A.J.K. v. HHS - MMR, posterior reversible leukoencephalopathy or stroke, seizure disorder and their sequelae (2023)
Case summary [AI summaries can sometimes make mistakes]
On September 28, 2017, Andrew Kaltenmark and Danielle Kaltenmark, parents of A.J.K., a minor, filed a petition alleging that A.J.K.'s Measles, Mumps, and Rubella (MMR), varicella, and Influenza (flu) vaccinations administered on September 29, 2014, caused posterior reversible leukoencephalopathy syndrome (PRES), seizure disorder, and their sequelae. An amended petition later included Hepatitis A (Hep A) vaccine and alleged aggravation of an underlying seizure condition.
The case proceeded as an off-Table claim, requiring petitioners to prove causation-in-fact. Petitioners' experts, pediatric neurologist AHM Mahbubul Huq and immunologist M.
Eric Gershwin, theorized that the vaccinations, in combination with a resolving hand, foot, and mouth disease (HFMD) infection, triggered an inflammatory cytokine response that disrupted the blood-brain barrier, leading to PRES. Respondent's experts, immunologist Thomas G.
Forsthuber and pediatric neurologist Peter M. Bingham, argued that the medical literature does not support vaccines causing PRES, that the cytokine levels expected from vaccination are too low to disrupt the blood-brain barrier, and that A.J.K.'s condition was more likely a stroke caused by hypertension or her prior HFMD infection.
The Special Master, Daniel T. Horner, found that while PRES is a recognized condition and can be theorized as cytokine-mediated, petitioners failed to present preponderant evidence that vaccines can cause PRES or that A.J.K.'s specific condition was vaccine-caused.
The Special Master noted that the timing of A.J.K.'s symptoms (approximately two days post-vaccination) was consistent with an innate immune response, but the lack of clinical evidence of inflammation and the insufficient scientific support for the vaccine-cytokine-PRES pathway led to the denial of entitlement. The petition was dismissed.
Petitioner counsel was Edward Kraus. Respondent counsel was Colleen Hartley.