Joy Houston v. HHS - Tdap, chronic inflammatory demyelinating polyneuropathy (CIDP) (2021)

Joy Houston, a 33-year-old adult, received a Tdap vaccine on October 6, 2016. She later developed chronic inflammatory demyelinating polyneuropathy (CIDP).

The petition alleged that the Tdap vaccine caused her CIDP. Ms.

Houston's medical history was complicated by uncontrolled type 2 diabetes with neuropathy, which predated the vaccination. She experienced various symptoms, including pain, weakness, and numbness, particularly in her lower extremities, following her vaccination and subsequent childbirth.

The case proceeded as an off-Table claim, meaning Ms. Houston had to prove causation.

She presented expert testimony from Dr. Cornel Rogers, her treating neurologist, who opined that the Tdap vaccine could have caused her CIDP, primarily through molecular mimicry and by eliminating other potential causes.

Respondent presented expert testimony from Dr. Brian Callaghan, who disputed the causal link between the Tdap vaccine and CIDP, highlighting differences in the disease mechanisms of CIDP and Guillain-Barré syndrome (GBS) and noting a lack of evidence supporting molecular mimicry as a trigger for CIDP.

Dr. Callaghan also emphasized the petitioner's pre-existing diabetes and poor glycemic control as potential contributors to her neurological symptoms.

The court found that Ms. Houston failed to establish the first Althen prong, that the Tdap vaccine can cause CIDP, as Dr.

Callaghan's expert opinion was given greater weight due to his specialized expertise and the scientific literature presented. The court also found that Ms.

Houston did not sufficiently prove a logical sequence of cause and effect linking the vaccine to her CIDP, noting the significant influence of her pre-existing diabetes and the difficulty in untangling symptoms. Consequently, the petition was dismissed for failure to meet the burden of proof.