Muhammad Alqulissi v. HHS - Influenza, seronegative rheumatoid arthritis (2026)

On October 13, 2022, Muhammad Alqulissi filed a petition alleging that a Fluzone Quadrivalent influenza vaccination administered at a CVS Minute Clinic in Houston on November 11, 2019 caused seronegative rheumatoid arthritis and elevated inflammatory markers. He was 36 years old at vaccination, five days short of his thirty-seventh birthday.

Respondent opposed compensation. The record showed a complex medical background, including chronic microcytosis, fatty and mildly enlarged liver, possible thyrotoxic goiter, recurrent tonsillitis, hematuria, positive Helicobacter pylori testing, and GERD.

In early December 2019, Mr. Alqulissi sought orthopedic and primary-care evaluation for widespread joint pain and stiffness involving his cervical spine, shoulders, hips, knees, hands, wrists, fingers, and feet.

His primary care physician documented severe aching pain worse in the morning, swelling and tenderness in the fingers and hand joints, and a family history that included rheumatoid arthritis and lupus. Rheumatologist Dr.

Padma Chimata saw him on December 10, 2019. Mr.

Alqulissi reported that most symptoms started around the same time as the flu shot and that he was worried it triggered something; the history also described symptom onset as one to two months earlier. Testing showed elevated ESR and CRP with normal rheumatoid factor and ACPA, and X-rays did not show inflammatory arthropathy.

In January 2020, Dr. Chimata diagnosed seronegative RA and treated him with methotrexate, folic acid, sulindac, and later Arava, with improvement by June 2020.

Petitioner relied on Dr. David Axelrod, a clinical immunologist and rheumatologist, who opined that Mr.

Alqulissi met criteria for seronegative RA and proposed two possible immune mechanisms: a cytokine-driven innate immune response or an adaptive immune response after vaccination. Respondent relied on Dr.

Mehrdad Matloubian, who disputed the causal theory and the evidentiary support for connecting flu vaccination to RA. Special Master Nora Beth Dorsey found that Mr.

Alqulissi had proven the diagnosis of seronegative RA. She denied compensation because the causation proof did not satisfy Althen.

The decision found the cytokine and adaptive-response theories insufficiently supported, found that the literature and timing evidence did not establish that influenza vaccination can cause RA, and noted that onset evidence was inconsistent: Mr. Alqulissi's affidavit placed onset eight days after vaccination, medical records suggested widespread pain four days after vaccination, a Motrin request came around fourteen days after vaccination, and Dr.

Chimata's history could place onset before vaccination or only one or two days after it. The petition was dismissed on March 16, 2026.

An earlier interim attorney-fees decision awarded fees and costs, but no vaccine-injury compensation was awarded.