Jose Gamboa-Avila v. HHS - Pneumococcal, Guillain-Barré syndrome (2023)

Jose Gamboa-Avila, a 48-year-old male with HIV-AIDS, filed a petition alleging that a pneumococcal vaccine received on November 13, 2017, caused him to develop Guillain-Barré syndrome (GBS). He reported symptoms including body aches, headache, night sweats, and numbness starting around the vaccination date, progressing to facial droop, difficulty eating, and weakness.

He was hospitalized and diagnosed with GBS in December 2017. The case proceeded as an off-Table claim, requiring proof of causation.

Petitioner's expert, Dr. Lawrence Steinman, proposed a molecular mimicry theory, suggesting that components of the pneumococcal vaccine, specifically phosphoglycerol and phosphocholine, could cross-react with nerve myelin, leading to GBS.

He also proposed a secondary theory involving the vaccine's conjugate component. Respondent's expert, Dr.

J. Lindsay Whitton, countered that the pneumococcal vaccine's components are not known to cause GBS, that the underlying bacterium is not associated with GBS, and that the vaccine's structure differs significantly from known GBS triggers like Campylobacter jejuni.

Dr. Whitton also argued that studies cited by Dr.

Steinman, particularly those related to Multiple Sclerosis (MS), were not applicable to GBS. The Chief Special Master denied entitlement, finding that Petitioner failed to preponderantly establish that the pneumococcal vaccine can cause GBS, which was a sufficient basis for dismissal.

The court later affirmed this decision on review, agreeing that the Chief Special Master applied the correct preponderance standard and that the evidence presented did not establish the necessary causal link.