Encephalopathy and Vaccines: What You Should Know
Encephalopathy is a serious neurological condition that is recognized on the Vaccine Injury Table for certain vaccines under the National Vaccine Injury Compensation Program (“VICP”). Because encephalopathy has specific timing requirements, diagnostic criteria, and exclusions, it is important to understand when a case may qualify as an on-Table claim.
What is Encephalopathy?
For Vaccine Injury Table purposes, a vaccine recipient is considered to have suffered encephalopathy if an acute encephalopathy occurs within the applicable time period after vaccination and results in a chronic encephalopathy.
In other words, not every post-vaccination neurological symptom qualifies as Table encephalopathy. The medical record must support both:
an acute encephalopathic event within the required time period, and
a chronic encephalopathy that persists as required by the Table.
Which Vaccines Cover On-Table Encephalopathy?
Under the Vaccine Injury Table, encephalopathy is listed as a covered injury for the following vaccines:
Vaccines containing whole cell pertussis bacteria, extracted or partial cell pertussis bacteria, or specific pertussis antigen(s). Examples include DTP, DTaP, P, and DTP-Hib
Time period: first symptom or manifestation must occur within 72 hours after vaccination
Vaccines containing measles, mumps, and rubella virus or any of its components. Examples include MMR, MM, and MMRV
Time period: first symptom or manifestation must occur between 5 and 15 days after vaccination
If the first symptom or manifestation of onset occurs within the applicable time period, the injury may qualify as a Table injury if the remaining criteria are met.
What Counts as Acute Encephalopathy?
The Vaccine Injury Table provides different criteria depending on age.
For children younger than 18 months, acute encephalopathy is indicated by:
a significantly decreased level of consciousness lasting at least 24 hours, or
following a seizure, a significantly decreased level of consciousness lasting at least 24 hours that cannot be attributed to a postictal state or medication.
For adults and children 18 months of age or older, acute encephalopathy must persist for at least 24 hours and be characterized by at least two of the following:
a significant change in mental status that is not medication-related,
a significantly decreased level of consciousness independent of a seizure and not attributable to medication, or
a seizure associated with loss of consciousness.
The Table also makes clear that certain symptoms, by themselves, do not demonstrate an acute encephalopathy or a significant change in mental status or level of consciousness. These include:
sleepiness,
irritability or fussiness,
high-pitched or unusual screaming,
poor feeding,
persistent inconsolable crying,
bulging fontanelle, or
symptoms of dementia.
The Table further provides that seizures alone are not sufficient to establish a diagnosis of encephalopathy in the absence of other evidence of an acute encephalopathy.
What is Chronic Encephalopathy?
For Table purposes, chronic encephalopathy means a change in mental or neurologic status that:
first manifested during the applicable Table time period as an acute encephalopathy, and
persists for at least 6 months from the first symptom or manifestation of onset.
If the individual returns to baseline neurologic functioning in less than 6 months, the Table generally does not presume a chronic encephalopathy.
Encephalopathy on the Vaccine Injury Table: Important Exclusions
Not every encephalopathic event after vaccination qualifies as a Table injury. The Vaccine Injury Table excludes encephalopathy when the condition is shown to have been caused by:
an underlying condition or systemic disease unrelated to the vaccine, such as malignancy, structural lesion, psychiatric illness, dementia, genetic disorder, or prenatal or perinatal central nervous system injury; or
an acute event unrelated to the vaccine, such as head trauma, stroke, transient ischemic attack, complicated migraine, drug use, or infectious disease.
Because of these exclusions, the medical record is especially important in encephalopathy claims.
The Severity Requirement
Even if encephalopathy meets the Vaccine Injury Table’s timing and diagnostic requirements, the VICP also requires that the injury meet a severity threshold. You can file a petition when the effects of the injury:
Lasted for more than six months after the vaccination; or
Resulted in inpatient hospitalization and surgical intervention; or
Resulted in death.
Contact a Vaccine Injury Lawyer Today
At Texas Vaccine Lawyers, a Division of The Greenwood Law Firm, we help clients navigate the VICP claims process to seek justice for vaccine-related injuries. Schedule a free consultation to discuss your case and explore your legal options.
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