VICP Registry Case Source Bundle
Canonical URL: https://vicp-registry.org/case/USCOURTS-cofc-1_21-vv-00680
Package ID: USCOURTS-cofc-1_21-vv-00680
Petitioner: Isabel Del Vecchio
Filed: 2021-01-12
Decided: 2025-09-16
Vaccine: influenza
Vaccination date: 2018-02-17
Condition: left shoulder injury related to vaccine administration (SIRVA)
Outcome: compensated
Award amount USD: 63820

AI-assisted case summary:
On January 12, 2021, Isabel Del Vecchio filed a petition alleging that an influenza vaccination administered on February 17, 2018, caused a left shoulder injury related to vaccine administration. The vaccine record did not clearly identify the side, and respondent contested the Table SIRVA elements.

Ms. Del Vecchio had a remote history of neck and shoulder complaints, but her last documented treatment was well before vaccination. On March 1, 2018, she reported left arm pain beginning the day of the flu shot and left-sided neck, upper back, and shoulder pain the next day. She described pain while driving and turning pages. Later records noted persistent arm pain, pain with shoulder testing, reduced range of motion in physical therapy, and MRI findings of trace subacromial/subdeltoid bursal fluid. Orthopedist Dr. Anbari diagnosed chemical bursitis secondary to injection and distinguished the shoulder problem from later cervical radiculitis and degenerative neck findings.

Special Master Nora Beth Dorsey Horner found that Ms. Del Vecchio proved a Table SIRVA. The decision acknowledged that the case was close because some symptoms involved the neck and radiating pain, but credited the contemporaneous shoulder records and treating opinion tying the shoulder bursitis to the injection.

On September 16, 2025, Ms. Del Vecchio was awarded $63,820.00: $62,500.00 for pain and suffering and $1,320.00 for unreimbursable expenses. She was represented by Renee Gentry.

Theory of causation field:
Influenza vaccine, February 17, 2018, competent adult exact age not stated, left shoulder SIRVA. ENTITLEMENT GRANTED May 5, 2025; COMPENSATED September 16, 2025. Key evidence: same-day left arm pain, March-April 2018 primary-care and orthopedic records, pain with external rotation and movement, MRI trace subacromial/subdeltoid bursal fluid, PT reduced ROM, Dr. Anbari's diagnosis of chemical bursitis secondary to injection, and later cervical findings distinguished from the initial shoulder injury. Award: $62,500 pain/suffering + $1,320 expenses = $63,820. Attorney Renee Gentry.

Public staged source text:

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DOCUMENT 1: USCOURTS-cofc-1_21-vv-00680-0
Date issued/filed: 2025-06-02
Pages: 15
Docket text: PUBLIC ORDER/RULING (Originally filed: 05/05/2025) regarding 59 Ruling on Entitlement. Signed by Special Master Daniel T. Horner. (cd) Service on parties made.
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Case 1:21-vv-00680-UNJ Document 61 Filed 06/02/25 Page 1 of 15
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-680V
Filed: May 5, 2025
Special Master Horner
ISABEL DEL VECCHIO,
Petitioner,
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Renee J. Gentry, The Law Office of Renee J. Gentry, Washington, D.C., for petitioner.
Mary E. Holmes, U.S. Department of Justice, Washington, DC, for respondent.
RULING ON ENTITLEMENT1
On January 12, 2021, petitioner filed a petition under the National Childhood
Vaccine Injury Act, 42 U.S.C. § 300aa, et seq. (2012) (“Vaccine Act”),2 alleging that she
suffered a left shoulder injury as a result of an influenza (“flu”) vaccination she received
on February 17, 2018. (ECF No. 1.) For the reasons set forth below, I conclude that
petitioner is entitled to compensation.
I. Applicable Statutory Scheme
Under the National Vaccine Injury Compensation Program, compensation
awards are made to individuals who have suffered injuries after receiving vaccines. In
general, to gain an award, a petitioner must make a number of factual demonstrations,
including showing that an individual received a vaccination covered by the statute;
1 Because this document contains a reasoned explanation for the action taken in this case, it must be
made publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic
Government Services). This means the document 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 Within this decision, all citations to § 300aa will be the relevant sections of the Vaccine Act at 42 U.S.C.
§ 300aa-10, et seq.
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received it in the United States; suffered a serious, long-standing injury; and has
received no previous award or settlement on account of the injury. Finally – and the key
question in most cases under the Program – the petitioner must also establish a causal
link between the vaccination and the injury. In some cases, the petitioner may simply
demonstrate the occurrence of what has been called a “Table Injury.” That is, it may be
shown that the vaccine recipient suffered an injury of the type enumerated in the
“Vaccine Injury Table,” corresponding to the vaccination in question, within an
applicable time period following the vaccination also specified in the Table. If so, the
Table Injury is presumed to have been caused by the vaccination, and the petitioner is
automatically entitled to compensation, unless it is affirmatively shown that the injury
was caused by some factor other than the vaccination. § 300aa-13(a)(1)(A);
§ 300aa-11(c)(1)(C)(i); § 300aa-14(a); § 300aa-13(a)(1)(B).
As relevant here, the Vaccine Injury Table lists Shoulder Injury Related to
Vaccine Administration (“SIRVA”) as a compensable injury if it occurs within ≤48 hours
of administration of a flu vaccine. § 300aa-14(a), amended by 42 C.F.R. § 100.3. Table
Injury cases are guided by a statutory “Qualifications and aids in interpretation” (“QAI”),
which provides more detailed explanation of what should be considered when
determining whether a petitioner has actually suffered an injury listed on the Vaccine
Injury Table. § 300aa-14(a). To be considered a Table SIRVA petitioner must show
that his/her injury fits within the following definition:
SIRVA manifests as shoulder pain and limited range of motion occurring
after the administration of a vaccine intended for intramuscular
administration in the upper arm. These symptoms are thought to occur as
a result of unintended injection of vaccine antigen or trauma from the needle
into and around the underlying bursa of the shoulder resulting in an
inflammatory reaction. SIRVA is caused by an injury to the musculoskeletal
structures of the shoulder (e.g. tendons, ligaments, bursae, etc.). SIRVA is
not a neurological injury and abnormalities on neurological examination or
nerve conduction studies (NCS) and/or electromyographic (EMG) studies
would not support SIRVA as a diagnosis . . . A vaccine recipient shall be
considered to have suffered SIRVA if such recipient manifests all of the
following:
(i) No history of pain, inflammation or dysfunction of the affected
shoulder prior to intramuscular vaccine administration that would
explain the alleged signs, symptoms, examination findings, and/or
diagnostic studies occurring after vaccine injection;
(ii) Pain occurs within the specified time-frame;
(iii) Pain and reduced range of motion are limited to the shoulder in which
the intramuscular vaccine was administered; and
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(iv) No other condition or abnormality is present that would explain the
patient’s symptoms (e.g. NCS/EMG or clinical evidence of
radiculopathy, brachial neuritis, mononeuropathies, and any other
neuropathy).
42 CFR § 100.3(c)(10).
Alternatively, if no injury falling within the Table can be shown, a petitioner could
still demonstrate entitlement to an award by instead showing that the vaccine recipient’s
injury or death was caused-in-fact by the vaccination in question. § 300aa-13(a)(1)(A);
§ 300aa-11(c)(1)(C)(ii). In particular, a petitioner must demonstrate that the vaccine
was “not only [the] but-for cause of the injury but also a substantial factor in bringing
about the injury.” Moberly v. Sec’y of Health & Human Servs., 592 F.3d 1315, 1321-22
(Fed. Cir. 2010) (quoting Shyface v. Sec’y of Health & Human Servs., 165 F.3d 1344,
1352-53 (Fed. Cir. 1999)); Pafford v. Sec’y of Health & Human Servs., 451 F.3d 1352,
1355 (Fed. Cir. 2006). To successfully demonstrate causation-in-fact, petitioner bears a
burden to show: (1) a medical theory causally connecting the vaccination and the injury;
(2) a logical sequence of cause and effect showing that the vaccination was the reason
for the injury; and (3) a showing of proximate temporal relationship between vaccination
and injury. Althen v. Sec’y of Health & Human Servs., 418 F.3d 1274, 1278 (Fed. Cir.
2005).
For both Table and Non-Table claims, Vaccine Program petitioners bear a
“preponderance of the evidence” burden of proof. § 300aa-13(1)(a). That is, a petitioner
must offer evidence that leads the “trier of fact to believe that the existence of a fact is
more probable than its nonexistence before [he] may find in favor of the party who has
the burden to persuade the judge of the fact’s existence.” Moberly, 592 F.3d at 1322
n.2 (alternation in original); see also Snowbank Enters., Inc. v. United States, 6 Cl. Ct.
476, 486 (1984) (explaining that mere conjecture or speculation is insufficient under a
preponderance standard). Proof of medical certainty is not required. Bunting v. Sec’y
of Health & Human Servs., 931 F.2d 867, 873 (Fed. Cir. 1991). A petitioner may not
receive a Vaccine Program award based solely on her assertions; rather, the petition
must be supported by either medical records or by the opinion of a competent
physician. § 300aa-13(a)(1).
Cases in the Vaccine Program are assigned to special masters who are
responsible for “conducting all proceedings, including taking such evidence as may be
appropriate, making the requisite findings of fact and conclusions of law, preparing a
decision, and determining the amount of compensation, if any, to be awarded.” Vaccine
Rule 3(b)(1). Special masters must ensure each party has had a “full and fair
opportunity” to develop the record. Vaccine Rule 3(b)(2). However, special masters are
empowered to determine the format for taking evidence based on the circumstances of
each case. Vaccine Rule 8(a); Vaccine Rule 8(d). Special masters are not bound by
common law or statutory rules of evidence but must consider all relevant and reliable
evidence in keeping with fundamental fairness to both parties. Vaccine Rule 8(b)(1).
The special master is required to consider “all [] relevant medical and scientific evidence
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contained in the record,” including “any diagnosis, conclusion, medical judgment, or
autopsy or coroner’s report which is contained in the record regarding the nature,
causation, and aggravation of the petitioner’s illness, disability, injury, condition, or
death,” as well as the “results of any diagnostic or evaluative test which are contained in
the record and the summaries and conclusions.” § 300aa-13(b)(1)(A). The special
master is required to consider all the relevant evidence of record, draw plausible
inferences, and articulate a rational basis for the decision. Winkler v. Sec’y of Health &
Human Servs., 88 F.4th 958, 963 (Fed. Cir. 2023) (citing Hines ex rel. Sevier v. Sec’y of
Health & Human Servs., 940 F.2d 1518, 1528 (Fed. Cir. 1991)).
II. Procedural History
Petitioner filed medical records and other evidence marked as Exhibits 1-25 over
several months and then filed her Statement of Completion in May of 2021. (ECF Nos.
7-8, 10-12, 15-19, 23.) Based on the allegations in the petition, this case was initially
assigned to the Chief Special Master as part of the Special Processing Unit (“SPU”),
which is intended to expedite cases having a high likelihood of informal resolution.
(ECF Nos. 21-22.) Respondent completed his medical review in February of 2023, and
the parties thereafter explored settlement, though they were unable to informally resolve
the case. (ECF Nos. 37, 43.) In the meantime, petitioner filed updated medical records
marked as Exhibits 26-27. (ECF Nos. 33, 41.)
Respondent filed his Rule 4 Report in September of 2023, and the case was
reassigned to the undersigned the following month. (ECF Nos. 45-47.) In his report,
respondent argued that petitioner cannot meet the requirements for a Table Injury of
SIRVA because her clinical presentation is not compatible with any of the four QAI
criteria. Specifically, respondent argued that petitioner did not have any reduced range
of motion in her shoulder, but instead had pre-existing cervicalgia inclusive of left
shoulder pain that predated her vaccination. (ECF No. 45, pp. 5-6.) Regarding
causation-in-fact, respondent argued that, without an expert medical opinion,
petitioner’s medical records were inadequate to satisfy the Althen test. (Id. at 6.)
Shortly after reassignment, I issued a Rule 5 Order. (ECF No. 49.) Within the
order, I explained that my initial review suggested that there could be issues that
potentially confound a Table SIRVA claim, but stressed that petitioner’s treating
orthopedist had specifically opined that petitioner suffered chemical bursitis secondary
to her vaccination. (Id. at 3 (discussing Ex. 12, pp. 6, 11).) Although I expressed doubt
that petitioner would meet the specific SIRVA requirements, I concluded there was a
high likelihood petitioner would prevail. (Id.) I indicated that it might be reasonable for
petitioner to seek to rely on her orthopedist’s opinion to support a cause-in-fact claim
based on the existing record, but cautioned that a more detailed expert opinion would
likely be needed if respondent opted to file an expert report of his own. (Id.)
Thereafter, both parties confirmed that the case is ripe for adjudication without
having filed any expert reports. (ECF Nos. 53, 54.) Petitioner filed an affidavit by
chiropractor Tyler Page and updated medical records marked as Exhibits 28-29,
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respectively. (ECF Nos. 51, 55.) Petitioner then filed a motion for a ruling on the written
record, which is fully briefed. (ECF Nos. 56-58.)
In light of the above, I have determined that the parties have had a full and fair
opportunity to present their cases and that it is appropriate to resolve entitlement on the
existing record. See Vaccine Rule 8(d); Vaccine Rule 3(b)(2); see also Kreizenbeck v.
Sec’y of Health & Human Servs., 945 F.3d 1362, 1366 (Fed. Cir. 2020) (noting that
“special masters must determine that the record is comprehensive and fully developed
before ruling on the record”).
III. Factual History
Prior to the vaccination at issue, petitioner had a history of neck pain that she
associated with shoulder pain and which may have been related to a motor vehicle
accident in 2015. (Ex. 2, pp. 5, 9; Ex. 20, p. 2; Exs. 28-29.) Prior to vaccination, she
was last seen for neck pain on October 19, 2016. (Ex. 2, p. 9.) Petitioner received the
vaccination at issue on February 17, 2018. (Ex. 4, p. 4.) Although the administration
record confirms an intramuscular injection into the deltoid, it does not specify whether
the site of injection was the right or left deltoid. (Id.)
On March 1, 2018, petitioner presented to her primary care provider, where she
was seen by Physician Assistant (“PA”) Grodzki, with a chief complaint of “Left Arm
Pain.” (Ex. 2, p. 21.) PA Grodzki recorded:
Patient reports that 2 weeks ago she received a flu vaccine, administered
by a pharmacist at Hannaford[’]s in Maine. The vaccine was administered
into her left arm. Patient has not received a vaccine since she was a child
so she does not know if the vaccine administration felt like a typical vaccine
administration. Patient reports that she had left arm pain the day she
received the vaccine, but the next day that pain was accompanied by left
sided neck pain and upper back/shoulder pain. Patient is continuing to
endorse left arm, neck, and upper back/shoulder pain, although it has been
improving. The pain is constant 4/10 pain, although it is slightly less painful
in the morning and slightly more painful at night. Patient has been taking
ibuprofen, using heat/ice, and applying icy-hot to area, all of which provide
temporary [relief]. The pain is worse when patient is turning pages or driving
with her left hand. Patient also reports severe clavicle pain a few days after
receiving the vaccine, and that clavicle pain has now resolved. She also
endorses mild weakness to the left arm. Patient denies any ecchymosis,
erythema, or swelling after incident throughout now. Patient also denies
any recent exercise or trauma to area. She denies any fevers, chills,
paresthesia, loss of sensation, nausea, vomiting, headaches, palpitations,
trouble breathing, or losing control of bowel or bladder.
(Id.) On physical exam, petitioner had full strength in all major muscle groups, as well
as full range of motion of her neck, arm, and back muscles. However, she endorsed
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mild pain with external rotation of the shoulder. (Id. at 23.) PA Grodzki felt that a
SIRVA was “[p]ossible,” but at only two-weeks post-vaccination, she would not rule out
normal post-vaccination pain. (Id. at 24.) Petitioner was advised to rest and to continue
using over-the-counter treatments. (Id.)
Petitioner returned to the same provider on April 19, 2018, with a continued
complaint of arm pain following her flu shot. (Ex. 2, p. 27.) She reported pain that was
dull, aching 4/10, increases to 10/10 with movement. She also notes pain
in the right upper back, and isn’t sure if the pain is radiating to the other
side. Patient also notes that she had some paresthesias into her pinky last
week that was intermittent and only lasted 1-2 days, then resolved. . . .
Patient notes that she worked out a few weeks ago and the next day she
had very limited range of motion, was unable to extend her left arm. This
lasted about a week and was eventually relieved with gradual stretching.
(Id.) On physical exam, petitioner again had full range of motion in her neck, arm, and
back muscles. However, she had mild pain with lateral extension of her neck, a positive
lag sign with internal rotation, and mild pain with external rotation of the shoulder. (Id. at
28.) PA Grodzki continued to suspect a SIRVA and recommended either an MRI or a
specialist referral. (Id. at 29.) Petitioner opted for the MRI, which showed “[t]race
amount of fluid in the subacromial/subdeltoid bursa suggesting possible bursitis” and no
rotator cuff or labral tears. (Id. at 29, 35.) When petitioner returned for review of her
MRI, she reported that her pain had not changed from her prior appointment, but noted
that “the pain radiates to the other side.” (Id. at 33.) She denied any further numbness
or tingling, but it was noted that she “continues to have limited range of motion and
decreased strength in that extremity.” (Id.) PA Grodzki’s impression then changed to
bursitis. Petitioner declined a steroid injection, and an orthopedic or physical therapy
referral was therefore recommended. (Id. at 35.)
Petitioner had a consultation with an orthopedist, Dr. Anbari, on August 6, 2018,
at which she described her left shoulder pain as occurring within 24 hours of her prior flu
vaccination. (Ex. 12, p. 11.) She also noted some numbness in the ulnar nerve of her
hand. (Id.) On physical exam, petitioner had “quite a bit of discomfort in the anterior
aspect of the shoulder,” scapular winging, discomfort with rotator cuff testing, and
positive impingement signs. (Id.) The orthopedist also recorded that “[s]he has full
range of motion, strength and stability to the opposite shoulder with no issues coming
from the neck.” (Ex. 12, p.11.) Upon review of petitioner’s MRI, the orthopedist
interpreted the study as showing “significant” subacromial bursitis and no rotator cuff
tears. (Id.) The orthopedist’s impression was that petitioner “examines as if she has
chemical bursitis secondary to her injection.” (Id.) He diagnosed “[l]eft shoulder
chemical bursitis status post flu shot” and recommended a course of physical therapy.
(Id.)
Petitioner then presented for a physical therapy evaluation on August 13, 2018.
(Ex. 3, p. 5.) The “reason for referral” states that petitioner “presents with left shoulder
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pain, decreased active range of motion, hypertonicity and tenderness of shoulder
complex muscles, and decreased rotator cuff activation resulting from subacromial
bursitis following a flu shot in February.” (Id.) It was noted that the “entire shoulder
complex” is sore and that the pain radiates down into the bicep with occasional
numbness or tingling down the arm to the pinky finger. (Id.) In pertinent part, the
objective examination found reduced strength of the left shoulder with internal and
external rotation, as well as reduced active range of motion with flexion, abduction, and
external rotation. (Id. at 6.) Petitioner continued her physical therapy into October of
2018. (Ex. 3.)
Petitioner returned to the orthopedist on September 17, 2018, seeing PA
Farrington. (Ex. 12, p. 10.) It was noted that her range of motion had improved with
physical therapy, but that she still had pain. Because she wanted to avoid either
surgery or a steroid injection, she was prescribed a Medrol Dosepak. She was advised
to continue physical therapy and return in six weeks. (Id.) She returned on October 29,
2018, seeing Dr. Anbari again. (Id. at 9.) Physical therapy was reportedly doing “a
really good job” with petitioner’s motion, but she felt she had developed clicking with
internal and external rotation, which she attributed to a thick bursa. (Id.) Petitioner’s
physical exam that day produced numbness down her arm, which Dr. Anbari believed
“is contributing a lot to her symptoms.” (Id.) Physical exam confirmed the clicking
petitioner had reported and it was noted that her humeral head was “sitting forward
quite a bit,” but there was no sign of instability. (Id.) Petitioner had developed
weakness as compared to her opposite shoulder. Dr. Anbari recommended continued
physical therapy, with added attention on strengthening, and she was to follow up in
three months. (Id.) Her diagnosis remained chemical bursitis status post flu shot
injection. (Id.)
Petitioner saw Dr. Anbari again on January 28, 2019. (Ex. 12, p. 8.) She was
reportedly feeling better, but with continuing discomfort in her left shoulder. (Id.) On
physical exam, she had full range of motion of the shoulder, but with popping and
clicking, as well as discomfort with flexion and extension and scapular winging. (Id.)
Dr. Anbari recommended continued physical therapy and instructed petitioner to follow
up as needed. (Id.) Her diagnosis remained chemical bursitis. (Id.)
Petitioner returned to Dr. Anbari about four months later, on May 30, 2019. (Ex.
12, p. 6.) Petitioner reported that
[s]he has been having a really hard time with her shoulder. Despite
everything she has done for it, it really does not seem to be making any
difference. Today she is describing a lot of pain which has been going on
for two weeks now and going from the neck down to her shoulder in addition
to everything she has been dealing with before. She has had it before but
not to this extent.
(Id.) On physical exam, petitioner had decreased range of motion in all directions and
“a lot of discomfort with rotator cuff testing.” (Id.) Additionally, “[h]er neck has
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discomfort with rotation of neck especially towards the left side with positive Spurling
sign.” (Id.) Dr. Anbari recommended x-rays of the neck to check for cervical spine
abnormalities, but opined that “I think this may be a separate entity.” (Id.) He noted that
it might be contributing to some of her shoulder symptoms, “although I doubt it because
the pain she had was immediately after her flu shot that she had to the shoulder.” (Id.)
Regarding the shoulder, Dr. Anbari concluded that petitioner had failed conservative
treatment and recommended an arthroscopic bursectomy and subacromial
decompression. Regarding the neck, however, he advised waiting to see whether it
improved. (Id.) Petitioner now had separate diagnoses of persistent chemical bursitis,
as well as cervical radiculitis. (Id.) Petitioner re-raised her neck pain with her primary
care provider a few days later, but it was noted that her orthopedist had scheduled
further follow up. (Ex. 2, pp. 57-59.)
About a month later, on June 19, 2019, petitioner saw a rehabilitation specialist,
Dr. Abella, on referral from Dr. Anbari, for her neck issue. (Ex. 12, p. 4.) Petitioner
reported that “about three weeks ago she awoke with a stiff neck, unable to move. No
obvious precipitating event.” (Id.) She indicated that her symptoms had subsided with
Advil and heat, and it was further noted that her symptoms “do not refer into the upper
extremity, although she does have some chronic left shoulder pain.” (Id.) On physical
exam, petitioner’s cervical range of motion included “a pulling sensation” with forward
flexion, but she had no pain, and her range of motion was otherwise within functional
limits. (Id.) She had normal strength and intact light touch sensation in both upper
extremities. Review of petitioner’s x-rays showed disc space narrowing with endplate
spurring at C5-6, but with no spondylolisthesis. (Id. at 5.) Petitioner was assessed as
having a resolved exacerbation of neck pain associated with her C5-6 disc
degeneration. (Id.) However, petitioner subsequently began seeing a chiropractor in
mid-July 2015, reporting that she had aggravated her neck pain after shoveling hay.
(Ex. 15, p. 4.) She reported that her neck pain was radiating into her left upper
extremity. (Id.)
More recent records show that petitioner returned for a revaluation in March of
2023, at which time she was evaluated by PA Farrington. (Ex. 27, p. 6.) It was noted
that petitioner “was injured in 2019 with a vaccine injury from a flu shot” and that she
had been suffering “significant bursitis and impingement.” (Id.) Petitioner felt she was
able to do most things, but felt she still had some limitations in the shoulder. On
physical exam, she had full range of motion of both the shoulder and cervical spine and
with no signs of impingement. (Id.) However, petitioner complained “about a lot of
scapular pain, and pain that radiates down to her elbow and into her hand, with
numbness of her pinky.” (Id.) PA Farrington recommended further follow up after a new
MRI of the shoulder, but no further orthopedic records have been filed.
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IV. Analysis
a. Site of Vaccination
A threshold question is whether petitioner actually received the vaccination at
issue in the shoulder affected by her alleged SIRVA. Respondent has repeatedly noted
that petitioner’s vaccine administration record does not confirm into which shoulder
petitioner’s vaccine was injected. (ECF No. 57, p. 2; ECF No. 45, p. 2.) However,
respondent has never explicitly argued that the evidence does not preponderate in favor
of a finding that it was administered in her left shoulder. (ECF No. 57, pp. 5-10; ECF
No. 45, p. 5.) Petitioner’s vaccine administration record does confirm she received an
intramuscular injection into her deltoid. (Ex. 4, p. 4.) Moreover, when petitioner sought
treatment for her condition, she consistently attributed her injury to her flu vaccination,
which she reported as having been administered in her left shoulder. (E.g., Ex. 2, p.
21.) This is some evidence as to the injection site. See, e.g., Hanna v. Sec’y of Health
& Human Servs., No. 18-1455V, 2021 WL 3486248, at *9 (Fed. Cl. Spec. Mstr. July 15,
2021) (collecting prior cases for the proposition that subsequent treatment records are
probative evidence regarding the site of injection). By contrast, petitioner stresses that
“[t]here is not a single notation in the record” that contradicts a left shoulder
administration. (ECF No. 56, p. 10.)
Accordingly, considering the record as a whole, there is preponderant evidence
that petitioner received the February 17, 2018 flu vaccination at issue intramuscularly
into her left shoulder.
b. Table SIRVA QAI Criterion (i) - No History of Pain, Inflammation or
Dysfunction of the Affected Shoulder.
Petitioner acknowledges that she had prior neck issues inclusive of complaints of
shoulder pain, but contends that her treating physicians distinguished her alleged
SIRVA as a separate condition. (ECF No. 56, p. 12.) Thus, petitioner contends that her
prior condition is not incompatible with a Table SIRVA. (Id.) Respondent argues,
however, that “[p]etitioner’s history of cervicalgia also prevents her from meeting the
QAI due to ‘[an]other condition or abnormality’ under 42 C.F.R. § 100.3(c)(10)(iv) and, in
conjunction with her imaging studies confirming a C5-C6 spine injury, indicates a pre-
existing ‘inflammation or dysfunction’ that would explain her post vaccination diagnostic
findings under 42 C.F.R. § 100.3(c)(10)(i).” (ECF No. 45, p. 6; ECF No. 57, p. 9.)
The first SIRVA criterion states that there must be “[n]o history of pain,
inflammation or dysfunction of the affected shoulder prior to intramuscular vaccine
administration that would explain the alleged signs, symptoms, examination findings,
and/or diagnostic studies occurring after vaccine injection.” 42 C.F.R. § 100.3(c)(10)(i)
(emphasis added). Here, respondent cites preexisting pain and dysfunction having an
etiology related to the spine rather than “of the affected shoulder.” And, while
petitioner’s history of neck pain and dysfunction may be related to the C5-C6
degeneration evidenced on her x-rays, petitioner’s post-vaccination shoulder symptoms
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were diagnosed as bursitis that was also confirmed by diagnostic study, i.e., MR
imaging that showed fluid in the subacromial space. (Ex. 2, p. 35.) Respondent has
neither pointed to any evidence suggesting that petitioner’s bursitis pre-dated the
vaccination at issue nor sought to explain how the cervical spine dysfunction he cites
could explain a diagnostic study finding bursal fluid in the subacromial space. Instead,
petitioner’s treating physicians correlated her diagnosed buritis to her reports of post-
vaccination shoulder pain. (Ex. 12, p. 11; Ex. 2, pp. 29, 35.)
Accordingly, considering the record as a whole, there is preponderant evidence
that petitioner was free of any history of pain, inflammation, or dysfunction of the
affected shoulder prior to the vaccination at issue that would explain her diagnosed
bursitis.
c. Table SIRVA QAI Criterion (ii) - Pain Occurs Within 48 Hours of
Vaccination.
Respondent argues that petitioner cannot establish that she experienced onset of
shoulder pain within 48 hours of vaccination “because her initial accounts of neck and
shoulder pain predate her vaccination.” (ECF No. 57, p. 8.) Specifically,
Petitioner’s records indicate that she experienced neck and associated
shoulder pain intermittently since a 2015 motor vehicle accident. Ex. 2 at
64; Ex. 20 at 3. At an urgent care visit in 2016, petitioner was diagnosed
with cervicalgia and treated for neck and shoulder pain, which she reported
as worse on the left side. Ex. 20 at 2-3. She also reported muscle spasms
in her neck and shoulders to her PCP prior to the vaccination in October
2016. Ex. 2 at 9.
(Id.)
Respondent’s argument is not persuasive. Petitioner contends that her prior
neck complaints reflected “at most generalized neck pain,” which is not diagnostic of
cervicalgia and is distinct from her post-vaccination complaints. (ECF No. 58, p. 3
(emphasis omitted).) But, in any event, respondent acknowledges that petitioner’s prior
reports of neck pain affecting her shoulder were only “intermittent” and the most recent
medical record he cites is from October 2016, about a year and a half prior to the
vaccination in question. There is no evidence of record indicating that petitioner had
been symptomatic during that period. Moreover, when petitioner sought treatment for
her alleged SIRVA, she consistently reported a distinct onset of post-vaccination
shoulder pain beginning within 48 hours of vaccination. (E.g., Ex. 12, p. 11; Ex. 2, p.
21.) Petitioner’s treating physicians correlated her presentation of post-vaccination pain
to bursitis that was confirmed by MRI. (Ex. 2, pp. 29, 35; Ex. 12, p. 11.) Thus, the
contemporaneous clinical judgment of petitioner’s treating physicians is contrary to
respondent’s assertion that petitioner’s post-vaccination presentation of shoulder pain
was a continuation of her prior neck complaints.
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Accordingly, considering the record as a whole, there is preponderant evidence
that petitioner experienced onset of left shoulder pain within 48 hours of the vaccination
at issue.
d. Table SIRVA QAI Criterion (iii) – Presence of Reduced Range of
Motion.
Respondent raises two concerns with respect to the third SIRVA criterion. First,
he contends that this criterion requires that there be reduced range of motion, which he
asserts is absent in this case. (ECF No. 57, pp. 6-7.) Second, he argues that petitioner
had symptoms beyond the confines of her affected shoulder. (Id. at 7-8.) Because
respondent’s second argument rises or falls in connection with his arguments under the
fourth criterion, it will be addressed separately in the following section.
Although reduced range of motion is a requirement, see Bolick v. Sec’y of Health
& Human Servs., No. 20-893V, 2023 WL 8187307, at *6-8 (Fed. Cl. Spec. Mstr. Oct. 19,
2023), respondent does not account for the complete history of petitioner’s alleged
SIRVA. Respondent cites petitioner’s initial presentation to her primary care provider as
demonstrating full range of motion on physical exam, as well as an April 19, 2018
notation (ECF No. 57, p. 6 (discussing Ex. 2, pp. 23, 27)), in which petitioner provided a
history to her primary care provider indicating that “[p]atient notes that she worked out a
few weeks ago and the next day she had very limited range of motion, was unable to
extend her arm. This lasted about a week and was eventually relieved with gradual
stretching” (Ex. 2, p. 27). Respondent asserts that petitioner has not provided any
“objective findings” that she suffered reduced range of motion. (ECF No. 57, pp. 6-7.)
However, petitioner persuasively counters that her reduced range of motion was
objectively confirmed during her physical therapy evaluation. (ECF No. 56, p. 13
(discussing Ex. 3, p. 6).)
Although petitioner’s primary care provider did not detect reduced range of
motion upon examination, he is not a shoulder specialist and he did not document what
maneuvers he tested. By contrast, both petitioner’s orthopedist and physical therapist
documented reduced range of motion and the physical therapist documented the
examination in detail.3 (Ex. 12, pp. 10-11; Ex. 3, p. 6.) The history petitioner provided
3 Petitioner’s initial orthopedic encounter is ambiguous with respect to any explicit documentation of
reduced range of motion. (Ex. 12, p. 11.) However, respondent interprets the initial orthopedic encounter
as indicating that petitioner had full range of motion of the left shoulder. (ECF No. 57, p. 3 (discussing Ex.
12, p. 11).) Upon close inspection, this is not how I read this record. After identifying several ways in
which petitioner was experiencing discomfort in the left shoulder, the orthopedist states that “[s]he has full
range of motion, strength and stability to the opposite shoulder with no issues coming from the neck.”
(Ex. 12, p. 11 (emphasis added).) While “to the opposite shoulder” is not entirely clear, the same
orthopedic practice documented at petitioner’s next encounter (this time she was seen by a PA) that,
following physical therapy, “[h]er range of motion has improved but she still has pain.” (Id. at 10.) Given
that petitioner’s physical therapy evaluation documented reduced range of motion and given that the
orthopedic practice subsequently documented an improvement in range of motion, it is unlikely that
petitioner’s August 6, 2018 encounter record actually documented full range of motion of the left shoulder.
Instead, I read the notation at issue as documenting full range of motion in the right shoulder.
11

Case 1:21-vv-00680-UNJ Document 61 Filed 06/02/25 Page 12 of 15
on April 19, 2018, does cloud the issue a bit; however, that history describes “very
limited” range of motion consisting of an inability to extend the arm. (Ex. 2, p. 27.) It is
not clear that this notation speaks to the entire course of her reduced range of motion
(as opposed to an exacerbation) or that this would account for all the planes of reduced
range of motion recorded by the physical therapist. (Ex. 3, p. 6.)
Accordingly, considering the record as a whole, there is preponderant evidence
that petitioner suffered reduced range of motion of the shoulder affected by her alleged
SIRVA.
e. Table SIRVA QAI Criteria (iii) and (iv) – Pain and Reduced Range of
Motion are Limited to the Affected Shoulder and No Other Condition
or Abnormality is Present that Would Explain the Symptoms.
Finally, respondent argues relative to the fourth SIRVA criterion that petitioner
suffered “preexisting cervicalgia associated with shoulder pain that would explain her
post vaccination symptoms” and further argued that “petitioner continued to report neck
pain after her vaccination, including at her initial presentation after receiving the
vaccine.” (ECF No. 57, p. 9.) Relatedly, he argues relative to the third criterion that
petitioner’s complaints were not “primarily” related to her shoulder and that she
“consistently reported pain outside her shoulder,” including her neck, back, and down
her arm to her pinky finger. (Id. at 7-8.) Petitioner disagrees, contending that the
symptoms she reported beyond the confines of the shoulder were incidental in that
there is no evidence her symptoms were of a spinal etiology and her treating physicians
were able to distinguish her alleged SIRVA from her other complaints. Accordingly, she
contends she has satisfied the third and fourth criteria. (ECF No. 56, pp. 13-14; ECF
No. 58, pp. 1-5.)
The third SIRVA criterion requires that the petitioner’s “[p]ain and reduced range
of motion are limited to the shoulder in which the intramuscular vaccine was
administered.” 42 C.F.R. § 100.3(c)(10)(iii). Radiating pain does not per se prevent
petitioner from demonstrating a Table SIRVA where the petitioner’s condition is
otherwise diagnosed and treated as a shoulder condition. E.g., Werning v. Sec’y of
Health & Human Servs., No. 18-0267V, 2020 WL 5051154, at *10 (Fed. Cl. Spec. Mstr.
July 27, 2020). Instead, “the gravamen of this requirement is to guard against
compensating claims involving patterns of pain or reduced range of motion indicative of
a contributing etiology beyond the confines of a musculoskeletal injury to the affected
shoulder.” Grossmann v. Sec’y of Health & Human Servs., No. 18-00013V, 2022 WL
779666, at *15 (Fed. Cl. Spec. Mstr. Feb. 15, 2022). Thus, for example, petitioners
having symptoms radiating down the arm and to the hand have been found to have met
the Table requirements for SIRVA where “[t]he evidence supporting a SIRVA can be
distinguished from other incidental complaints of pain and neurological symptoms.”
Kahler v. Sec’y of Health & Human Servs., No. 19-1938V, 2024 WL 1928451, at *8
(Fed. Cl. Spec. Mstr. Mar. 27, 2024). By contrast, a prior petitioner was found not to
have met the third SIRVA criterion where she had pain and sensory symptoms
stemming from her neck to her hand that were “prominent” symptoms and “were
12

Case 1:21-vv-00680-UNJ Document 61 Filed 06/02/25 Page 13 of 15
contemplated by her treating physicians in attempting to arrive at a unifying diagnosis.”
Durham v. Sec’y of Health & Human Servs., No. 17-1899V, 2023 WL 3196229, at *12
(Fed. Cl. Spec. Mstr. May 2, 2023).
The fourth SIRVA criterion requires that “[n]o other condition or abnormality is
present that would explain the patient’s symptoms (e.g. NCS/EMG or clinical evidence
of radiculopathy, brachial neuritis, mononeuropathies, or any other neuropathy).” 42
C.F.R. § 100.3(c)(10)(iv). This element of petitioner’s showing “requires consideration
of a petitioner’s medical condition as a whole.” Record v. Sec’y of Health & Human
Servs., No. 21-1312V, 2025 WL 868957, at *6 (Fed. Cl. Feb. 26, 2025). However, while
the “other condition or abnormality” at issue must qualify as an explanation for the
petitioner’s symptoms, it “need not be a better or more likely explanation.” French v.
Sec’y of Health & Human Servs., No. 20-0862V, 2023 WL 7128178, at *6 (Fed. Cl.
Spec. Mstr. Sept. 27, 2023). Indeed, a petitioner may fail to meet the fourth SIRVA
criterion even where there is clinical evidence of an alternative condition that falls short
of a definitive diagnosis. Durham, 2023 WL 3196229, at *14 (noting that the regulation
cites “clinical evidence of” various conditions).
In this case, petitioner did have a prior history of neck pain, which respondent
acknowledged to be “intermittent,” and she often reported symptoms as part of her post-
vaccination history that were not strictly limited to her shoulder. For example, when she
first presented to her primary care provider, she reported that her shoulder pain radiated
to her neck, arm, and back, and even reported transient clavicle pain. (Ex. 2, pp. 21,
27.) She also reported “intermittent” parasthesia and numbness down her arm into her
hand. (Id. at 27, 33; Ex. 3, p. 5; Ex. 12, pp. 9, 11.) However, the core complaint at each
of petitioner’s encounters was with regard to her shoulder. Moreover, petitioner’s
orthopedist specifically confirmed shoulder impingement upon physical exam and also
concluded based on examination that she had “no issues coming from the neck.” (Ex.
12, p. 11.) The orthopedist diagnosed petitioner’s initial post-vaccination presentation
as bursitis, which was confirmed by MR imaging. (Id.; Ex. 2, p. 35.) It was not until May
of 2019, well over a year after the initial onset of petitioner’s post-vaccination shoulder
pain, that petitioner otherwise reported a distinct onset of neck pain arising at that time.
(Ex. 12, p. 6.) Although that presentation was diagnosed by petitioner’s orthopedist as
cervical radiculitis, he was explicit in concluding that this was a new and separate
condition. (Id.)
This case represents a close call with respect to the third and fourth SIRVA
criteria. Other petitioners have been found not to have met the Table requirements for
SIRVA due to suspicion of a cervical radiculopathy even where there was otherwise
enough evidence of a shoulder injury to demonstrate causation-in-fact. Colbert v. Sec’y
of Health & Human Servs., No. 18-166V, 2022 WL 2232210, at *16-17 (Fed. Cl. Spec.
Mstr. May 27, 2022) (finding, especially in light of positive EMG/NCS findings, that “it
does not appear that petitioner’s clinical presentation can be definitively parsed between
her various overlapping diagnoses”); Layne v. Sec’y of Health & Human Servs., No. 18-
57V, 2022 WL 3225437, at *16-17 (Fed. Cl. Spec. Mstr. July 12, 2022) (finding that,
although petitioner’s neurologic conditions would not wholly explain her condition, she
13

Case 1:21-vv-00680-UNJ Document 61 Filed 06/02/25 Page 14 of 15
carried a diagnosis of cervical radiculopathy supported by objective evidence that
contributed to her overall presentation). However, this case is distinguishable.
Although petitioner did have a prior history of neck complaints, and did present
subjective complaints beyond the shoulder, very little evidence exists during the post-
vaccination period to support a cervical complaint. (E.g. Ex. 12, p. 11 (initial orthopedic
examination confirming “no issues coming from the neck.”) The x-ray imaging
respondent cites as evidencing degenerative disc disease as a source of symptoms
was not completed until May of 2019, after petitioner had reported a distinct and acute
onset of neck pain separate from her preceding chronic presentation. (Ex. 12, p. 6 (May
2019 encounter noting new onset of neck pain), pp. 4-5 (June 2019 encounter noting
C5-6 disc degeneration on cervical spine x-ray and that her neck “symptoms do not
refer into the upper extremity”).) Additionally, petitioner’s orthopedist was very clear in
distinguishing petitioner’s neck and shoulder issues throughout the course of her
treatment. (See, e.g., id. at 6 (noting, after providing a diagnosis of cervical radiculitis
for petitioner’s neck pain, that “I think this may be a separate entity, may have been a
silent entity and may have contributed some too her symptoms in her shoulder although
I doubt it because the pain she had was immediately after her flu shot that she had to
the shoulder”); at 11 (noting “no issues coming from the neck” and diagnosing “chemical
bursitis secondary to her injection.”)
Accordingly, considering the record as a whole, there is preponderant evidence
that petitioner suffered a shoulder injury with pain and reduced range of motion limited
to the affected shoulder and that no other condition or abnormality is present that would
explain the symptoms of that shoulder injury.4
f. Factor Unrelated to Vaccination
Once petitioner has met her prima facie burden of proof, the burden shifts to
respondent to demonstrate that petitioner’s injury was caused by factor(s) unrelated to
vaccination. § 300aa-13(a)(1)(B); Deribeaux v. Sec’y of Health & Human Servs., 717
F.3d 1363, 1367 (Fed. Cir. 2013). Respondent has not raised any such argument in
this case apart from his argument under the fourth SIRVA criterion that petitioner’s
condition is due to cervicalgia. (ECF No. 57.) Respondent’s argument with respect to
cervicalgia fails under respondent’s shifted burden of proof for the same reasons as
discussed above. In particular, even if respondent were persuasive in attributing some
subset of petitioner’s symptoms to cervicalgia, he has not explained how cervicalgia
would explain petitioner’s documented bursitis.
4 Because this represents a close case under the specific Table criteria for SIRVA, I additionally note that,
even if petitioner had not met the Table criteria, a successful cause-in-fact claim would be highly likely
based on Dr. Anbari’s medical opinion as petitioner’s treating orthopedist that she suffered bursitis
secondary to vaccination. (Ex. 12, p. 11.) Respondent agreed as a factor in creating the SIRVA concept
that “scientific evidence convincingly supports a causal relationship between an injection-related event
and deltoid bursitis.” Proposed Rulemaking, 2015 WL 4538923, at *45135-36; Morris v. Sec’y of Health &
Human Servs., No. 19-1570V, 2023 WL 5092691, at *6 (Fed. Cl. Spec. Mstr. July 11, 2023) (quoting L.J.
v. Sec’y of Health & Human Servs., No. 17-59V, 2021 WL 6845593, at *14 (Fed. Cl. Spec. Mstr. Dec. 2,
2021) for the proposition that “the very decision to add a claim [to the Vaccine Injury Table] reflects
Respondent’s determination that valid science supports revising the Table.”)
14

Case 1:21-vv-00680-UNJ Document 61 Filed 06/02/25 Page 15 of 15
V. Conclusion
After weighing the evidence of record, I find by preponderant evidence that
petitioner suffered a Table Injury of SIRVA resulting from the flu vaccination she
received on February 17, 2018. Accordingly, petitioner is entitled to compensation for
her SIRVA. A separate damages order will be issued.
IT IS SO ORDERED.
s/Daniel T. Horner
Daniel T. Horner
Special Master
15

================================================================================
DOCUMENT 2: USCOURTS-cofc-1_21-vv-00680-1
Date issued/filed: 2025-10-14
Pages: 5
Docket text: PUBLIC DECISION (Originally filed: 09/16/2025) regarding 68 DECISION Stipulation/Proffer. Signed by Special Master Daniel T. Horner. (cd) Service on parties made.
--------------------------------------------------------------------------------
Case 1:21-vv-00680-UNJ Document 72 Filed 10/14/25 Page 1 of 5
In the United States Court of Federal Claims
OFFICE OF SPECIAL MASTERS
No. 21-680V
Filed: September 16, 2025
ISABEL DEL VECCHIO, Special Master Horner
Petitioner,
v.
SECRETARY OF HEALTH AND
HUMAN SERVICES,
Respondent.
Renee Ja Gentry, The Law Office of Renee J. Gentry, Washington, DC, for petitioner.
Mary Eileen Holmes, U.S. Department of Justice, Washington, DC, for respondent.
DECISION AWARDING DAMAGES1
On January 12, 2021, petitioner, Isabel Del Vecchio, 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 left
shoulder injury related to vaccine administration (“SIRVA”) as a result of an influenza
(“flu”) vaccination that she received on February 17, 2018. (ECF No. 1.)
On May 5, 2025, a ruling on entitlement was issued, finding petitioner entitled to
compensation for her SIRVA. On September 16, 2025, respondent filed a proffer on
award of compensation (“Proffer”) indicating petitioner should be awarded $63,820.00,
including $62,500.00 for pain and suffering and $1,320.00 in past unreimbursable
expenses. (ECF No. 67.) 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.
1 Because this document contains a reasoned explanation for the action taken in this case, it must be
made publicly accessible and will be posted on the United States Court of Federal Claims' website, and/or
at https://www.govinfo.gov/app/collection/uscourts/national/cofc, in accordance with the E-Government
Act of 2002. 44 U.S.C. § 3501 note (2018) (Federal Management and Promotion of Electronic
Government Services). This means the document 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 “§” references to the Vaccine Act will be to the pertinent subparagraph of 42 U.S.C.
§ 300aa (2012).

Case 1:21-vv-00680-UNJ Document 72 Filed 10/14/25 Page 2 of 5
Pursuant to the terms stated in the attached Proffer, I award petitioner a lump
sum payment of $63,820.00, representing $62,500.00 in compensation for pain
and suffering and $1,320.00 in compensation for past unreimbursable expenses,
to be paid through an ACH deposit to petitioner’s counsel’s IOLTA account for
prompt disbursement to petitioner. This amount represents compensation for all
damages that would be available under § 15(a).
The clerk of the court is directed to enter judgment in accordance with this
decision.3
IT IS SO ORDERED.
s/Daniel T. Horner
Daniel T. Horner
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-00680-UNJ Document 72 Filed 10/14/25 Page 3 of 5
IN THE UNITED STATES COURT OF FEDERAL CLAIMS
OFFICE OF SPECIAL MASTERS
ISABEL DEL VECCHIO,
Petitioner,
v. No. 21-680V
Special Master Horner
SECRETARY OF HEALTH AND ECF
HUMAN SERVICES,
Respondent.
PROFFER ON AWARD OF COMPENSATION1
On January 12, 2021, Isabel Del Vecchio (“petitioner”) filed a petition for compensation
under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. §§ 300aa-1 to -34
(“Vaccine Act” or “Act”), as amended, alleging that her receipt of an influenza (“flu”)
vaccination on February 17, 2018, caused her to suffer a left shoulder injury related to vaccine
administration (“SIRVA”). Petition at 1. On May 5, 2025, Special Master Horner issued a
ruling on entitlement, finding petitioner entitled to compensation for a Table SIRVA injury.
Entitlement Ruling, ECF No. 59.
I. Items of Compensation
Based upon the evidence of record, respondent proffers that petitioner should be awarded
the following:
1 This Proffer does not include attorneys’ fees and costs, which the parties intend to address after
the Damages Decision is issued.

Case 1:21-vv-00680-UNJ Document 72 Filed 10/14/25 Page 4 of 5
A. Pain and Suffering
Respondent proffers that petitioner should be awarded $62,500.00 in pain and suffering.
42 U.S.C. § 300aa-15(a)(4). Petitioner agrees.
B. Past Unreimbursable Expenses
Evidence supplied by petitioner documents that she incurred past unreimbursable
expenses related to her vaccine-related injury. Respondent proffers that petitioner should be
awarded past unreimbursable expenses in the amount of $1,320.00. 42 U.S.C. § 300aa-
15(a)(1)(B). Petitioner agrees.
These amounts represent all elements of compensation to which petitioner is entitled
under 42 U.S.C. § 300aa-15(a). Petitioner agrees.
II. Form of the Award
The parties recommend that compensation provided to petitioner should be made through
a lump sum payment, as described below, and request that the Special Master’s decision and the
Court’s judgment award the following:2
A lump sum payment of $63,820.00 to be paid through an ACH deposit to petitioner’s
counsel’s IOLTA account for prompt disbursement to petitioner, Isabel Del Vecchio.
Petitioner is a competent adult. Proof of guardianship is not required in this case.
Respectfully submitted,
BRETT A. SHUMATE
Assistant Attorney General
C. SALVATORE D’ALESSIO
Director
Torts Branch, Civil Division
2 Should petitioner die prior to entry of judgment, respondent would oppose any award for future
medical expenses, future lost earnings, and future pain and suffering, and the parties reserve the
right to move the Court for appropriate relief.
2

Case 1:21-vv-00680-UNJ Document 72 Filed 10/14/25 Page 5 of 5
HEATHER L. PEARLMAN
Deputy Director
Torts Branch, Civil Division
VORIS E. JOHNSON
Assistant Director
Torts Branch, Civil Division
/s/Mary E. Holmes
MARY E. HOLMES
Trial Attorney
Torts Branch, Civil Division
U. S. Department of Justice
P.O. Box l46, Benjamin Franklin Station
Washington, D.C. 20044-0146
Tel: (202) 616-5022
Mary.E.Holmes@usdoj.gov
DATED: September 16, 2025
3