Tetanus Vaccine and Transverse Myelitis – Timing


Mosley v. HHS, No. 08-724V (Fed. Cl. Spec. Mstr. Apr. 27, 2015)(Millman)

Denial of entitlement on remand.  Petitioner had alleged her transverse myelitis (TM) was caused by a tetanus vaccine and the special master denied the claim after a hearing.  Petitioner appealed and the entitlement decision was vacated and remanded with instructions to consider and explain the impact of the treating physicians’ supportive statements on causation.

This case turned on Althen prong three, timing.  Petitioner’s expert had committed to an onset interval of 54 hours post-vaccine; Respondent’s expert argued for a 5-hour onset and the special master found the onset of symptoms occurred within one day of receipt of the tetanus vaccine.

On remand, the court held that the treating physicians’ opinions either did not expressly support a one-day onset as causative or did so without elaboration or explanation as to why that was a medically appropriate temporal interval.  Accordingly, the court again held that one day was not a medically appropriate interval for transverse myelitis caused by the tetanus vaccine and denied entitlement.

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