R.W. v. HHS - Tdap, transverse myelitis, neurogenic bladder, neurogenic bowel, scoliosis, and paraplegia (2026)

Jennifer and Charles Williford, parents of R.W., filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that their daughter developed transverse myelitis (TM), neurogenic bladder, neurogenic bowel, scoliosis, and paraplegia caused by the Tdap and meningococcal vaccines she received on September 11, 2015. R.W. was 11 years old at the time of vaccination.

Sixteen days after vaccination, R.W. presented with leg weakness and numbness, progressing to paralysis. She was hospitalized and diagnosed with TM, later transferred to Duke University Hospital for further treatment.

Extensive medical workup was performed, including MRIs, blood tests, and consultations with various specialists. The medical team at Duke ultimately characterized her condition as acute flaccid myelitis (AFM), likely virally mediated, though a specific virus was not definitively identified.

Petitioners' experts argued for TM caused by the vaccines via molecular mimicry, while Respondent's experts argued for AFM caused by a virus, not the vaccines. After reviewing the evidence, the Special Master concluded that R.W.'s condition was more consistent with AFM than TM.

However, the court found that Petitioners failed to establish a sound medical theory connecting the vaccines to AFM (Althen prong one) and failed to prove a logical sequence of cause and effect (Althen prong two). Therefore, entitlement was denied.