Andres Nieves v. HHS - Influenza, Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) (2023)

Andres Nieves, a 57-year-old male, received an influenza vaccine on October 28, 2015. He filed a petition alleging the vaccine caused Guillain-Barré syndrome (GBS).

Initially, his symptoms included feverishness and achiness on the day of vaccination, followed by malaise and body aches the next day. By October 31, he reported feeling strange, noticing a change in his walking, and experiencing loss of sensation in his hands and feet.

He sought medical attention on November 2 with complaints of fatigue, leg pain, and lower back pain, and saw a neurologist on November 3, reporting paresthesias. He was admitted to the hospital on November 10 with weakness and concerns for GBS, and was diagnosed with GBS and treated with IVIG.

However, two months later, in January 2016, his symptoms persisted, and a neurologist suggested chronic inflammatory demyelinating polyneuropathy (CIDP) due to the prolonged duration. Subsequent EMG testing in February 2016 was consistent with CIDP.

The case initially proceeded as a Table claim for GBS, but the Chief Special Master dismissed it, finding the ultimate diagnosis was CIDP, not GBS. The case then moved to an off-Table causation-in-fact claim for CIDP.

Petitioner's experts argued the flu vaccine likely caused his CIDP, citing molecular mimicry and case reports. Respondent's experts contested the diagnosis and causation.

The Chief Special Master ultimately denied entitlement, finding that while the CIDP diagnosis was supported, the record did not establish that the flu vaccine caused the CIDP or that the onset of neurologic symptoms occurred within a medically acceptable timeframe following vaccination. This decision was affirmed on review by the Court of Federal Claims, which found the Special Master's factual findings were not arbitrary and capricious and that case management decisions were within the Special Master's discretion.