Geoff Mead v. HHS - Meningococcal, chronic inflammatory demyelinating polyneuropathy (2022)

Geoff Mead, as parent and guardian of minor petitioner M.M., filed a petition on May 6, 2019, alleging that a dose of the meningococcal vaccine (Trumenba brand) administered to M.M. on May 16, 2016, caused him to develop chronic inflammatory demyelinating polyneuropathy (CIDP). M.M., born in 2004, received the vaccine during a routine health visit.

According to Mr. Mead, within an hour of vaccination, M.M. developed a fever, followed by lethargy and numbness.

The following day, M.M. was seen by Dr. Eve Meltzer, who noted fever, a "tingly sensation over [his] body, achiness and a feeling of weakness." Dr.

Meltzer's neurologic exam was normal, and she opined the reaction should last no more than 24-36 hours. On May 19, 2016, M.M. was seen at Huntington Hospital, where he was reported to be in no distress.

He was then referred to neurologist Dr. Greg Rosenn.

Dr. Rosenn's neurologic exam was "non-focal," and his impression was "reaction to vaccine meningococcal (5/16)," with a plan to "rule out polyneuropathy." Tests ordered by Dr.

Rosenn, including an EEG and MRI of the brain, were normal. By May 31, 2016, M.M.'s symptoms had improved, and Dr.

Rosenn's neurologic exam was normal. Dr.

Rosenn assessed M.M. as having "possible polyneuropathy but no objective findings" and "possible post viral general malaise resolving." By June 23, 2016, M.M. reported his symptoms had "slowly resolved," and Dr. Rosenn's exam showed only minor deviations from normal, with an impression of "Reaction to vaccine meningococcal (5/16), Mild polyneuropathy, Post viral malaise," noting symptoms had resolved.

M.M. continued to see various doctors for eczema and other issues, with some records noting a "severe reaction to the Trumenba vaccine" or "neurologic reaction he had to the new meningitis vaccine." In May 2017, M.M. presented to Huntington Hospital with "upper extremity and lower extremity weakness and numbness extending to the waist," with a history of "migraines and history of Guillain Barre syndrome-like episode after meningitis vaccine in the fall." An exam revealed normal reflexes and decreased sensation. He was transferred to Cohen Children's Medical Center, where his history again mentioned a "Guillain Barre syndrome-like episode after meningitis vaccine." An exam there also showed normal reflexes and decreased sensation.

Dr. Rosenn, discussing M.M.'s condition in May 2017, noted that M.M. had a "'strange' reaction to Meningitis B vaccine with neuro[logical] [signs and symptoms] but these resolved" the previous year and wondered if a neurological issue was re-emerging.

He recommended an EMG/NCS, which M.M. did not receive due to difficulty finding a provider. In July 2017, M.M.'s pediatrician, Dr.

Caravella, noted "ongoing neurological issues since receiving [the] [T]rumenba vaccine last year," including "numbness/burning sensation," "extreme pain to torso when shower[ing]," and "weakness in both legs." Dr. Caravella's impressions included "extreme exercise intolerance: related to neurological situation post vaccination or ??beginning of an emotional component to this illness," and suggested evaluations from neurology, allergy/immunology, and rheumatology.

Dr. Bello-Espinosa, a neurologist, saw M.M. in October 2017, noting numbness and tingling in M.M.'s extremities, but her neurologic exam was normal.

Her impression included "headaches, neuropathy and post vaccination reaction" and she recommended electrodiagnostic testing. An EMG/NCV study on November 20, 2017, was reported as normal, with "no unequivocal evidence of neuropathy at this time." Dr.

Bello-Espinosa reviewed these results in December 2017, stating the study "showed decreased amplitude of potential, likely indicative of recovery from his prior injury," and her neurologic exam remained normal. Subsequent neurological exams in 2018 and 2019 with Dr.

Bello-Espinosa were also normal. The respondent argued that M.M.'s treating doctors did not diagnose him with CIDP.

Petitioner's retained experts, Dr. Yehuda Shoenfeld and Dr.

Avinoam Shuper, provided reports. Dr.

Shoenfeld's initial reports were found unpersuasive for not adequately addressing CIDP, causation, or timing. Dr.

Shuper opined that M.M. suffered from "inflammatory neuropathy which resembled GBS in the beginning but progressed to CIDP," but the Special Master found this undermined the CIDP claim and lacked support, especially given normal neurological exams by treating physicians and normal EMG/NCS results. The Special Master noted that Dr.

Shuper did not explain why his diagnosis was appropriate given the normal exams and tests. The Special Master also focused on the timing issue, noting that the petitioner's experts asserted M.M. experienced neurologic problems within one hour of vaccination.

The Special Master found that theories like molecular mimicry, proposed by the experts, typically take multiple days to manifest symptoms, and the experts failed to explain how symptoms could occur within one hour. This temporal gap, along with the failure to establish CIDP as the diagnosis, led to the dismissal of the case.

Petitioner was represented by Patricia A. Finn of Patricia Finn, P.C., and respondent was represented by Kimberly S.

Davey and Julia M. Collison of the United States Department of Justice.

Special Master Christian J. Moran issued the decision on June 17, 2022, dismissing the petition.