M.M. v. HHS - Influenza, Guillain-Barré Syndrome (“GBS”); Neuroinflammation; Asthma exacerbation (2024)

On April 24, 2018, M.M. (Petitioner) filed a petition seeking compensation under the National Vaccine Injury Compensation Program, alleging that an influenza vaccine administered on September 19, 2015, caused an exacerbation of her pre-existing asthma and an unspecified neurological injury, specifically neuroinflammation and Guillain-Barré Syndrome (GBS). Respondent, the Secretary of Health and Human Services, argued against compensation.

Special Master Nora Beth Dorsey issued a decision on July 18, 2024, finding that Petitioner failed to prove by a preponderance of the evidence that the flu vaccination caused her alleged neurological condition or significantly aggravated her asthma. The petition was dismissed.

Petitioner, who was 53 years old at the time of vaccination, had a 20-year history of asthma, including a hospitalization in 2011 and an emergency department visit in 2012. The parties stipulated to this pre-existing condition.

The dispute centered on whether Petitioner developed a definable neuroinflammatory autoimmune disease or suffered a neurological injury, and whether the flu vaccine caused these conditions or significantly aggravated her asthma. The parties also disputed whether an intervening upper respiratory infection (URI) was the cause of any alleged conditions.

Regarding the neurological injury, Petitioner reported experiencing paresthesias (numbness and tingling) in her hands and feet approximately three weeks after vaccination. However, her neurological examinations, including those by neurologists Dr.

Leslie S. Saland and Dr.

Sami Khella, were largely normal, showing intact strength, sensation, and reflexes. Diagnostic tests, including nerve conduction studies (NCS), did not support a diagnosis of GBS or neuroinflammation.

An NCS revealed mild right median neuropathy consistent with carpal tunnel syndrome, a condition not attributed to the vaccine. While Petitioner's primary care physician, Dr.

Gary Rogg, and her expert, Dr. Omid Akbari (an immunologist), suggested a link between the vaccine and neurological symptoms, the Special Master found the opinions of Respondent's expert, Dr.

Arnold I. Levinson, to be more persuasive.

Dr. Levinson opined that Petitioner's symptoms were inconsistent with GBS and that there was no evidence of a neuroinflammatory disorder.

The Special Master noted that Petitioner had pre-existing conditions, including lumbar radiculopathy and degenerative disc disease, which could explain her symptoms of numbness and tingling. Ultimately, the Special Master concluded that Petitioner failed to prove she suffered from neuroinflammation or GBS, and therefore, a causation analysis was not necessary.

Even if she had proven the injury, the Special Master found she failed to prove a logical sequence of cause and effect linking the vaccine to the alleged neurological injury. Regarding the asthma exacerbation, Petitioner experienced symptoms of a URI and sinusitis starting around October 8, 2015, about two weeks after vaccination.

Her pulmonologist, Dr. Scott M.

Klares, diagnosed an asthma exacerbation related to the URI and sinusitis. Petitioner's respiratory function returned to baseline by November 12, 2015.

The Special Master found that Petitioner experienced a significant aggravation of her asthma between October 8 and November 12, 2015. However, the Special Master found Petitioner's expert, Dr.

Akbari's, theory that the flu vaccine could cause asthma exacerbation via an autoreactive T cell mechanism to be unpersuasive, citing a lack of supporting medical literature and Dr. Levinson's opinion that asthma is not an autoimmune disease.

Furthermore, the Special Master found that Respondent proved by a preponderance of the evidence that an intervening URI was the overwhelming cause of Petitioner's asthma exacerbation, citing the opinions of Petitioner's treating physicians and Dr. Levinson, as well as supporting medical literature.

Therefore, the petition was dismissed.