Gregory Cress v. HHS - Tdap, myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) (2025)
Case summary [AI summaries can sometimes make mistakes]
On September 7, 2018, Gregory Cress filed a petition alleging that a Tdap vaccination administered on September 15, 2015 caused a demyelinating neurologic illness. He was 36 years old at vaccination.
Mr. Cress's early records described vision problems by October 6, 2015.
Later that month, MRI imaging showed an extensive thoracic spinal cord lesion, and he was treated with steroids for what was first considered transverse myelitis or seronegative neuromyelitis optica. Aquaporin-4 testing was negative.
His diagnosis later shifted after MOG antibody testing was positive in 2017 and again in 2019, leading his physicians to characterize the illness as myelin oligodendrocyte glycoprotein antibody-associated disease. His clinical course included relapsing neurologic symptoms, visual complaints, weakness, and continuing treatment.
Petitioner initially relied on an expert opinion framed around neuromyelitis optica, then proceeded with Dr. Rizvi's opinion after the MOGAD diagnosis became central.
Dr. Rizvi proposed molecular mimicry and bystander activation, asserting that Tdap could trigger immune dysregulation leading to demyelination.
Respondent relied on neurologic and immunologic experts, including Dr. Sriram and Dr.
He, who argued that the medical literature did not show a reliable mechanism by which Tdap causes MOGAD and that the case did not contain persuasive treating-physician support for vaccine causation. Special Master Christian J.
Moran denied compensation on September 23, 2025. He found that the molecular mimicry theory did not identify a specific Tdap antigen or meaningful homology to MOG, that the bystander activation theory was too conclusory, and that the cited case reports and prior Vaccine Program decisions did not establish a reliable Tdap-MOGAD theory.
He also found that the case-specific record did not show a logical sequence of cause and effect. No compensation was awarded.
Mr. Cress was represented by Bridget McCullough of Muller Brazil.
Theory of causation
Tdap vaccine, September 15, 2015, age 36, alleged to cause MOG antibody-associated disease after visual symptoms by October 6, 2015 and transverse-myelitis-like findings by late October. DENIED. Petitioner relied on Dr. Rizvi after the diagnosis shifted from seronegative neuromyelitis optica to MOGAD; theories were molecular mimicry and bystander activation. Respondent's experts Dr. Sriram and Dr. He argued that the literature did not identify a reliable Tdap-MOGAD mechanism and that the case-specific proof was weak. Special Master Moran found no persuasive Althen prong one theory, no logical sequence tying Tdap to petitioner's MOGAD, and no treating-physician support for vaccine causation. Attorney Bridget McCullough.
Source PDFs
USCOURTS-cofc-1_18-vv-01369