Christian M. Gatto v. HHS - Meningococcal, Guillain-Barré syndrome (2025)

On February 12, 2021, Christian M. Gatto, who was 16 years old at the time, filed a petition for compensation under the National Vaccine Injury Compensation Program.

He alleged that two meningococcal vaccines he received on February 13, 2019, caused his Guillain-Barré syndrome (GBS). Petitioner received the Bexsero and Menactra vaccines.

There was no record of an immediate reaction to the vaccination. Approximately two weeks later, on February 28, 2019, Mr.

Gatto began experiencing symptoms including chills, headache, and fever. He was seen by a doctor that day and diagnosed with acute frontal sinusitis, for which he was prescribed antibiotics.

Nine days later, on March 9, 2019, he reported additional symptoms including runny nose, cough, decreased appetite and activity, nausea, vomiting, muscle aches, and fatigue. He tested positive for influenza A and was prescribed Tamiflu.

On March 12, 2019, his father reported to his doctor that Mr. Gatto had persistent vomiting, weakness, tingling in his feet, and had stopped taking Tamiflu.

He was taken to the emergency room that evening, where he reported nausea, weakness, fevers, and abdominal pain. Initial neurologic findings were normal, but he was later found to have diminished reflexes in his lower extremities and urinary retention.

The emergency room provider suspected GBS and transferred him to St. Christopher’s Hospital for Children.

At St. Christopher’s, he was diagnosed with suspected GBS, with differential diagnoses including a post-infectious process or systemic illness.

While hospitalized, he was treated with intravenous immunoglobulin. An infectious disease specialist noted that GBS can be associated with recent respiratory or gastrointestinal infections.

Testing for certain infectious agents, including Campylobacter jejuni, was negative. The attending neurologist concluded that a viral etiology was most likely causing an atypical GBS, noting cerebrospinal fluid results were consistent with GBS.

Mr. Gatto was discharged on April 8, 2019, and by late May 2019, he reported feeling well with no pain or numbness.

Petitioner presented expert testimony from Dr. Georges Ghacibeh and Dr.

Lawrence Steinman. Dr.

Ghacibeh opined that the meningococcal vaccine could cause GBS through molecular mimicry or immune system overstimulation, citing passive surveillance data from VAERS and arguing that alternative explanations were not supported by testing. Dr.

Steinman also theorized molecular mimicry, using BLAST searches to find homology between the vaccine's diphtheria toxoid component and nerve proteins, and argued that alternative causes were not credible. The respondent, the Secretary of Health and Human Services, presented expert testimony from Dr.

Gregory Holmes, Dr. Andrew MacGinnitie, and Dr.

Hayley Gans. These experts argued that epidemiological studies did not support a link between the meningococcal vaccine and GBS, and that Mr.

Gatto's symptoms were more consistent with antecedent viral or bacterial infections, such as influenza A, which he had tested positive for. They also noted that the temporal relationship between vaccination and symptom onset was not definitively established as causal, and that Mr.

Gatto's initial symptoms were not consistent with vaccine-associated malaise. Dr.

Holmes emphasized the frequency of antecedent infections preceding GBS and found Mr. Gatto's timeline unlikely for vaccine causation.

Dr. MacGinnitie disputed the molecular mimicry theory, citing limitations in the studies used and the commonality of sequence homology in nature.

Dr. Gans concluded that Mr.

Gatto's GBS was most likely attributable to a respiratory or gastrointestinal illness, noting that vaccines are less commonly associated with GBS than infections. Chief Special Master Brian H.

Corcoran found that Petitioner failed to establish by a preponderance of the evidence that the meningococcal vaccine can cause GBS or that it did cause his GBS. The court found that the Petitioner's causation theory relied heavily on homology arguments that were insufficient on their own and that epidemiological evidence weighed against a vaccine-GBS association.

Furthermore, the court found that the Petitioner's medical records indicated a likely infectious process preceding his GBS, undermining the claim that the vaccine was the cause. Consequently, entitlement to compensation was denied.

Petitioner was represented by Phyllis Widman of Widman Law Firm, LLC, and Respondent was represented by Nina Ren of the U.S. Department of Justice.