Marcie Unrue v. HHS - Tdap, transverse myelitis and neuromyelitis optica spectrum disorder (NMOSD) (2025)

On March 1, 2018, Marcie Unrue filed a petition alleging that a Tdap vaccine administered on May 6, 2017 caused transverse myelitis and neuromyelitis optica spectrum disorder. Her prior history included non-Hodgkin lymphoma in remission, hypertension, smoking, and orthopedic/nerve issues.

Ms. Unrue developed abrupt neurologic symptoms about two weeks after vaccination, including numbness from the chest down and urinary incontinence.

MRI findings supported transverse myelitis, and she was treated with steroids and plasmapheresis. Her course later evolved into recurrent neuromyelitis optica spectrum disorder, including flares treated with additional immunotherapy such as CellCept, plasmapheresis, and rituximab.

Petitioner relied on neurologist Dr. Fredrick Nahm, who proposed an immune-mediated/molecular mimicry theory linking Tdap to the first demyelinating event and later NMOSD.

Respondent relied on neurologist Dr. Marc Bouffard and immunologist Dr.

William Hawse. Special Master Herbrina D.

Young denied entitlement on December 4, 2025, finding that petitioner had not shown by preponderant evidence that Tdap caused the transverse myelitis or NMOSD.