Wilbert L. Townsend, Sr. v. Secretary of Health and Human Services

N OTE: This disposition is nonprecedential.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 K UMAR SHARMA, AKS Law, LLC, Potomac, MD,
for petitioner-appellant.
RYAN D. P YLES , 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, L ARA A. ENGLUND,
HEATHER L YNN P EARLMAN.
______________________
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TOWNSEND v HHS 2
Before D YK, 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
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TOWNSEND v. HHS 3
Table1 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.
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TOWNSEND v HHS 4
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
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TOWNSEND v. HHS 5
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. D ISCUSSION
“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
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TOWNSEND v HHS 6
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
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TOWNSEND v. HHS 7
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
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TOWNSEND v HHS 8
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.
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