Rebecca Lake Pool v. HHS - Influenza, myasthenia gravis (2025)

On December 5, 2022, Rebecca Lake Pool filed a petition alleging that an influenza vaccine administered at a CVS pharmacy on October 14, 2020 caused myasthenia gravis (MG). She was 39 years old at vaccination.

Ms. Pool had a pre-vaccination history that included migraines, dizziness, nausea, eye twitching, hand twitching, and bilateral hand numbness.

Shortly after the flu shot, she went to the emergency department with headache and vomiting. In the following days and weeks she repeatedly sought emergency and outpatient care for facial numbness, tingling in her extremities and tongue, chest heaviness, dizziness, brain fog, weakness, headache, nausea, and paresthesias.

Early neurologic evaluations considered but did not support Guillain-Barre syndrome; spinal imaging and other initial testing were not diagnostic. In February 2021, neurologist Dr.

Nivedita Jerath began treating Ms. Pool and later served as her causation expert.

Dr. Jerath noted normal lumbar puncture and spinal MRI results, borderline EMG evidence of a possible neuromuscular junction disorder, and normal MG antibody-panel results.

She ultimately proposed seronegative MG and an autoimmune reaction to the flu vaccine. Her theory was that the vaccination could trigger immune activity leading to attack at the neuromuscular junction, with immediate post-vaccination symptoms and later neuromuscular complaints fitting that process.

Respondent disputed both the diagnosis and causation. Respondent relied on Dr.

Mark Bromberg, who emphasized the absence of clear early ocular MG findings such as ptosis or diplopia, vague or inconsistent strength findings, normal or nonspecific testing, and treatment responses that did not clearly behave like MG. Chief Special Master Brian H.

Corcoran assumed for analysis that Ms. Pool could have seronegative MG, but found that she had not proved a medically acceptable temporal relationship or a logical sequence of vaccine causation.

He also noted that the evidence did not preponderantly establish that flu vaccine can likely cause seronegative MG. Entitlement was denied on August 15, 2025.

A later March 11, 2026 decision awarded attorney's fees and costs after the denial. That fee award did not change the denial of vaccine-injury compensation.