Marissa Nicole Como v. HHS - Meningococcal, small fiber neuropathy and related sequelae (2020)

Marissa Nicole Como, a 20-year-old college student, received a meningococcal B vaccine (Trumenba) on February 8, 2015. She alleged that this vaccination caused her to develop small fiber neuropathy and related sequelae.

The primary issue in this decision was determining the onset of her symptoms. The respondent argued that medical records indicated symptoms began before the vaccination, while Ms.

Como presented extensive evidence, including contemporaneous records and later statements, to rebut this. The court found that Ms.

Como was in good health before the vaccination and that her symptoms, including arm pain, fatigue, headache, neck and shoulder pain, nausea, dizziness, and a rash, began on the evening of vaccination or shortly thereafter. The court determined that the student health center and emergency room records suggesting an earlier onset were inaccurate, likely due to the busy environment and Ms.

Como's severe symptoms hindering her ability to communicate accurately. Multiple treating physicians noted a potential causal link between the vaccine and her subsequent symptoms, including suspected aseptic meningitis and small fiber neuropathy.

A skin biopsy later confirmed small fiber neuropathy. The court made findings of fact regarding the onset of symptoms and ordered the parties to propose further proceedings, indicating entitlement was likely to be granted but damages were pending.