in September 2016, his mother noticed a bald spot on his head, which progressed. He was diagnosed with alopecia areata (AA), an autoimmune condition causing hair loss. On October 12, 2016, the same day he received his second HPV vaccine dose, Petitioner's pediatrician observed patchy, non-scarring bald spots and diagnosed AA, referring him to a dermatologist. However, subsequent visits to his pediatrician noted improvement with cortisone injections, and a diagnosis of fungal infection was also considered and treated. By September 2017, he was diagnosed with widespread alopecia areata on about 80 percent of his scalp and prescribed an oral steroid. Medical records ceased in January 2018, with ongoing issues related to financing care and psychological harm from hair loss.\n\nThe Petitioner's expert, immunologist M. Eric Gershwin, M.D., opined that the HPV vaccine could trigger an autoimmune response via molecular mimicry, leading to T cell attacks on hair follicles, causing AA or exacerbating it. Dr. Gershwin cited general principles of AA pathogenesis, the potential for vaccines to cause rare adverse events, and small studies suggesting T cell upregulation after HPV vaccination. He proposed that cytotoxic T cells could generate within days of a vaccine signal.\n\nThe Respondent's expert, immunologist Andrew MacGinnitie, M.D., Ph.D., disputed the link between the HPV vaccine and AA. He argued that Dr. Gershwin's theory lacked reliable evidence of homology between vaccine antigens and hair follicle proteins, and that molecular mimicry is not a known mechanism for AA. Dr. MacGinnitie stated that large-scale epidemiologic studies do not associate the HPV vaccine with autoimmune conditions and that the HPV vaccine is designed to elicit a B cell antibody response, not the T cell response understood to drive AA. He also contended that the medical record did not support the claim that the second dose worsened Mr. Cordova's AA, noting improvement with treatment and that significant worsening was not evident until much later.\n\nChief Special Master Corcoran found that the Petitioner had not carried the burden of proof for entitlement. Regarding the first Althen prong (a medical theory connecting vaccination and injury), the Special Master found insufficient reliable evidence to support the theory that the HPV vaccine could cause AA. While acknowledging AA is autoimmune and T cell-mediated, the evidence presented, including small studies like Yokomine and Herrin, did not conclusively demonstrate that the HPV vaccine causes an upregulation of the specific cytotoxic T cells responsible for AA, or that any observed T cell increases were pathogenic rather than a normal immune response. The Special Master also noted the lack of general epidemiologic studies linking the HPV vaccine to AA and found that Petitioner could not rely on the rarity of the injury to excuse the lack of sufficient proof.\n\nFor the second Althen prong (a logical sequence of cause and effect), the Special Master found that only a temporal association linked the AA onset to the first HPV dose, with no evidence of an immediate reaction or preceding inflammatory process, and no treating physician linked the vaccine to the AA. The claim for significant aggravation also failed because the Petitioner did not establish that the HPV vaccine could cause AA to worsen, as the evidence did not preponderantly show the vaccine could initiate the autoimmune attack or impact AA once present.\n\nConsequently, the petition was denied.","is_minor_inferred":null,"is_pediatric_broad":1,"special_master":"Brian H. Corcoran","petitioner_identifier_original":null,"caption_petitioner_name":null,"petitioner_attorney_name":"Amy Senerth","petitioner_attorney_firm":"Muller Brazil, LLP","petitioner_attorney_location":"Dresher, PA","adjudicator_name":null,"caption_people_backfilled_at":null,"attorney_canonical_keys":"|amy-senerth|","firm_canonical_key":"muller-brazil","package_title":"CORDOVA v. SECRETARY OF HEALTH AND HUMAN SERVICES","canonical_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01282","plain_text_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01282.txt","json_url":"https://vicp-registry.org/case/USCOURTS-cofc-1_17-vv-01282.json","source_documents":[{"granule_id":"USCOURTS-cofc-1_17-vv-01282-0","title":"CORDOVA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 06/23/2021) regarding 83 DECISION of Special Master Signed by Chief Special Master Brian H. Corcoran. (omg) Service on parties made.","date_issued":"2021-08-02","pdf_url":"https://api.govinfo.gov/packages/USCOURTS-cofc-1_17-vv-01282/granules/USCOURTS-cofc-1_17-vv-01282-0/pdf","pdf_bytes":485637,"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-01282/USCOURTS-cofc-1_17-vv-01282-0"},{"granule_id":"USCOURTS-cofc-1_17-vv-01282-1","title":"CORDOVA v. SECRETARY OF HEALTH AND HUMAN SERVICES","docket_text":"PUBLIC DECISION (Originally filed: 11/22/2021) regarding 90 DECISION of Special Master - Fees. Signed by Chief Special Master Brian H. Corcoran. (kav) Service on parties made.","date_issued":"2021-12-17","pdf_url":null,"pdf_bytes":null,"triage_decision":"skip","triage_reason":"fees-only decision (attorney compensation)","download_status":"skipped"}]}