E. A. v. HHS - Influenza, Bell's palsy (2023)

E.A., a 62-year-old woman, filed a petition alleging that her influenza vaccine administered on October 19, 2015, caused her to develop Bell's palsy. The respondent argued against compensation, stating the case was not appropriate for compensation under the Vaccine Act.

The parties stipulated that E.A. received the flu vaccine, that her symptoms consistent with Bell's palsy began on November 28, 2015 (40 days post-vaccination), and that she experienced residual effects for over six months. The central issue was whether E.A. proved causation under the Althen standard.

E.A. presented expert testimony from Dr. Kazim Sheikh, a neurologist, who opined that the flu vaccine caused Bell's palsy through an autoimmune response, specifically molecular mimicry.

Dr. Sheikh cited medical literature suggesting a link between vaccines and Bell's palsy, drawing parallels with Guillain-Barré syndrome.

Respondent presented expert testimony from Dr. Dara Jamieson, a neurologist, and Dr.

S. Mark Tompkins, an immunologist.

Dr. Jamieson opined that E.A.'s Bell's palsy was unrelated to the vaccine, citing a lack of recent epidemiological data linking parenteral flu vaccines to Bell's palsy and suggesting Ramsay Hunt syndrome as a differential diagnosis, though acknowledging no definitive proof.

Dr. Tompkins suggested infection or stress as more likely causes, but the court found his opinions less persuasive due to his lack of medical expertise in diagnosing and treating neurological conditions and his inconsistent use of probability standards.

The court found E.A. met all three Althen prongs: a sound medical theory (molecular mimicry), a logical sequence of cause and effect supported by her clinical course and MRI findings, and a proximate temporal relationship (40 days post-vaccination). The court also found the respondent failed to prove an alternative cause.

Therefore, the court ruled that E.A. is entitled to compensation, with damages to be determined in a separate order.