Off-Table causation wins
The citable precedent set for causation-in-fact. These are the reasoned decisions in which a Special Master found, under Althen v. HHS, that a vaccine more likely than not caused an injury that is not on the Vaccine Injury Table, or fell outside its onset window. Filter by condition and vaccine to find the decisions, Special Masters and experts behind a theory that has already succeeded.
Decisions
| Decided | Case | Vaccine | Condition | Special Master | Petitioner's expert(s) | Basis | Award |
|---|---|---|---|---|---|---|---|
| 2025-02-05 | Wendy Williams | Hepatitis A | Other / multiple | Mindy Michaels Roth | not identified | Off-Table | $1.6M |
| 2024-12-30 | Matthew J. Johnson | Hepatitis A | Small fiber neuropathy | Thomas L. Gowen | Marcel Kinsbourne | Althen analysis (Table also discussed) | entitlement |
| 2024-01-08 | J. G. | Hepatitis A | Guillain-Barré Syndrome | Nora Beth Dorsey | not identified | Off-Table | $189K |
| 2018-11-07 | Jodi Cooper | Hepatitis A | SIRVA | Nora Beth Dorsey | not identified | Off-Table | $114K |
| 2018-03-20 | Paul Mondello | Hepatitis A | Seizure disorder | Mindy Michaels Roth | not identified | Off-Table | $51K |
| 2014-09-09 | K.A. | Hepatitis A | Seizure disorder | Thomas L. Gowen | not identified | Althen analysis (Table also discussed) | — |
How off-Table causation is decided
When an injury is not on the Vaccine Injury Table, or falls outside its onset window, the petitioner must prove causation under the three-part test from Althen v. Secretary of HHS (Fed. Cir. 2005): a medical theory connecting the vaccine to the injury, a logical sequence of cause and effect in this petitioner's case, and a medically appropriate interval between vaccination and onset. The standard is preponderance of the evidence, and the Special Master weighs competing expert reports rather than requiring epidemiological proof.
That makes prior reasoned decisions the working precedent of the program. A theory accepted for a given vaccine and condition is easier to carry the second time, and the experts who carried it are the ones later petitioners retain. Decisions are not formally binding on other Special Masters, but they are cited constantly, and the Court of Federal Claims and the Federal Circuit review them for arbitrariness rather than re-trying the facts.