VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00676
Package ID: USCOURTS-cofc-1_21-vv-00676
Petitioner: Tracy Jefferies
Filed: 2021-01-12
Decided: 2023-05-18
Vaccine: Tdap
Vaccination date: 2019-08-01
Condition: left-sided shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 65098

AI-assisted case summary:
Tracy Jefferies filed a petition on January 12, 2021, alleging she suffered a left-sided shoulder injury related to vaccine administration (SIRVA) after receiving a Tdap vaccine on August 1, 2019. The case was assigned to the Special Processing Unit. On January 23, 2023, Respondent conceded that Petitioner was entitled to compensation, agreeing that she met the criteria for SIRVA under the Vaccine Injury Table and that there was no more likely than not alternative cause. Respondent also confirmed that the case was timely filed, the vaccination occurred in the United States, and the statutory severity requirement was met. A ruling on entitlement was issued on January 24, 2023, finding Petitioner entitled to compensation. On April 13, 2023, Respondent filed a proffer on award of compensation, proposing $65,000.00 for pain and suffering and $98.07 for out-of-pocket expenses, totaling $65,098.07. Petitioner agreed with this award. On May 18, 2023, the court issued a decision awarding Petitioner the stipulated sum of $65,098.07.

Theory of causation field:
Table

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00676-0
Date issued/filed: 2023-02-24
Pages: 2
Docket text: PUBLIC ORDER/RULING (Originally filed: 01/24/2023) regarding 36 Ruling on Entitlement . Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:21-vv-00676-UNJ Document 39 Filed 02/24/23 Page 1 of 2
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0676V
UNPUBLISHED
TRACY JEFFERIES, Chief Special Master Corcoran
Petitioner, Filed: January 24, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Ruling on Entitlement; Concession;
HUMAN SERVICES, Table Injury; Tetanus Diphtheria
acellular Pertussis (Tdap) Vaccine;
Respondent. Shoulder Injury Related to Vaccine
Administration (SIRVA)
Catherine Wallace Costigan, Maglio Christopher & Toale, Washington, DC, for
Petitioner.
Andrew Henning, U.S. Department of Justice, Washington, DC, for Respondent.
RULING ON ENTITLEMENT1
On January 12, 2021, Tracy Jefferies filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that that she suffered a left-sided shoulder injury related
to vaccine administration (“SIRVA”) as a result of a tetanus-diphtheria-acellular pertussis
(“Tdap”) vaccine that was administered on August 1, 2019. Petition at 1. The case was
assigned to the Special Processing Unit of the Office of Special Masters.
On January 23, 2023, Respondent filed his Rule 4(c) report in which he concedes
that Petitioner is entitled to compensation in this case. Respondent’s Rule 4(c) Report at
1 Because this unpublished Ruling contains a reasoned explanation for the action in this case, I am required
to post it on the United States Court of Federal Claims' website in accordance with the E-Government Act
of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic Government
Services). This means the Ruling will be available to anyone with access to the internet. In accordance
with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information,
the disclosure of which would constitute an unwarranted invasion of privacy. If, upon review, I agree that
the identified material fits within this definition, I will redact such material from public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:21-vv-00676-UNJ Document 39 Filed 02/24/23 Page 2 of 2
1. Specifically, Respondent agrees that “[P]etitioner has satisfied the criteria set forth in
the Vaccine Injury Table (“Table”) and the Qualifications and Aids to Interpretation (“QAI”)
for SIRVA, and there is no more likely than not alternative cause.” Id. at 5. Respondent
further agrees that “[P]etitioner timely filed her case, that she received the Tdap
vaccination in the United States, and that she satisfied the statutory severity requirement
by suffering the residual effects or complications or her injury for more than six months
after vaccine administration.” Id.
In view of Respondent’s position and the evidence of record, I find that
Petitioner is entitled to compensation.
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
2

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DOCUMENT 2: USCOURTS-cofc-1_21-vv-00676-1
Date issued/filed: 2023-05-18
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 04/17/2023) regarding 44 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
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Case 1:21-vv-00676-UNJ Document 48 Filed 05/18/23 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0676V
UNPUBLISHED
TRACY JEFFERIES, Chief Special Master Corcoran
Petitioner, Filed: April 17, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Catherine Costigan, Maglio, Christopher & Toale, Washington, DC, for Petitioner.
Andrew Henning, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 12, 2021, Tracy Jefferies filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine that was administered on August 1, 2019. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On January 24, 2023, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On April 13, 2023, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $65,098.07 (comprised
of $65,000.00 in pain and suffering and $98.07 in out-of-pocket expenses). Proffer at 1.
1 Because this unpublished Decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the Decision will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:21-vv-00676-UNJ Document 48 Filed 05/18/23 Page 2 of 4
In the Proffer, Respondent represented that Petitioner agrees with the proffered award.
Id. Based on the record as a whole, I find that Petitioner is entitled to an award as stated
in the Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $65,098.07 (comprised of $65.000.00 in pain and suffering and
$98.07 in out-of-pocket expenses) in the form of a check payable to Petitioner. This
amount represents compensation for all damages that would be available under Section
15(a).
The Clerk of Court is directed to enter judgment in accordance with this decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2

Case 1:21-vv-00676-UNJ Document 48 Filed 05/18/23 Page 3 of 4
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
TRACY JEFFERIES,
Petitioner,
v. No. 21-676V (ECF)
Chief Special Master Corcoran
SECRETARY OF HEALTH AND SPU
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 23, 2023, respondent conceded that entitlement to compensation was
appropriate under the terms of the Vaccine Act. ECF No. 35. On January 24, 2023, Chief
Special Master Corcoran issued a Ruling on Entitlement, finding that petitioner was entitled to
vaccine compensation for her SIRVA. ECF No. 36.
I. Items of Compensation
A. Pain and Suffering and Out-of-Pocket Expenses
Respondent proffers that petitioner should be awarded $65,000.00 in pain and suffering
and $98.07 in out-of-pocket expenses. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
1 Should petitioner die prior to the entry of judgment, the parties reserve the right to move
the Court for appropriate relief. In particular, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering.

Case 1:21-vv-00676-UNJ Document 48 Filed 05/18/23 Page 4 of 4
a lump sum payment of $65,098.07, in the form of a check payable to petitioner. Petitioner
agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
/s/ ANDREW J. HENNING
ANDREW J. HENNING
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-4405
Email: andrew.j.henning@usdoj.gov
DATED: April 13, 2023
2

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DOCUMENT 3: USCOURTS-cofc-1_21-vv-00676-2
Date issued/filed: 2023-05-18
Pages: 4
Docket text: PUBLIC DECISION (Originally filed: 04/17/2023) regarding 44 DECISION Stipulation/Proffer. Signed by Chief Special Master Brian H. Corcoran. (tlf) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00676-UNJ Document 49 Filed 05/18/23 Page 1 of 4
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-0676V
UNPUBLISHED
TRACY JEFFERIES, Chief Special Master Corcoran
Petitioner, Filed: April 17, 2023
v.
Special Processing Unit (SPU);
SECRETARY OF HEALTH AND Damages Decision Based on Proffer;
HUMAN SERVICES, Tetanus Diphtheria acellular
Pertussis (Tdap) Vaccine; Shoulder
Respondent. Injury Related to Vaccine
Administration (SIRVA)
Catherine Costigan, Maglio, Christopher & Toale, Washington, DC, for Petitioner.
Andrew Henning, U.S. Department of Justice, Washington, DC, for Respondent.
DECISION AWARDING DAMAGES1
On January 12, 2021, Tracy Jefferies filed a petition for compensation under the
National Vaccine Injury Compensation Program, 42 U.S.C. §300aa-10, et seq.2 (the
“Vaccine Act”). Petitioner alleges that she suffered a shoulder injury related to vaccine
administration (“SIRVA”) as a result of a tetanus-diphtheria-acellular pertussis (“Tdap”)
vaccine that was administered on August 1, 2019. Petition at 1. The case was assigned
to the Special Processing Unit of the Office of Special Masters.
On January 24, 2023, a ruling on entitlement was issued, finding Petitioner entitled
to compensation for SIRVA. On April 13, 2023, Respondent filed a proffer on award of
compensation (“Proffer”) indicating Petitioner should be awarded $65,098.07 (comprised
of $65,000.00 in pain and suffering and $98.07 in out-of-pocket expenses). Proffer at 1.
1 Because this unpublished Decision contains a reasoned explanation for the action in this case, I am
required to post it on the United States Court of Federal Claims' website in accordance with the E-
Government Act of 2002. 44 U.S.C. § 3501 note (2012) (Federal Management and Promotion of Electronic
Government Services). This means the Decision will be available to anyone with access to the
internet. In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact
medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.
If, upon review, I agree that the identified material fits within this definition, I will redact such material from
public access.
2 National Childhood Vaccine Injury Act of 1986, Pub. L. No. 99-660, 100 Stat. 3755. Hereinafter, for ease
of citation, all section references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C. §
300aa (2012).

Case 1:21-vv-00676-UNJ Document 49 Filed 05/18/23 Page 2 of 4
In the Proffer, Respondent represented that Petitioner agrees with the proffered award.
Id. Based on the record as a whole, I find that Petitioner is entitled to an award as stated
in the Proffer.
Pursuant to the terms stated in the attached Proffer, I award Petitioner a lump
sum payment of $65,098.07 (comprised of $65.000.00 in pain and suffering and
$98.07 in out-of-pocket expenses) in the form of a check payable to Petitioner. This
amount represents compensation for all damages that would be available under Section
15(a).
The Clerk of Court is directed to enter judgment in accordance with this decision.3
IT IS SO ORDERED.
s/Brian H. Corcoran
Brian H. Corcoran
Chief Special Master
3 Pursuant to Vaccine Rule 11(a), entry of judgment can be expedited by the parties’ joint filing of notice
renouncing the right to seek review.
2

Case 1:21-vv-00676-UNJ Document 49 Filed 05/18/23 Page 3 of 4
THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
TRACY JEFFERIES,
Petitioner,
v. No. 21-676V (ECF)
Chief Special Master Corcoran
SECRETARY OF HEALTH AND SPU
HUMAN SERVICES,
Respondent.
RESPONDENT’S PROFFER ON AWARD OF COMPENSATION
On January 23, 2023, respondent conceded that entitlement to compensation was
appropriate under the terms of the Vaccine Act. ECF No. 35. On January 24, 2023, Chief
Special Master Corcoran issued a Ruling on Entitlement, finding that petitioner was entitled to
vaccine compensation for her SIRVA. ECF No. 36.
I. Items of Compensation
A. Pain and Suffering and Out-of-Pocket Expenses
Respondent proffers that petitioner should be awarded $65,000.00 in pain and suffering
and $98.07 in out-of-pocket expenses. See 42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a).1 Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
1 Should petitioner die prior to the entry of judgment, the parties reserve the right to move
the Court for appropriate relief. In particular, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering.

Case 1:21-vv-00676-UNJ Document 49 Filed 05/18/23 Page 4 of 4
a lump sum payment of $65,098.07, in the form of a check payable to petitioner. Petitioner
agrees.
Petitioner is a competent adult. Evidence of guardianship is not required in this case.
Respectfully submitted,
BRIAN M. BOYNTON
Principal Deputy Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
ALEXIS B. BABCOCK
Assistant Director
Torts Branch, Civil Division
/s/ ANDREW J. HENNING
ANDREW J. HENNING
Trial Attorney
Torts Branch, Civil Division
U.S. Department of Justice
P.O. Box 146
Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel.: (202) 616-4405
Email: andrew.j.henning@usdoj.gov
DATED: April 13, 2023
2