Paul Pellegrino v. HHS - Influenza, oligoarticular juvenile idiopathic arthritis (2025)

On July 23, 2021, Paul Pellegrino filed a petition on behalf of his minor child, A.P., alleging that childhood vaccinations were connected to oligoarticular juvenile idiopathic arthritis. A.P. was born on April 23, 2017.

She received DTaP and Hib vaccines at her fifteen-month visit on July 26, 2018, and later received hepatitis A and influenza vaccines on November 1, 2018, when she was about 18 months old. The original petition alleged that the July vaccines caused arthritis and that the November vaccines aggravated it, but petitioner later restricted the causation theory to the flu vaccine as the cause of the injury.

A.P. had normal health and development during her first year and had received routine childhood vaccines without documented adverse events. After the July 2018 vaccines, her parents later told treaters that they began noticing concerns at the end of July: locking of the left knee during diaper changes, intermittent limping, unsteadiness in the mornings, and later ankle swelling.

Records from August through October 2018 did not document those joint complaints, and her November 1, 2018 visit was normal. By late December 2018, however, her parents sought orthopedic care for limping and swelling.

Dr. Virginia Casey observed left knee swelling, reduced range of motion, slight effusion, and left ankle swelling, assessed probable JIA, and referred A.P. to rheumatology.

In January 2019, pediatric rheumatology confirmed oligoarticular JIA. Petitioner relied on Dr.

M. Eric Gershwin, who argued that the flu vaccine could stimulate innate immune activity and pro-inflammatory cytokines in a genetically susceptible child, producing a dysregulated autoimmune process.

Respondent's experts, including pediatric rheumatology expert Dr. Carlos Rose and immunology expert Dr.

John MacGinnitie, agreed that A.P. had oligoarticular JIA but disputed vaccine causation. They emphasized the parents' repeated reports that symptoms began after the July vaccinations and before the November flu vaccine, the absence of a close-in-time inflammatory reaction after the flu shot, the idiopathic nature of oligoarticular JIA, and literature not supporting flu vaccine causation or aggravation.

Chief Special Master Brian H. Corcoran denied entitlement on July 25, 2025 without a hearing, finding the written record sufficient.

He found that the flu-vaccine theory failed because A.P.'s symptoms most likely began before the November 1 flu shot, and because Dr. Gershwin had not shown by preponderant evidence that the flu vaccine can cause oligoarticular JIA.

He also found that, even if the case were treated as significant aggravation of a preexisting JIA process, the record did not show that the November vaccinations likely worsened the condition. A later attorney-fees decision awarded fees and costs because the claim had reasonable basis, but no vaccine-injury compensation was awarded.