P.J. v. HHS - Meningococcal, cerebrovascular injury; focal cerebral arteriopathy; stroke (2025)

P.J., an 18-year-old, received a meningococcal vaccine on August 11, 2016. Within approximately 26-27 hours, P.J. experienced symptoms consistent with a stroke, including right-sided weakness and aphasia.

Medical evaluations revealed an acute ischemic infarct in the left basal ganglia and left frontal lobe, and subsequent imaging showed abnormal stenoses in cerebral arteries, leading to a diagnosis of focal cerebral arteriopathy. The case proceeded as an off-Table claim, requiring P.J. to prove causation-in-fact.

Petitioner's experts argued that the meningococcal vaccine could cause systemic inflammation leading to focal cerebral arteriopathy, citing studies on cytokines and vaccine-induced inflammation. Respondent's experts countered that the evidence did not establish a reliable link between the vaccine and the injury, emphasizing that vaccines generally reduce stroke risk and that the petitioner's condition was more likely cryptogenic or potentially related to a bacterial vaginosis infection.

The court found that P.J. did not preponderantly establish that the meningococcal vaccine can cause focal cerebral arteriopathy or stroke, nor did P.J. present sufficient evidence of an inflammatory response linked to the vaccine. While the temporal proximity between vaccination and symptom onset was deemed medically acceptable, the lack of a proven causal mechanism and insufficient evidence of vaccine-induced inflammation led to the denial of compensation.

The petition was dismissed.