Townsend v. Hhs

• Court: Court of Appeals for the Federal Circuit
• Decided: March 2, 2026
• Docket: 24-1740
• Status: Unpublished

Opinion

Case: 24-1740 Document: 47 Page: 1 Filed: 03/02/2026

NOTE: This disposition is nonprecedential.

United States Court of Appeals for the Federal Circuit ______________________

WILBERT L. TOWNSEND, SR., Petitioner-Appellant

v.

SECRETARY OF HEALTH AND HUMAN SERVICES, Respondent-Appellee ______________________

2024-1740 ______________________

Appeal from the United States Court of Federal Claims in No. 1:14-vv-00266-ZNS, Judge Zachary N. Somers. ______________________

Decided: March 2, 2026 ______________________

AMIT KUMAR SHARMA, AKS Law, LLC, Potomac, MD, for petitioner-appellant.

RYAN D. PYLES, Torts Branch, Civil Division, United States Department of Justice, Washington, DC, for re- spondent-appellee. Also represented by BRIAN M. BOYNTON, C. SALVATORE D'ALESSIO, LARA A. ENGLUND, HEATHER LYNN PEARLMAN. ______________________ Case: 24-1740 Document: 47 Page: 2 Filed: 03/02/2026

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Before DYK, STOLL, and CUNNINGHAM, Circuit Judges. CUNNINGHAM, Circuit Judge. Wilbert L. Townsend appeals a judgment and decision of the United States Court of Federal Claims, denying Mr. Townsend’s motion for review and sustaining the Spe- cial Master’s decision denying Mr. Townsend’s claim for compensation under the National Vaccine Injury Compen- sation Program, 42 U.S.C. §§ 300aa–10 to –34 (“Vaccine Act”). J.A. 1; Townsend v. Sec’y of Health & Hum. Servs., 170 Fed. Cl. 130, 135, 146 (2024) (“Decision”); Townsend v. Sec’y of Health & Hum. Servs., No. 14-266V, 2023 WL 6212496, at *31 (Fed. Cl. Spec. Mstr. Aug. 29, 2023) (“Spe- cial Master Decision”). For the reasons discussed below, we affirm. I. BACKGROUND On October 4, 2011, Mr. Townsend received an influ- enza vaccination. Decision at 135. In mid-November, Mr. Townsend went to urgent care for hand tremors, sharp bilateral ear pain, a lingering cough, and a progressively worsening sore throat, which suggested an upper respira- tory infection. Id. Mr. Townsend later experienced symp- toms such as numbness in arms, neck pain, and trouble walking and sought medical care over the next months. Id. at 135–36. After examination by neurologists and mag- netic resonance imaging showing lesions in the brain and on the spine, Mr. Townsend was diagnosed with multiple sclerosis (“MS”) in 2012. Id. On April 7, 2014, Mr. Townsend filed a petition for compensation under the Vaccine Act, alleging that receiv- ing the influenza vaccine caused him to develop MS. Spe- cial Master Decision at *1; J.A. 57. A petitioner seeking compensation for an injury not listed in the Vaccine Injury Case: 24-1740 Document: 47 Page: 3 Filed: 03/02/2026

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Table 1 must prove, by a preponderance of the evidence, the vaccination actually caused his injury by presenting: “(1) a medical theory causally connecting the vaccination and the injury; (2) a logical sequence of cause and effect showing that the vaccination was the reason for the injury; and (3) a showing of a proximate temporal relationship between vac- cination and injury.” Althen v. Sec’y of Health & Hum. Servs., 418 F.3d 1274, 1278 (Fed. Cir. 2005); 42 U.S.C. § 300aa–11(c)(1)(C)(ii)(I). As to Althen prong one, Mr. Townsend’s expert witness, Dr. Rosenspire, advanced a theory that viral infections can cause MS based on “molecular mimicry,” which is the “sharing of molecular structures between genetically dif- ferent organisms that occurs when peptides from a patho- gen share sequences or structural similarities of proteins of the pathogen’s host.” Special Master Decision at *7 (cleaned up). In support of this theory, Dr. Rosenspire cited an article, which explained that molecular mimicry was one theory of causation for MS but that “no one virus has ever been demonstrated to be the cause of MS” and “molecular mimicry alone may not be able to induce” the development of MS. Id. at *8 (cleaned up). Dr. Samuels, another expert witness for Mr. Townsend, admitted that “epidemiology studies indicate that it is unlikely there is a relationship between the [influenza] vaccine and MS.” Id. at *14. Dr. Tompkins and Dr. Alexander, expert witnesses on behalf of the Secretary of Health and Human Services, explained that a significant body of data shows no associa- tion between the flu vaccine and MS and that the cause of MS is unknown. Id. at *16, *20. With respect to Althen prong two, Dr. Rosenspire and Dr. Samuels opined that it was more likely than not that the flu vaccine was a substantial factor in causing or

1 It is undisputed that this is an off-Table case. 42 C.F.R. § 100.3; Appellant’s Br. 1; Appellee’s Br. 1. Case: 24-1740 Document: 47 Page: 4 Filed: 03/02/2026

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caused Mr. Townsend’s MS, considering factors such as Mr. Townsend’s age and that his MS was late onset. Id. at *11–12, *14. Dr. Tompkins and Dr. Alexander disa- greed, and Dr. Tompkins concluded that Mr. Townsend’s upper respiratory infection was more likely to have caused his MS than the influenza vaccination. Id. at *19, *21–22. The Special Master found that Mr. Townsend “failed to provide preponderant evidence of a sound and reliable the- ory” as required by Althen prong one. Id. at *24. The Spe- cial Master found that Mr. Townsend’s theories were “speculative” or “conclusory in nature.” Id. at *27. The Special Master stated that the medical literature did not show that “more likely than not, the flu vaccine can cause MS.” Id. at *24. The Special Master further indicated that analogies made to dissimilar diseases were not persuasive evidence that the influenza vaccine can cause MS. Id. at *26. The Special Master also considered that Special Masters have denied entitlement in other Vaccine Act cases regarding whether influenza vaccinations can aggra- vate or cause MS via molecular mimicry. Id. at *27 (citing W.C. v. Sec’y of Health & Hum. Servs., 704 F.3d 1352, 1354–55 (Fed. Cir. 2013)). The Special Master further found that Mr. Townsend “failed to provide preponderant evidence of a logical se- quence of cause and effect to satisfy his burden under Al- then prong two.” Id. at *30. The Special Master found that there was evidence of another possible cause of MS, Mr. Townsend’s upper respiratory infection, along with a lack of evidence that the influenza vaccine can cause MS. Id. Although the Special Master found that Mr. Townsend had “provided preponderant evidence satisfying Althen prong three,” she found that Mr. Townsend had “failed to establish by preponderant evidence that his flu vaccination caused his MS.” Id. at *31. The Special Master denied compensation and dismissed the petition. Id. The Court of Federal Claims denied Mr. Townsend’s motion for review Case: 24-1740 Document: 47 Page: 5 Filed: 03/02/2026

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and sustained the Special Master’s decision denying com- pensation. Decision at 146. Mr. Townsend timely appealed to this court. We have jurisdiction under 42 U.S.C. § 300aa–12(f). II. DISCUSSION “In Vaccine Act cases, we review the [Court of Federal Claims’s] decision de novo, applying the same standard of review as the Court of Federal Claims applied to its review of the [S]pecial [M]aster’s decision.” Dupuch-Carron v. Sec’y of Health & Hum. Servs., 969 F.3d 1318, 1324 (Fed. Cir. 2020) (cleaned up). We review “a decision of the [S]pecial [M]aster under the same standard as the Court of Federal Claims and determine[] if it is arbitrary, capri- cious, an abuse of discretion, or otherwise not in accordance with law.” Rodriguez v. Sec’y of Health & Hum. Servs., 632 F.3d 1381, 1383–84 (Fed. Cir. 2011) (cleaned up); see 42 U.S.C. § 300aa–12(e)(2)(B). “While review of the factual findings made by a [S]pecial [M]aster is highly deferential, both this court and the Court of Federal Claims have a duty to ensure that the [S]pecial [M]aster has properly applied Vaccine Act evidentiary standards, considered the relevant evidence of record, drawn plausible inferences and articu- lated a rational basis for [her] decision.” Paluck v. Sec’y of Health & Hum. Servs., 786 F.3d 1373, 1380 (Fed. Cir. 2015) (cleaned up). A. Mr. Townsend argues that the Special Master improp- erly “elevated [Mr. Townsend’s] burden of proof for estab- lishing that there is a plausible theory that causally connects [his] vaccination and his MS” and that the theory of molecular mimicry satisfied Althen prong one. Appel- lant’s Br. 22–23. We disagree. The Special Master did not err in stating that Althen prong one required “preponderant evidence of a sound and reliable theory.” Special Master Decision at *24. Here, the Case: 24-1740 Document: 47 Page: 6 Filed: 03/02/2026

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Special Master accurately cited the Althen prong one standard: “A petitioner must provide a reputable medical or scientific explanation for [his] theory. While it does not require medical or scientific certainty, it must still be sound and reliable.” Boatmon v. Sec’y of Health & Hum. Servs., 941 F.3d 1351, 1359 (Fed. Cir. 2019) (cleaned up). As we previously explained, the “petitioner must do more than demonstrate a ‘plausible’ or ‘possible’ causal link be- tween the vaccination and the injury; he must prove his case by a preponderance of the evidence.” W.C., 704 F.3d at 1356. Accordingly, the Special Master did not err in her application of the burden of proof. Additionally, the Special Master’s application of Althen prong one was not arbitrary and capricious. For example, Dr. Rosenspire acknowledged, Special Master Decision at *24, and the “literature filed by the parties is replete with statements that the cause of MS is not known.” Id. at *25. After assessing the evidence, the Special Master found that the evidence did not weigh in Mr. Townsend’s favor because of the lack of “medical literature or any other evidence to show that more likely than not, the [influenza] vaccine can cause MS or that it causes MS via molecular mimicry and/or bystander activation.” Id. at *24. The Spe- cial Master properly considered the evidence in the record to conclude that the evidence did not weigh in Mr. Town- send’s favor. See Moberly ex rel. Moberly v. Sec’y of Health & Hum. Servs., 592 F.3d 1315, 1326 (Fed. Cir. 2010) (“Finders of fact are entitled—indeed, expected—to make determinations as to the reliability of the evidence pre- sented to them and, if appropriate, as to the credibility of the persons presenting that evidence.”). Accordingly, the Special Master did not err in considering the evidence and making such an assessment, and the Court of Federal Claims did not err in sustaining the Special Master’s as- sessment. See W.C., 704 F.3d at 1360 (explaining that the Special Master “found that molecular mimicry is a well-re- garded theory in some contexts, but correctly required Case: 24-1740 Document: 47 Page: 7 Filed: 03/02/2026

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additional evidence showing that molecular mimicry can cause the influenza vaccine to significantly aggravate [MS]” (cleaned up)). B. Mr. Townsend argues that the Special Master’s error at Althen prong one taints the prong two analysis. Appel- lant’s Br. 25. As we conclude that there is no error at prong one, we disagree. Additionally, Mr. Townsend argues that the Special Master erred by failing to address the Althen burden of proof standard of “logical sequence of cause and effect showing that the vaccination was the reason for the injury.” Id. (quoting Althen, 418 F.3d at 1278). Here too, we disagree. The Special Master did not err in analyzing Althen prong two. Under prong two, a petitioner must show that the vaccine was the “‘but for’ cause of the harm . . . or in other words, that the vaccine was the ‘reason for the injury’ as stated in the second prong of the Althen test.” Pafford v. Sec’y of Health & Hum. Servs., 451 F.3d 1352, 1356 (Fed. Cir. 2006). Mr. Townsend’s argument that he re- ceived “the vaccine and shortly thereafter exhibited symp- toms of MS” amounts to an argument that we have rejected—“that proof that an injury could be caused by a vaccine and that the injury occurred within an appropriate period of time following the vaccination is sufficient to re- quire an award of compensation unless the respondent can prove some other cause for the injury.” Appellant’s Br. 25; Hibbard v. Sec’y of Health & Hum. Servs., 698 F.3d 1355, 1366 (Fed. Cir. 2012). Additionally, the Special Master did not err by “consider[ing] the record as a whole in determin- ing causation, especially in a case involving multiple poten- tial causes acting in concert” and determining that, based on the record and the opinion of Dr. Tompkins, there was evidence of another possible cause of MS—the upper res- piratory infection. Stone v. Sec’y of Health & Hum. Servs., 676 F.3d 1373, 1380 (Fed. Cir. 2012); Special Master Case: 24-1740 Document: 47 Page: 8 Filed: 03/02/2026

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Decision at *29–30. Accordingly, we conclude that the Spe- cial Master did not err in her analysis of Althen prong two, and the Court of Federal Claims did not err in sustaining the Special Master’s decision. III. CONCLUSION We have considered Mr. Townsend’s remaining argu- ments and find them unpersuasive. For the foregoing rea- sons, we affirm. AFFIRMED COSTS No costs.