J.N.H. v. HHS - Tdap, autoimmune encephalitis and/or a significant aggravation of a preexisting autoimmune encephalitis (2020)

John and Marie Louise Heath filed a petition on February 19, 2020, on behalf of their minor son, J.N.H., alleging that the Tdap vaccine administered on June 1, 2016, caused autoimmune encephalitis or a significant aggravation of a preexisting autoimmune encephalitis. J.N.H., who was thirteen years old at the time of vaccination, had a medical history including autism spectrum disorder, anxiety, attention deficit disorder, and obsessive compulsive disorder.

Following the Tdap vaccination, J.N.H. experienced immediate arm soreness, followed by a fever that night, and nausea and headache the next day. His condition then reportedly worsened significantly, with symptoms including increased obsessive-compulsive behaviors leading to dermatologic injury, fatigue, flu-like symptoms, mood swings, headaches, nausea, memory problems, delusions, speech difficulties, severe anxiety attacks, sound sensitivity, catatonia symptoms, depression, frequent urination, and a deterioration of reading and writing skills.

Physicians diagnosed J.N.H. with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)/Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), noting a streptococcal infection in May 2016, one month prior to vaccination and symptom onset. The petitioners did not assert a claim based on the Vaccine Injury Table but proceeded on an "off-Table" theory, alleging causation-in-fact and significant aggravation.

The respondent was the Secretary of Health and Human Services. Chief Special Master Brian H.

Corcoran issued a decision on February 19, 2020, denying entitlement to compensation. The Special Master found that the petitioners failed to establish a reputable medical theory connecting the Tdap vaccine to autoimmune encephalitis, thus failing the first prong of the Althen test for off-Table claims.

The public decision does not describe the specific mechanism of causation alleged or name expert witnesses for either party, other than referencing a written opinion from one of J.N.H.'s treating physicians, Dr. Nicole Shorrock.

The Special Master also found that the petitioners did not preponderantly establish that the vaccine significantly aggravated a preexisting condition, noting that Dr. Shorrock's opinion, prepared for litigation, was minimized in its evidentiary value.

The decision was made on the record without a hearing. Entitlement to compensation was denied.