Laura Surace v. HHS - Tdap, vestibular/balance dysregulation/difficulty walking, myalgia, malaise, markedly declined functioning, severe premenstrual dysphoric disorder [“PMDD”] and other neurological impairments (2025)

On July 12, 2021, Laura Surace filed a petition alleging that a Tdap vaccine administered on July 18, 2019 caused or significantly aggravated a wide constellation of problems, including vestibular or balance dysregulation, difficulty walking, myalgia, malaise, declined functioning, severe premenstrual dysphoric disorder, and other neurologic impairments. Chief Special Master Brian H.

Corcoran decided the case on the written record and denied entitlement on August 11, 2025. The medical history was central to the ruling.

Before vaccination, Ms. Surace had treatment for anxiety and depression, requested college accommodations based on reported disabilities, received psychiatric treatment for panic attacks and weekly meltdowns, and underwent a December 2017 neuropsychological evaluation documenting lifelong sensory-processing, executive-functioning, self-regulation, and organization difficulties.

Records also noted sensory disorder, anxiety, possible autism spectrum disorder, and premenstrual symptoms before the Tdap shot. At a wellness visit on July 18, 2019, Ms.

Surace received Tdap and a prescription for an oral contraceptive. One week later she returned to her primary-care doctor reporting that she woke the day after vaccination with severe exhaustion and fever, that moving her arms and legs was hard, and that dizziness developed over the next few days.

Her primary-care doctor arranged a same-day neurology consult to rule out post-vaccine GBS. Pediatric neurologist Dr.

Matthew McCarthy found normal strength, reflexes, and sensory findings and concluded there was no concern for an autoimmune post-vaccine demyelinating process; he viewed the episode as improving flu-like post-vaccine symptoms. Two days later, an emergency department evaluation for leg pain showed normal walking on repeated observation, normal exam and labs aside from low hemoglobin, and a normal CRP inflammation marker.

Ms. Surace later pursued physical therapy, vestibular/visual therapy, otolaryngology, optometry, psychiatric care, and neurology.

Some providers recorded her belief that the Tdap vaccine caused a decline, but the Special Master found many of those notes were based on her self-report rather than independent causal judgments. In May 2021, neurologist Dr.

Georges Ghacibeh evaluated her and later served as her expert. He proposed that the vaccine triggered a systemic inflammatory reaction, possibly interacting with an underlying metabolic or mitochondrial vulnerability, and described a biphasic course of acute symptoms followed by chronic neurologic complaints.

Respondent's expert, Dr. Subramaniam Sriram, a neurologist and neuroimmunology specialist at Vanderbilt, rejected the theory as unsupported and emphasized the lack of a defined vaccine-caused neurologic injury.

Chief Special Master Corcoran found that Ms. Surace had not established a cognizable vaccine injury.

He treated the immediate malaise and fever as transient and not enough to satisfy the Vaccine Act's six-month requirement. He found that the broader symptoms did not cohere into a supported diagnosis, that proposed encephalopathy, cranial neuropathy, vestibular neuropathy, and metabolic or mitochondrial disorder theories lacked reliable record support, and that the Tdap causation theory relied too heavily on timing.

He also rejected significant aggravation, including as to PMDD, anxiety, neurodevelopmental symptoms, and sensory issues, because the record did not show that Tdap more likely than not worsened a defined preexisting condition. A March 30, 2026 fees decision awarded attorney fees and costs because the unsuccessful claim had reasonable basis, but no injury compensation was awarded.