Dana Broussard v. HHS - Hepatitis B, neuromyelitis optica (2024)

Dana Broussard, born in October 1966, received her third dose of the hepatitis B vaccine on April 24, 2016. Within approximately two weeks, she began experiencing severe back pain, which progressed to leg weakness, loss of sensation, and paraplegia.

She was diagnosed with transverse myelitis (TM) and neuromyelitis optica (NMO), an autoimmune demyelinating disease. Ms.

Broussard alleged that the hepatitis B vaccine caused her NMO. The Secretary of Health and Human Services disputed this, arguing that Ms.

Broussard failed to prove a causal link. The case proceeded as an off-Table claim, requiring proof of causation under the Althen standard.

Ms. Broussard's expert, Dr.

Salvatore Napoli, proposed the theory of molecular mimicry, suggesting that the hepatitis B vaccine's antigens shared similarities with the aquaporin-4 water channels targeted in NMO. However, the court found that Dr.

Napoli did not provide persuasive evidence of homology between the hepatitis B vaccine and aquaporin-4. The respondent's expert, Dr.

Subramaniam Sriram, testified that different demyelinating diseases have different pathogenic pathways and that there were no articles specifically showing cross-reactivity or shared homologies between aquaporin-4 and the hepatitis B vaccine. The court also noted that case reports, which formed a significant part of Ms.

Broussard's evidence, generally have limited value in establishing causation. Ultimately, the court concluded that Ms.

Broussard did not present preponderant evidence of a medical theory causally connecting the hepatitis B vaccination to her NMO. Therefore, her claim for compensation was denied.