{
  "_meta": {
    "description": "COVID-19 mRNA vaccine injury causality table (COMPREHENSIVE). Strict WHO criteria (high evidence threshold, confirmed signals).",
    "criteriaVersion": "strict",
    "framework": "WHO causality assessment framework",
    "lastUpdated": "2026-07-10",
    "schemaVersion": "1.1.0",
    "totalDocumentedAEsWithCaseReports": 74,
    "notes": "Includes only High evidence conditions with confirmed signals across multiple independent surveillance systems."
  },
  "entries": [
    {
      "vaccine": "COVID-19 mRNA",
      "condition": "Myocarditis / Pericarditis",
      "causality_level": "Very likely / Probable",
      "time_window_days": [
        0,
        7
      ],
      "evidence_level": "High",
      "supporting_studies_count": 40,
      "who_assessment_notes": "Confirmed across multiple large surveillance systems (VSD, GVDN, multinational cohorts). Strongest signal in young males after dose 2.",
      "key_mechanisms": [
        "Molecular mimicry between spike protein and cardiac myosin",
        "Direct mRNA-LNP endothelial inflammation"
      ],
      "supporting_literature": [
        {
          "label": "Klein NP et al. VSD surveillance",
          "pmid": "34477808",
          "type": "surveillance",
          "url": "https://pubmed.ncbi.nlm.nih.gov/34477808/",
          "summary": "CDC confirmed myocarditis signal."
        }
      ],
      "last_updated": "2026-07-10"
    },
    {
      "vaccine": "COVID-19 mRNA",
      "condition": "Anaphylaxis",
      "causality_level": "Very likely / Probable",
      "time_window_days": [
        0,
        1
      ],
      "evidence_level": "High",
      "supporting_studies_count": 50,
      "who_assessment_notes": "Well-established rare but confirmed adverse event. FDA and EMA monitor closely. Rate ~2–5 per million doses.",
      "key_mechanisms": [
        "IgE-mediated hypersensitivity to PEG or other excipients"
      ],
      "supporting_literature": [
        {
          "label": "Shimabukuro TT et al. Anaphylaxis surveillance",
          "pmid": "33326773",
          "type": "surveillance",
          "url": "https://pubmed.ncbi.nlm.nih.gov/33326773/",
          "summary": "Anaphylaxis confirmed post-vaccination."
        }
      ],
      "last_updated": "2026-07-10"
    }
  ]
}