Hortencia Torres v. HHS - Tdap, trigeminal neuralgia (2026)

Hortencia Torres, a 58-year-old woman, received a Tdap vaccine on May 22, 2018. She subsequently developed symptoms that she and some of her treating physicians believed to be trigeminal neuralgia (TN).

Her symptoms began approximately 14 days after vaccination, with initial complaints of headaches, facial pain, and some autonomic symptoms like nasal congestion and eye redness. Over several years, she was treated by various specialists, including neurologists, who considered diagnoses such as TN, trigeminal autonomic cephalalgias (TACs), and hemicrania continua.

Petitioner's expert, Dr. Jeret, opined that the Tdap vaccine caused her TN through molecular mimicry or an immune-mediated inflammatory response, citing literature on other vaccine-related nerve injuries and case reports of TN after COVID-19 vaccines.

Respondent's expert, Dr. Jamieson, disagreed, opining that Petitioner's condition was more consistent with hemicrania continua, which she believed predated the vaccination and was unrelated to it.

Dr. Jamieson also argued that Petitioner's symptoms did not fully meet the criteria for TN and that the proposed causation theories were not sufficiently supported by evidence linking the Tdap vaccine to TN.

The court found that Petitioner failed to provide preponderant evidence of a sound and reliable medical theory explaining how the Tdap vaccine could cause TN, thus failing the first prong of the Althen test for causation. Although the court found the temporal relationship to be met, the lack of a viable causation theory meant Petitioner could not demonstrate actual causation.

Therefore, the court denied her claim for compensation.