Ashley T. Hunsucker v. HHS - Influenza, small fiber neuropathy (2025)

Ashley T. Hunsucker, a 39-year-old adult, received an influenza vaccine on October 5, 2015.

She subsequently developed symptoms including numbness, tingling, paresthesias, muscle spasms, and weakness, which were eventually diagnosed as small fiber neuropathy (SFN) in 2017. Petitioner presented medical records and expert reports from Dr.

Lawrence Steinman, who theorized that the flu vaccine triggered an autoimmune response via molecular mimicry, causing SFN. Petitioner's treating physicians, including Dr.

Justin Mhoon, also noted a potential link between the vaccination and her symptoms, with Dr. Mhoon ordering a skin biopsy that confirmed reduced epidermal nerve fiber density consistent with SFN.

Respondent, the Secretary of Health and Human Services, contested entitlement, arguing through expert Dr. Christopher Gibbons that Petitioner did not have SFN, or if she did, it was caused by pre-diabetes, not the vaccine.

Dr. Gibbons also questioned the reliability of the skin biopsy and argued that Petitioner's symptoms were more consistent with pre-diabetes and anxiety, citing her prior history of these conditions and intermittent neurological symptoms dating back years before the vaccination.

The court found that Petitioner provided preponderant evidence of SFN and that the flu vaccine caused her condition, satisfying the three prongs of the Althen test for off-Table claims. The court found Dr.

Steinman's molecular mimicry theory to be a sound medical explanation and that the temporal relationship between the vaccination and symptom onset (approximately six days) was medically acceptable. The court was not persuaded by Respondent's arguments regarding alternative causes like pre-diabetes or anxiety, finding insufficient evidence that these factors were the sole substantial cause of Petitioner's SFN.

As entitlement was granted, a separate damages order will issue.