Michael Schwarz v. HHS - Tdap, arthralgias (2024)

On May 1, 2018, Michael Schwarz filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine he received on May 20, 2015, caused him to develop transverse myelitis. However, during the course of litigation, Mr.

Schwarz clarified that his claim was for a severe inflammatory reaction characterized by arthralgias, and he was not alleging transverse myelitis, brachial neuritis, or chronic fatigue syndrome. The respondent, the Secretary of Health and Human Services, initially argued that Mr.

Schwarz's non-specific inflammatory response was not a cognizable injury. Special Master Katherine E.

Oler issued a ruling on May 1, 2024, finding that Mr. Schwarz had demonstrated he developed arthralgias post-vaccination and that the Tdap vaccine caused this condition, granting entitlement to compensation and deferring a decision on damages.

Mr. Schwarz, a 40-year-old physical therapist, received the Tdap vaccine on May 20, 2015.

Within two days, he developed neck pain and stiffness that spread to his shoulders and jaw, along with difficulty moving his right hand. Initial diagnoses included acute strain of his neck muscle and later polyarthralgia and bilateral arm weakness, with one physician noting it was "most likely this is an inflammatory reaction to the tetanus shot he received." His symptoms included migratory joint pain, swelling, and stiffness.

He was treated with a tapering course of prednisone and other medications. Over the course of his treatment, numerous other conditions were considered, including transverse myelitis, brachial neuritis, chronic fatigue syndrome, systemic inflammatory response syndrome (SIRS), reactive arthritis, and various other inflammatory and neurological conditions.

Petitioner's counsel was Richard Gage, and respondent's counsel was Catherine Stolar. The Special Master found that arthralgia is a medically recognized injury, supported by ICD-9 coding (719.49 for "pain in joint, multiple sites") and consistent diagnoses from treating physicians.

The Special Master also found that Mr. Schwarz met the severity requirement, demonstrating residual effects for more than six months post-vaccination, citing his continued wrist pain and localized tenderness in peripheral joints, shoulders, and knees as late as February 2016.

The Special Master determined that the Tdap vaccine caused his arthralgias, satisfying the three prongs of the Althen test for an off-Table claim: a sound medical theory connecting the vaccine and the injury (conceded by respondent's expert, Dr. Michael Wilson, who agreed the Tdap vaccine "did cause" his initial arthralgias), a logical sequence of cause and effect (supported by treating physicians' consistent attribution of symptoms to the vaccine and elevated inflammatory markers), and a proximate temporal relationship (symptoms began two days post-vaccination).

Entitlement to compensation was granted, with a decision on damages to follow.