Meghan True v. HHS - HPV, transverse myelitis (2025)

On October 29, 2021, Meghan True filed a petition for compensation under the National Vaccine Injury Compensation Program, alleging that a third human papillomavirus (HPV) vaccine administered on June 7, 2019, caused her to develop transverse myelitis (TM). The respondent argued that the petitioner had not met her burden of proof.

The Special Master, Nora Beth Dorsey, found that the petitioner failed to provide preponderant evidence that the HPV vaccination caused her TM, and thus dismissed the petition. The parties stipulated that the petitioner received her third HPV vaccination on June 7, 2019, and that the vaccine is on the Vaccine Injury Table and was administered in the United States.

The core dispute was the nature and diagnosis of the petitioner's alleged injuries and whether the HPV vaccine caused them. The petitioner contended her diagnosis was TM, while the respondent's experts argued her symptoms were most consistent with fibromyalgia and/or functional neurological disorder (FND).

The Special Master determined that the petitioner's accurate diagnosis was TM, giving weight to the opinions of her treating physicians who diagnosed her with presumed TM during her hospitalization. The Special Master found that while diagnostic testing did not confirm TM, variations in symptomology and testing results are known in TM patients, and the petitioner's rapid recovery following steroid treatment was consistent with TM.

The Special Master rejected the FND diagnosis as it was introduced late by the respondent's expert and not considered by treating physicians, and dismissed the fibromyalgia diagnosis as too remote in time from the alleged injury. However, the Special Master ultimately found that the petitioner failed to establish a sound and reliable medical theory for causation under the first prong of the Althen test.

Petitioner's expert, Dr. Lawrence Steinman, proposed a theory of molecular mimicry between the HPV vaccine's L1 protein and myelin basic protein (MBP), suggesting this could trigger an immune response leading to TM.

The Special Master found this theory lacked sufficient supportive evidence, noting Dr. Steinman's reliance on outdated literature, insufficient demonstration of sequence homology, and failure to conduct standard analyses like BLAST or IEDB searches.

Furthermore, the Special Master considered epidemiological studies presented by the respondent's expert, Dr. Mehrdad Matloubian, which found no increased risk of demyelinating diseases, including TM, following HPV vaccination.

Because the petitioner failed to establish a sound medical theory of causation, the petition was dismissed. The Special Master also found that the petitioner failed to satisfy the second and third prongs of the Althen test.

The petitioner did not prove a logical sequence of cause and effect showing the vaccination was the reason for the injury, partly due to her rapid recovery and the lack of definitive diagnostic findings. Additionally, the petitioner failed to establish a medically acceptable temporal relationship between the vaccination and the onset of her symptoms.

The Special Master found the alleged one-to-two-day onset of symptoms was too rapid, even considering a recall response, and not supported by the medical literature or the petitioner's expert's explanation of immune response latency. The petition was dismissed for failure to prove causation.

Petitioner was represented by Laura Levenberg of Muller Brazil PA, and the respondent was represented by Felicia Langel of the U.S. Department of Justice.

The decision was issued by Special Master Nora Beth Dorsey.