Scott Robertson v. HHS - Influenza, nonarteritic anterior ischemic optic neuropathy (NAION) (2022)

Scott Robertson, an adult, received an influenza vaccine on October 28, 2016. Several weeks later, he experienced vision loss in his left eye, which progressed and was diagnosed as optic nerve swelling.

This was followed by vision loss in his right eye approximately two months later. While initially considered optic neuritis by some treating physicians, both parties' experts ultimately agreed that the best diagnosis was nonarteritic anterior ischemic optic neuropathy (NAION).

Robertson alleged that the flu vaccine caused his NAION, proceeding as an off-Table claim. He presented expert testimony suggesting potential mechanisms like immune complex-mediated vasculopathy and molecular mimicry, supported by case reports.

However, the court found that NAION is primarily a vascular/ischemic condition, not demyelinating, and that the evidence did not preponderantly establish a causal link between the vaccine and his condition. The court noted the unknown etiology of NAION, the lack of definitive evidence of vasculitis, the presence of other risk factors for NAION in Robertson, and the sequential nature of his vision loss, which was inconsistent with typical acute vaccine complications.

Ultimately, the court concluded that Robertson failed to meet the burden of proof under the Althen test for causation-in-fact and dismissed his petition for compensation.