Sexual behavior and proclivities

The decision contains considerably more information about C.G.’s sexual behavior than would ordinarily be necessary to resolve the vaccine claim, largely because the medical experts used it to explain his CMV infection, which they considered the likely trigger for his GBS.

The record establishes the following:

C.G. was 29 years old when vaccinated in July 2017.

Several months before the vaccination, he moved to New York City. He testified that after moving there, he experienced an increase in sexual activity.

He was taking PrEP (pre-exposure prophylaxis) to prevent HIV infection. The vaccination appointment was specifically a visit to obtain a PrEP refill.

The contemporaneous medical records characterize his sexual behavior as “high-risk sexual behavior.” The Hepatitis A and meningococcal vaccinations were recommended in that context.

The record specifically states that his New York sexual activity involved unprotected homosexual activity.

Dr. Callaghan characterized C.G. as being at high risk because of his sexual behavior, and testified that gay men have an elevated risk of CMV infection.

Dr. Callaghan specifically described C.G. as engaging in “high risk homosexual behavior” immediately before his CMV infection and subsequent GBS.

Dr. Gershwin similarly testified that C.G.'s lifestyle change after moving to New York included unprotected homosexual activity and that his sexual activity had increased.

What the document does not establish

Importantly, the decision does not provide a detailed account of his sexual practices. I don't see evidence in the document identifying:

the number of sexual partners;

whether he was single or in relationships;

specific sexual acts or positions;

whether he was exclusively a top, bottom, or versatile;

whether he participated in group sex;

whether he used dating apps;

whether he exchanged sex for money;

whether there were particular fetishes or kinks;

or any other specific sexual proclivities.

So the strongest characterization supported by the record is that C.G. was a gay man who, after moving to New York, substantially increased his sexual activity, engaged in unprotected sex with men, and was sufficiently sexually active/high-risk that he was taking PrEP and was medically classified as engaging in high-risk sexual behavior.

Why the sexual history mattered to the case

It was principally medical causation evidence, not character evidence. The experts agreed that CMV is a recognized trigger of GBS. Dr. Callaghan noted both that C.G. had confirmed CMV viremia and that his high-risk sexual behavior provided a plausible route of exposure.

Dr. Gershwin went further, arguing that C.G.'s move to New York, increased/unprotected sexual activity, binge drinking, subsequent CMV infection, vaccination, and eventual GBS formed an important chronological sequence.

Ultimately, however, the Special Master accepted the basic proposition that CMV was capable of causing C.G.'s GBS but rejected the theory that the vaccines materially contributed to it. The decision therefore denied the claim.

Bottom line: The document portrays C.G. as having had a relatively sexually active period in New York involving unprotected male-male sex and enough perceived HIV exposure risk to warrant PrEP, but it does not contain enough information to characterize him as having any particular fetish, kink, or other more specific sexual proclivity.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128116)

the subject vaccinations. Id. at 10. In New York, he engaged in increased sexual activity. Id. at

11.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128007)

alcohol and drug abuse, depression, and prior hospitalizations for intoxication and “[m]edication

overdose.” See Ex. 2 at 11-16; Ex. 8 at 5-6, 12, 31, 36; Ex. 12 at 21-23, 38-40.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128010)

he received the Hepatitis A and meningococcal vaccines, which were recommended when he

reported engaging in high-risk sexual behavior. Id. at 8-9.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128011)

Mt. Sinai determined that long-term care was more appropriate. Ex. 6 at 184. On August 24,

2017, he was admitted to the Henry J. Carter Specialty Hospital and Nursing Facility (“Carter”)

for rehabilitation and long-term care; he remained there for seven months. Ex. 5 at 1.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128015)

[P]etitioner was engaging in high risk homosexual behavior right before his CMV infection and

subsequent GBS.” Id. (citing Maher K. Gandhi & Rajiv Khanna, Human cytomegalovirus: clinical

aspects, immune regulation, and emerging treatments, 4 INFECTIOUS DISEASES 725 (2004) (Ex. E)

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128019)

York City, where he engaged in unprotected homosexual activity. Id. at 35. “Homosexuals are

more likely to contact CMV,” have a much higher prevalence of CMV infection, and will “develop

it earlier.” Id. Moreover, Petitioner engaged in binge drinking, which will “impact the immune

system and make it more likely for CMV to go from latent to an active phase.” Id. The timeline

of Petitioner’s illness was important: he moved to New York in May, his sexual activity increased,

he was binge drinking, he received the vaccines, and he was “finally diagnosed with [GBS] around

two weeks after his vaccination.” Id. at 35-36. The onset of Petitioner’s GBS was “consistent

with a timeline of a few days to a couple weeks after some initiating factor [the vaccinations] . . .

which would promote the likelihood that CMV would lead to [GBS].” Id. at 36.

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128027)

back a week later with six of your big friends, and there’s another big guy sitting in the bar. And it’s not the same guy, but he looks just like him, so you beat him up anyway."

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128089)

******In accordance with Vaccine Rule 18(b), Petitioner has 14 days to identify and move to redact medical or other information, the disclosure of which would constitute an unwarranted invasion of privacy.******

If, upon review, I agree that the identified material fits within this definition, I will redact such material from public access."

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128108)

https://web.archive.org/web/20191022095120/https://phillipslytle.com/people/jennifer-a-shah/

(http://www.autoadmit.com/thread.php?thread_id=5902445&forum_id=2...id.#50128153)