Research findings — patterns the topline numbers obscure

The 4-tier compensation gating system

Compensation rates aren't a single distribution — they are four structural regimes. Conditions that fit "adult-style autoimmune" legal labels (Tier 1) compensate at 80–95%. Pediatric brain-injury labels off the Vaccine Injury Table (Tier 2) compensate at roughly half that rate. Autism-spectrum filings (Tier 3) compensate at 0% on the merits. The HPV-dysautonomia / POTS cluster (Tier 4) compensates at near-zero.

Each tier groups multiple condition categories; the per-condition breakdown drills into individual rates.

Same court, same statute, 60-point spread

Pediatric brain-injury compensation rates by Special Master, restricted to cases under conditions where the alleged injury includes encephalopathy, seizure disorder, developmental delay/regression, autism-spectrum, or CDD. Each Special Master hears the same docket of filings; case-mix differences do not explain the full spread.

The petitioner-counsel firm effect

The same statute applies regardless of who represents the petitioner. In practice, specialist firms (Conway-Homer-Chin-Caplan, Maglio Christopher & Toale, Kraus Law Group, Robert J. Krakow PC) compensate pediatric brain-injury claims at 70–75%, while pro-se filings — petitioners who could not retain specialist counsel — compensate at 0% across the corpus we sampled (n=31 pro-se).

The Vaccine Act reimburses petitioner attorneys' fees on dismissed petitions filed in good faith with reasonable basis (42 U.S.C. § 300aa-15(e)(1)), so specialist firms can afford to litigate uncertain causation theories without exposing the family to costs. Less experienced counsel and pro-se filers face the same evidentiary and procedural rules but without the institutional knowledge of which framings, experts, and Special Masters produce favorable outcomes for a given clinical picture.

This is one of the multi-layer access-to-counsel asymmetries that stratify outcomes in a no-fault federal compensation program. The Special Master profile pages show the per-master docket and comp rate; the autism-spectrum condition page documents the 0% on-the-merits rate that pro-se filers face.

How the genetic-vulnerability defense became a doctrine — then got reversed

The Vaccine Injury Compensation Program's evidentiary regime has shifted in identifiable phases. The shift most relevant to pediatric brain-injury and autism-spectrum cases is the rise (2010-2012) and partial appellate reversal (2022-2025) of the "genetic vulnerability defeats causation" framework.

• 1986 — National Childhood Vaccine Injury Act creates the program. Althen v. HHS later codifies a 3-prong causation test for off-Table claims.
• 1993 — Suel v. HHS: DPT-aggravation of pre-existing tuberous sclerosis paid — precedent for vaccine aggravation of genetic syndromes, 15 years before Hannah Poling.
• 2008 — Hannah Poling — HHS concedes Table encephalopathy in a child with mitochondrial dysfunction. Visible watershed for the modern doctrine.
• 2009-2010 — Cedillo, Snyder, Hazlehurst — OAP Theory 1 test cases denied. King, Mead, Dwyer — OAP Theory 2 test cases denied 2010-03-12. Categorical autism rejection takes effect.
• 2010-2012 — Hammitt, Barnette — SCN1A / Dravet defense framework crystallizes. Pediatric seizure cases with identified genetic mutations begin losing routinely.
• 2022 — Federal Circuit / CFC vacates the SM denial in L.M. (DYNC1H1 mutation): "Special Master improperly assumed injury was purely genetic." Direct appellate authority that the categorical genetic-defense framework cannot be used as a categorical bar.
• 2022 — Federal Circuit / CFC vacates and remands H.H. (Aicardi-Goutières Syndrome / Type I interferonopathy): "diagnosis of AGS was arbitrary and capricious because it did not adequately consider vaccine aggravation."
• 2024-2025 — Compensated post-genetic-defense cases stack: K.S.J. Jr. ($1.62M, MMR + SLC19A3 activation), J.C.T. ($2.22M, Pentacel + GABRA1 / Dravet), Weaver/T.M. ($1.63M, DTaP + pre-existing developmental delays). Federal Circuit reversal in Weaver: "Court of Federal Claims reversed — improperly elevated the burden of proof."
• 2025 — The 2025 Hazlehurst Rule 60(d) opinion acknowledges DOJ's expert "had expressed to DOJ attorneys that vaccines could cause autism in a subset of children with mitochondrial dysfunction" — same biology that paid Hannah Poling. The court calls the distinction "procedurally distinct."

The pattern is documented in autism-spectrum, seizure disorder, encephalitis/encephalopathy, and developmental delay/regression condition rosters. The Special Masters who decided the foundational denials (Hastings, Vowell, Lord) and the reversals (post-2018 Federal Circuit panels) are profiled in Special Master directory.

Same vaccine, same age window, opposite outcomes

Curated cohort of post-MMR pediatric neurological-injury cases at the 12–20 month age window. All involve post-vaccination neurodevelopmental injury. The variable that flipped each outcome was the legal label the petition was filed under — not the underlying clinical picture.

Source: public Special Master decisions in the U.S. Court of Federal Claims, Office of Special Masters. Cohort selected from the analysis batches by the registry maintainer; all listed cases link to their original decisions.