Evidence dossier · candidate cand-covid-acute-myocardial-infarction · CICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that COVID-19 vaccine causes Acute Myocardial Infarction, and not an incidence or legal finding. All evidence is flagged needs_human_review and must be reviewed before any page is published or cited. Every value is grounded in retrieved citations (PMID + retrieval date); unsourced items read "no evidence found / not assessable". Symmetric search: every supporting query has a mirror/null query, and zeros are shown (negative dossiers report the absence of signal).
Claim matrix (C1–C6, computed)
Claim
Label
Status
Missing nodes
C1
Coherent clinical object exists
supported
C2
Consistent temporal window
supported
C3
Epidemiologic excess risk
contested
C4
Consistency / replication
contested
C5
Specificity (product / dose)
contested
C6
Biological mechanism
insufficient_data
missing: E1
Two evidentiary bars apply to the epi nodes/claims (C3, C4): · VICP — preponderance of the evidence. · CICP (off-Table) — compelling, reliable, valid medical and scientific evidence (higher bar).
Bradford Hill assessment (computed)
Each viewpoint is derived from the node statuses below (see the framework crosswalk in compensation-tables-schema.md §8). Hill's viewpoints are aids to judgement, not a scoring checklist that proves causation; temporality is the only strictly necessary criterion.
Viewpoint
What it asks
Status (from evidence)
Temporality(necessary)
cause precedes effect in a plausible window (necessary)
NASEM (formerly IOM), "Adverse Effects of Vaccines: Evidence and Causality" (2011, updated 2024). Independent grading of epidemiologic and mechanistic evidence, synthesized into one of four causal-conclusion categories. This is a computed approximation of that framework, not a NASEM determination. See compensation-tables-schema.md §8bis.
Case-definition standard: Universal MI Definition (AMI/ACS per spec §1) — governs the case-certainty scale on A1/A2/A6/A8 below. See compensation-tables-schema.md §8ter.
Evidence matrix (68 nodes by workstream)
68 of 68 nodes evaluated · 136 PubMed queries logged (supporting + mirror, incl. zeros). Statuses are computed from retrieved citations; not hand-set.
Definition & attribution 24/24 evaluated
A1 · Case reportssupports
Measure: New definite object in risk window T Comparator: Pre-vaccination baseline Hit rule: Definite object present, onset in window, competing causes considered
Finding: A case report of acute myocardial infarction (AMI) one day after first inactivated COVID-19 vaccination in an 83-year-old male with coronary thrombosis and underlying stenosis.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Case reports pubmed · 66192 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
14 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
A2 · Series with objective confirmationsupports
Measure: Definite object plus objective test Comparator: Reference range / diagnostic criteria Hit rule: Objective confirmation in >=1 case per the working definition
Finding: Two case reports describe acute myocardial infarction (AMI) with coronary thrombosis after COVID-19 vaccination: one after inactivated vaccine (PMID 37324634) and one series of five autopsy-confirmed MI cases temporally linked to vaccination (PMID 36016266).
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Series with objective confirmation pubmed · 5674 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
14 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
A3 · Onset histogramsupports
Measure: Distribution of onset times after dose Comparator: Pre-specified risk window Hit rule: Onset clusters inside the pre-specified window (not uniform/flat)
Finding: Multiple case reports document acute myocardial infarction (AMI) occurring within 24 hours to one day after COVID-19 vaccination, with some reports noting onset as early as 10 minutes and 19 hours post-dose, suggesting temporal clustering within a pre-specified risk window.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Onset histogram pubmed · 35 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
19 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
supports_node 36439930 · Radiology case reports (2023) — Acute myocardial infarction complicated by severe left ventricle systolic dysfunction in a young patient after Covid 19 vaccination: a case report.
supports_node 35354757 · International heart journal (2022) — Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine.
does_not_resolve 36817791 · Frontiers in medicine (2023) — Myocardial infarction or myocarditis? A case report and review of a myocardial adverse event associated with mRNA vaccine.
A4 · Temporal plausibilitymixed
Measure: Onset latency vs object pathophysiology Comparator: Object's known natural latency Hit rule: Onset latency consistent with the object's pathophysiology
Finding: Case reports describe acute myocardial infarction occurring within one day of COVID-19 vaccination (e.g., onset at 10 minutes and 1 day post-vaccination in an 83-year-old male [PMID 37324634], and 19 hours after a third dose in a STEMI case [PMID 35718694]), with proposed mechanisms including coronary thrombosis secondary to allergic reactions (Kounis syndrome) and underlying coronary stenosis. However, the evidence is limited to individual case reports and small case series, lacking systematic epidemiological data to establish consistent onset latency or pathophysiological plausibility.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Temporal plausibility pubmed · 64 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
15 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
A5 · Onset-interval documentationsupports
Measure: Onset interval documented in source Comparator: Dose date Hit rule: Onset interval is recorded (not imputed) in a primary source
Finding: One case report explicitly documents a 10-minute onset interval for cold sweat and AMI one day after vaccination; two other case reports document onset within 24 hours. The remaining relevant reports do not specify precise onset intervals in the abstract.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Onset-interval documentation pubmed · 33 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
18 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 36800613 · Medicine (2023) — Microsurgical complication associated with vaccine-induced immune thrombotic thrombocytopenia (VITT): A case report.
ambiguous 38238833 · Journal of medical case reports (2024) — A young woman with acute coronary syndrome and antiphospholipid syndrome. Is it the antiphospholipid syndrome or COVID-19 vaccination or classical risk as the r
supports_node 35354757 · International heart journal (2022) — Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine.
supports_node 35154518 · Journal of cardiology cases (2022) — Recurrent Kounis syndrome - a life-threatening event after COVID-19 vaccine administration.
A6 · Differential diagnosis excludedmixed
Measure: Competing causes assessed and excluded Comparator: Likely alternative diagnoses Hit rule: Pre-specified competing causes ruled out per the working definition
Finding: A single case report describes an 83-year-old male who developed acute myocardial infarction one day after inactivated COVID-19 vaccination, with coronary angiography showing thrombosis and underlying stenosis; the authors propose type II Kounis syndrome as a potential mechanism.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Differential diagnosis excluded pubmed · 460 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
11 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 35797353 · Human vaccines & immunotherapeutics (2022) — The global mRNA vaccine patent landscape.
A7 · Rechallenge / re-exposureno_data
Measure: Object recurs on a further dose Comparator: First-dose response Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: The retrieved evidence includes multiple case reports of acute myocardial infarction (AMI) occurring after a first or second dose of COVID-19 vaccine, but no case describes recurrence of AMI after a subsequent (third or later) vaccine dose, which is the specific criterion for this rechallenge/exposure node.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Rechallenge / re-exposure pubmed · 35 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
19 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
supports_node 36800613 · Medicine (2023) — Microsurgical complication associated with vaccine-induced immune thrombotic thrombocytopenia (VITT): A case report.
supports_node 36439930 · Radiology case reports (2023) — Acute myocardial infarction complicated by severe left ventricle systolic dysfunction in a young patient after Covid 19 vaccination: a case report.
ambiguous 38238833 · Journal of medical case reports (2024) — A young woman with acute coronary syndrome and antiphospholipid syndrome. Is it the antiphospholipid syndrome or COVID-19 vaccination or classical risk as the r
A8 · Adjudicated by criteria (Universal MI Definition)mixed
Measure: Object adjudicated by published criteria Comparator: Published clinical / Brighton criteria Hit rule: Cases adjudicated to 'definite' by a published criterion set
Finding: Case reports describe acute myocardial infarction (AMI) temporally associated with COVID-19 vaccination, including cases meeting criteria for ST-segment elevation MI or coronary thrombosis, with adjudication details often limited or not explicitly using a published 'definite' criterion set.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Adjudicated by criteria pubmed · 72 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
17 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
supports_node 35354757 · International heart journal (2022) — Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine.
supports_node 35154518 · Journal of cardiology cases (2022) — Recurrent Kounis syndrome - a life-threatening event after COVID-19 vaccine administration.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
A9 · Natural-history consistencymixed
Measure: Course matches the object's natural history Comparator: Known natural history of the object Hit rule: Clinical course (onset, peak, recovery) matches the object's natural history
Finding: Two case reports describe acute myocardial infarction (AMI) after COVID-19 vaccination: one with onset one day after an inactivated vaccine in an 83-year-old male with coronary thrombosis (PMID 37324634), and five cases of sudden death due to MI with tight temporal relationship to vaccination (PMID 36016266). The evidence is limited to case reports and lacks systematic natural-history data.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series Natural-history consistency pubmed · 136 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
14 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
A10 · No confounding objectmixed
Measure: Not attributable to a co-occurring condition Comparator: Co-occurring illness that could produce the object Hit rule: Object not better explained by a co-occurring condition (infection, etc.)
Finding: Several case reports describe acute myocardial infarction (AMI) occurring within hours to days after COVID-19 vaccination, often in the context of Kounis syndrome or coronary thrombosis, but the evidence is limited to individual cases and small case series without controlled epidemiological data.
supporting: COVID-19 vaccine Acute Myocardial Infarction case report OR case series No confounding object pubmed · 52 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-06
17 retrieved record(s)
supports_node 37324634 · Frontiers in cardiovascular medicine (2023) — Acute myocardial infarction after inactivated COVID-19 vaccination: a case report and literature review.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
supports_node 36016266 · Viruses (2022) — Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
supports_node 35354757 · International heart journal (2022) — Acute Coronary Syndrome After Inactivated SARS-COV-2 Vaccine.
supports_node 35154518 · Journal of cardiology cases (2022) — Recurrent Kounis syndrome - a life-threatening event after COVID-19 vaccine administration.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
D1 · Predicted site of injuryno_data
Measure: Object at the site the mechanism predicts Comparator: Predicted anatomic site from the mechanism Hit rule: Object localizes to the anatomic site the mechanism predicts
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Predicted site of injury not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
D2 · Spared structuresno_data
Measure: Structures the mechanism should spare are spared Comparator: Structures predicted unaffected Hit rule: Structures predicted spared by the mechanism are indeed spared
mirror: COVID-19 vaccine Acute Myocardial Infarction Spared structures not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
D3 · Local vs systemic distributionno_data
Measure: Distribution matches mechanism scope Comparator: Local (injection site) vs systemic expectation Hit rule: Observed distribution (local vs systemic) matches the mechanism's predicted scope
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Local vs systemic distribution not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
D4 · Kinetics classno_data
Measure: Onset/offset kinetics match the mechanism Comparator: Expected kinetic class (acute vs chronic) Hit rule: Onset and offset kinetics are in the class the mechanism predicts
mirror: COVID-19 vaccine Acute Myocardial Infarction Kinetics class not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
D5 · Platform-mechanism matchno_data
Measure: Mechanism is consistent with the platform Comparator: Mechanistic expectation for the platform Hit rule: The proposed mechanism is biologically consistent with the vaccine platform
mirror: COVID-19 vaccine Acute Myocardial Infarction Platform-mechanism match not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
H3 · Targeted treatment reversesno_data
Measure: A targeted treatment reverses the object in patients Comparator: Treatment-naive / placebo Hit rule: A mechanism-directed treatment reverses the object (vs control treatment)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15141300 hits · run 2026-09-06
Measure: No node's finding contradicts another Comparator: Internal consistency across nodes Hit rule: No evaluated node directly contradicts another (coherence)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction No internal contradiction coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction No internal contradiction inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-06
I2 · Analogy to a known objectno_data
Measure: Object analogous to a well-established analog Comparator: Established analog's profile Hit rule: The object's profile matches a well-established analog on key features
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Analogy to a known object coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Analogy to a known object inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-06
I5 · Latency coherenceno_data
Measure: Observed latency matches the mechanism's latency Comparator: Mechanism-predicted latency Hit rule: Observed onset latency is coherent with the mechanism's predicted latency
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Latency coherence coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Latency coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-06
J1 · Pre-specificationno_data
Measure: Window/hit-rule pre-specified before data Comparator: Pre-specified vs post-hoc Hit rule: The risk window, object, and hit rule were pre-specified before data were seen
Finding: The retrieved evidence does not address pre-specification of risk windows or hit rules for COVID-19 vaccine-associated acute myocardial infarction; two studies discuss AI adjudication of immune-related adverse events and MACE in clinical trials, and one paper hypothesizes mechanisms for vaccine-induced thrombotic events, none of which pertain to pre-specification of endpoints.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Pre-specification pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Pre-specification post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-06
3 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 41493293 · Journal of the American College of Cardi (2026) — Using Artificial Intelligence to Adjudicate Major Adverse Cardiovascular Events in Clinical Trials.
does_not_resolve 35412949 · Human vaccines & immunotherapeutics (2022) — Explaining COVID-19 postvaccination-related immune thrombotic thrombocytopenia: a hypothesis-generating in-silico approach.
J2 · Contrary-evidence logno_data
Measure: Contrary evidence is logged, not omitted Comparator: Support-only dossier Hit rule: Contrary / null / refuting findings are logged and shown alongside support
Finding: The retrieved evidence does not address acute myocardial infarction as an adverse event following COVID-19 vaccination. Two studies discuss AI-based adjudication of immune-related adverse events and major adverse cardiovascular events in general, but none provide contrary or null findings specific to COVID-19 vaccine-associated acute myocardial infarction.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Contrary-evidence log pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-06
3 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 41493293 · Journal of the American College of Cardi (2026) — Using Artificial Intelligence to Adjudicate Major Adverse Cardiovascular Events in Clinical Trials.
does_not_resolve 35412949 · Human vaccines & immunotherapeutics (2022) — Explaining COVID-19 postvaccination-related immune thrombotic thrombocytopenia: a hypothesis-generating in-silico approach.
J3 · No temporality-only claimno_data
Measure: Claim not based on temporality alone Comparator: Sequence-only evidence Hit rule: The claim is not supported by temporal sequence alone (independent evidence exists)
Finding: The retrieved evidence does not address acute myocardial infarction following COVID-19 vaccination; PMID 39226489 focuses on immune-related adverse events from immune checkpoint inhibitors, not vaccines, and PMID 35412949 discusses immune thrombotic thrombocytopenia after adenovirus-vector vaccines, which is a thrombotic syndrome distinct from acute myocardial infarction.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction No temporality-only claim pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-06
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 35412949 · Human vaccines & immunotherapeutics (2022) — Explaining COVID-19 postvaccination-related immune thrombotic thrombocytopenia: a hypothesis-generating in-silico approach.
J4 · Passive-surveillance roleno_data
Measure: Passive-surveillance findings bounded correctly Comparator: Active-surveillance confirmation Hit rule: Passive-surveillance signals are framed as hypothesis-generating, not confirmatory
Finding: The retrieved evidence provides no direct information on passive-surveillance findings for acute myocardial infarction following COVID-19 vaccination; one abstract describes a method to identify immune-related adverse events using large language models, and the other presents a hypothesis-generating analysis of postvaccination thrombotic events, neither of which addresses acute myocardial infarction specifically.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Passive-surveillance role pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-06
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 35412949 · Human vaccines & immunotherapeutics (2022) — Explaining COVID-19 postvaccination-related immune thrombotic thrombocytopenia: a hypothesis-generating in-silico approach.
J5 · Dose mappingno_data
Measure: Dose/lot exposure mapped to the object Comparator: Unmapped exposure Hit rule: Dose / lot exposure is mapped to the object where the mechanism predicts it
Finding: The retrieved evidence does not address COVID-19 vaccine dose/lot exposure mapping to acute myocardial infarction. PMID 39226489 discusses LLM-based identification of immune-related adverse events from immune checkpoint inhibitors, not vaccines. PMID 41493293 describes AI adjudication of MACE in clinical trials but does not involve vaccine exposure mapping. PMID 42289847 is a narrative review on low cholesterol risks, unrelated to COVID-19 vaccines or myocardial infarction.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Dose mapping pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Dose mapping post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-06
3 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 41493293 · Journal of the American College of Cardi (2026) — Using Artificial Intelligence to Adjudicate Major Adverse Cardiovascular Events in Clinical Trials.
does_not_resolve 42289847 · Lipids (2026) — Very Low Cholesterol Non-Cardiovascular Risks: A Critical Appraisal and Framework for Individualized Management.
Epidemiologic chassis 13/13 evaluated
B1 · Excess vs baselineno_data
Measure: RR/IRR vs unexposed or prior window Comparator: Unvaccinated person-time or pre-vaccination window Hit rule: RR/IRR > 1 with CI excluding 1 after pre-specified confounders
Finding: No retrieved evidence directly examines the risk of acute myocardial infarction following COVID-19 vaccination with a primary analysis of that pair. One study (PMID 35667917) includes myocardial infarction as an outcome among several AESIs after COVID-19 vaccines but does not report a specific RR/IRR for this outcome, and its abstract does not state whether the CI excluded 1. Another study (PMID 40664645) lists acute myocardial infarction among 15 adverse events assessed after XBB.1.5-containing COVID-19 mRNA vaccines but provides no effect estimate in the abstract.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Excess vs baseline pubmed · 88540 hits · run 2026-09-06
10 retrieved record(s)
does_not_resolve 29020303 · Clinical infectious diseases : an offici (2018) — Risk of Venous Thromboembolism Following Hemorrhagic Fever With Renal Syndrome: A Self-controlled Case Series Study.
does_not_resolve 33748963 · British journal of haematology (2021) — Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
refutes_node 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
does_not_resolve 40794640 · European heart journal (2026) — Cardiovascular benefit of continuous positive airway pressure according to high-risk obstructive sleep apnoea: a multi-trial analysis.
B2 · SCCSno_data
Measure: Self-controlled case series risk ratio Comparator: Individuals' own risk intervals (no-event) Hit rule: SCCS risk ratio > 1 in the post-vaccination window, CI excluding 1
Finding: PMID 40664645 2025 reported that among 15 adverse events studied after XBB.1.5-containing mRNA vaccines using SCCS, acute myocardial infarction was included as an outcome, but abstract does not provide the specific risk ratio or confidence interval for acute myocardial infarction, only listing it among the outcomes assessed. No other retrieved SCCS study provides a risk ratio for acute myocardial infarction meeting the hit rule (RR > 1, CI excluding 1) for COVID-19 vaccination.
supporting: COVID-19 vaccine Acute Myocardial Infarction SCCS incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk SCCS pubmed · 88646 hits · run 2026-09-06
13 retrieved record(s)
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 37223097 · Frontiers in immunology (2023) — Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study.
refutes_node 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 42661284 · Expert review of vaccines (2026) — Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.
B3 · Cohort / risk-intervalno_data
Measure: Incidence rate ratio in defined window Comparator: Pre-specified risk vs comparison interval Hit rule: IRR > 1 in the pre-specified window, CI excluding 1, stratified by age/sex
Finding: No retrieved evidence directly examines the association between COVID-19 vaccination and acute myocardial infarction using a cohort or risk-interval design with IRR > 1, CI excluding 1, stratified by age/sex, as specified for this node.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Cohort / risk-interval pubmed · 88149 hits · run 2026-09-06
13 retrieved record(s)
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 37223097 · Frontiers in immunology (2023) — Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 34216049 · Pharmacoepidemiology and drug safety (2021) — Association between methylphenidate and risk of myocardial infarction: A multinational self-controlled case series study.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
B4 · Meta-analysis / poolingno_data
Measure: Pooled effect across studies Comparator: Pooled estimate with heterogeneity Hit rule: Pooled estimate > 1 (or < 1) with quantified heterogeneity (I2)
Finding: The retrieved evidence does not include a meta-analysis or pooled estimate for the association between COVID-19 vaccination and acute myocardial infarction. Retrieved studies focus on arrhythmias, retinal vein occlusion, Guillain-Barré syndrome, rotavirus vaccine, influenza, fall-risk drugs, general COVID-19 mRNA vaccine surveillance, and unrelated meta-analyses, but none provide a pooled estimate with quantified heterogeneity for this specific pair.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Meta-analysis / pooling pubmed · 111979 hits · run 2026-09-06
11 retrieved record(s)
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 31693865 · Expert review of vaccines (2019) — The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.
does_not_resolve 29402646 · Journal of the American Medical Director (2018) — Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
B5 · Negative-control outcomesno_data
Measure: No excess for outcomes the vaccine should not cause Comparator: Negative-control outcomes (unaffected by mechanism) Hit rule: Null for negative-control outcomes while target outcome is positive (specificity)
Finding: The retrieved evidence does not include any studies examining the association between COVID-19 vaccination and acute myocardial infarction as a negative-control outcome for specificity testing.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Negative-control outcomes pubmed · 88350 hits · run 2026-09-06
9 retrieved record(s)
does_not_resolve 29020303 · Clinical infectious diseases : an offici (2018) — Risk of Venous Thromboembolism Following Hemorrhagic Fever With Renal Syndrome: A Self-controlled Case Series Study.
does_not_resolve 33748963 · British journal of haematology (2021) — Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 36226469 · Epilepsia (2022) — Association between the risk of seizure and COVID-19 vaccinations: A self-controlled case-series study.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
B6 · Other-antigen comparisonno_data
Measure: Risk vs a different-antigen comparator Comparator: Comparator product with a different antigen Hit rule: Risk specific to the target antigen, not shared with the comparator antigen
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Other-antigen comparison pubmed · 88113 hits · run 2026-09-06
12 retrieved record(s)
does_not_resolve 29020303 · Clinical infectious diseases : an offici (2018) — Risk of Venous Thromboembolism Following Hemorrhagic Fever With Renal Syndrome: A Self-controlled Case Series Study.
does_not_resolve 33748963 · British journal of haematology (2021) — Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
B7 · Absolute riskno_data
Measure: Per-100k risk in window Comparator: Absolute incidence per 100k Hit rule: Absolute risk reported and stable across the window (not an artifact of rarity)
Finding: The retrieved evidence does not contain any study reporting absolute risk (per-100k) of acute myocardial infarction attributed to COVID-19 vaccination within a pre-specified risk window.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Absolute risk incidence risk cohort OR self-controlled case series pubmed · 947 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Absolute risk pubmed · 111379 hits · run 2026-09-06
15 retrieved record(s)
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 29020303 · Clinical infectious diseases : an offici (2018) — Risk of Venous Thromboembolism Following Hemorrhagic Fever With Renal Syndrome: A Self-controlled Case Series Study.
does_not_resolve 33748963 · British journal of haematology (2021) — Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 29211679 · The New England journal of medicine (2017) — Contemporary Hormonal Contraception and the Risk of Breast Cancer.
B8 · Platform splitno_data
Measure: Risk by vaccine platform / product Comparator: Platform (mRNA vs viral vector, etc.) Hit rule: Risk attributable to a specific platform, not to 'a vaccine' generally
Finding: Retrieved evidence does not address the risk of acute myocardial infarction attributable to a specific COVID-19 vaccine platform; studies either evaluate myocardial infarction as a secondary endpoint without platform stratification (PMID 35667917) or focus on cardiac outcomes unrelated to the platform-specific risk definition (e.g., arrhythmias, myocarditis, or all-cause mortality).
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Platform split incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Platform split pubmed · 88178 hits · run 2026-09-06
12 retrieved record(s)
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 31693865 · Expert review of vaccines (2019) — The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.
ambiguous 37534766 · Human vaccines & immunotherapeutics (2023) — Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-analysis of self-controlled case series studies.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
B9 · Host-structure stratificationno_data
Measure: Risk by age / sex / host structure Comparator: Unstratified estimate Hit rule: Risk concentrated in a defined host subgroup (e.g. young males), stable across sources
Finding: The retrieved evidence includes a self-controlled case series study that assessed the risk of acute myocardial infarction following XBB.1.5-containing COVID-19 mRNA vaccination, but no specific risk estimate or finding for this outcome was reported in the abstract. No other retrieved study provides direct evidence on the risk of acute myocardial infarction stratified by age, sex, or other host structure after COVID-19 vaccination.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Host-structure stratification pubmed · 88111 hits · run 2026-09-06
14 retrieved record(s)
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 29020303 · Clinical infectious diseases : an offici (2018) — Risk of Venous Thromboembolism Following Hemorrhagic Fever With Renal Syndrome: A Self-controlled Case Series Study.
does_not_resolve 33748963 · British journal of haematology (2021) — Glucocorticoid use and risk of first and recurrent venous thromboembolism: self-controlled case-series and cohort study.
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 31693865 · Expert review of vaccines (2019) — The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.
does_not_resolve 36226469 · Epilepsia (2022) — Association between the risk of seizure and COVID-19 vaccinations: A self-controlled case-series study.
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change Comparator: Pre- vs post-change formulation Hit rule: Risk change tracks a documented formulation / component change over time
Finding: No retrieved evidence directly addresses the risk of acute myocardial infarction (AMI) tracking a documented formulation or component change of a COVID-19 vaccine over time.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no association OR null OR no increased risk Formulation / component change pubmed · 88273 hits · run 2026-09-06
11 retrieved record(s)
does_not_resolve 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 31693865 · Expert review of vaccines (2019) — The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.
ambiguous 37534766 · Human vaccines & immunotherapeutics (2023) — Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-analysis of self-controlled case series studies.
refutes_node 35667917 · Vaccine (2022) — Risk of serious adverse events after the BNT162b2, CoronaVac, and ChAdOx1 vaccines in Malaysia: A self-controlled case series study.
does_not_resolve 36813998 · Eye (London, England) (2023) — Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series.
H2 · Formulation natural experimentno_data
Measure: Risk shifts with a formulation change in the field Comparator: Pre- vs post-change formulation Hit rule: Observed risk tracks a real-world formulation change (natural experiment)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Formulation natural experiment intervention OR treatment OR reversal pubmed · 15141300 hits · run 2026-09-06
Measure: Risk signal appears/disappears across a pause or policy change Comparator: Pre- vs post-pause period Hit rule: The signal appears or disappears coherently with a rollout / pause (H4)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Policy / pause signal intervention OR treatment OR reversal pubmed · 15141300 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Policy / pause signal no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-06
I3 · Infection coherenceno_data
Measure: Pattern is coherent with or distinct from infection Comparator: Infection-matched comparison Hit rule: The post-vaccine pattern is coherent with (or clearly distinct from) the infection pattern
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Infection coherence coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Infection coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-06
Mediator & biological gradient 24/24 evaluated
C1n · Dose strength gradientno_data
Measure: Risk vs dose strength (dose size) Comparator: Lower dose strength Hit rule: Monotonic dose-response in dose strength (larger dose -> higher risk)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Dose strength gradient dose-response OR dose effect pubmed · 1299126 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no dose effect OR no dose-response Dose strength gradient pubmed · 142 hits · run 2026-09-06
6 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 36090988 · Frontiers in immunology (2022) — A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
does_not_resolve 39077131 · Reviews in cardiovascular medicine (2022) — CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.
C2n · Dose number gradientno_data
Measure: Risk vs dose number (1st vs 2nd vs 3rd) Comparator: First dose Hit rule: Risk increases (or shows a defined pattern) with dose number
Finding: No retrieved evidence directly examines the risk gradient of acute myocardial infarction by COVID-19 vaccine dose number (1st vs 2nd vs 3rd). Available studies address myocarditis, takotsubo cardiomyopathy, or general vaccine effectiveness, but none specifically test a dose-number gradient for AMI.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Dose number gradient dose-response OR dose effect pubmed · 1299126 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no dose effect OR no dose-response Dose number gradient pubmed · 586 hits · run 2026-09-06
7 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 36090988 · Frontiers in immunology (2022) — A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
ambiguous 39077131 · Reviews in cardiovascular medicine (2022) — CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.
does_not_resolve 39244425 · Vaccine (2024) — Association of SARS-CoV-2 immunoserology and vaccination status with myocardial infarction severity and outcome.
C3n · Measured-exposure tertilesno_data
Measure: Risk vs measured exposure tertile Comparator: Lowest-exposure tertile Hit rule: Risk ordered by measured-exposure tertile (high > mid > low)
Finding: No retrieved evidence directly addresses a dose-response relationship between measured-exposure tertiles of COVID-19 vaccination and risk of acute myocardial infarction. The available studies are case reports, systematic reviews on unrelated vaccines, or analyses of vaccine efficacy/safety that do not stratify by exposure tertile.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Measured-exposure tertiles dose-response OR dose effect pubmed · 1299126 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no dose effect OR no dose-response Measured-exposure tertiles pubmed · 31 hits · run 2026-09-06
8 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 36090988 · Frontiers in immunology (2022) — A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
does_not_resolve 39077131 · Reviews in cardiovascular medicine (2022) — CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
does_not_resolve 39244425 · Vaccine (2024) — Association of SARS-CoV-2 immunoserology and vaccination status with myocardial infarction severity and outcome.
C4n · Organoid concentration curveno_data
Measure: Effect vs antigen concentration in organoid Comparator: Vehicle / zero antigen Hit rule: Dose-dependent effect across a graded concentration curve
Finding: The retrieved evidence includes case reports and observational studies describing acute myocardial infarction (MI) following COVID-19 mRNA vaccination, but no dose-dependent effect across a graded concentration curve in an organoid model was reported in any of the provided PMIDs.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Organoid concentration curve dose-response OR dose effect pubmed · 1299126 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no dose effect OR no dose-response Organoid concentration curve pubmed · 42 hits · run 2026-09-06
8 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 36090988 · Frontiers in immunology (2022) — A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
does_not_resolve 39077131 · Reviews in cardiovascular medicine (2022) — CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
does_not_resolve 39244425 · Vaccine (2024) — Association of SARS-CoV-2 immunoserology and vaccination status with myocardial infarction severity and outcome.
C5n · EC50 vs Cmax coherenceno_data
Measure: Measured exposure reaches effect threshold Comparator: Pharmacokinetic Cmax vs EC50 Hit rule: Achieved exposure (Cmax/tissue) plausibly reaches the in-vitro EC50
Finding: The retrieved evidence includes case reports and a systematic review mentioning acute myocardial infarction (MI) after COVID-19 vaccination (e.g., PMID 35718694, PMID 37692656), but no retrieved study provides pharmacokinetic (EC50 vs Cmax) data or demonstrates that measured exposure levels from vaccination reach an in-vitro EC50 threshold relevant to MI.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299126 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 31 hits · run 2026-09-06
8 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 36090988 · Frontiers in immunology (2022) — A comprehensive analysis of the efficacy and effectiveness of COVID-19 vaccines.
refutes_node 34477808 · JAMA (2021) — Surveillance for Adverse Events After COVID-19 mRNA Vaccination.
supports_node 34586408 · QJM : monthly journal of the Association (2023) — Acute myocardial infarction and myocarditis following COVID-19 vaccination.
does_not_resolve 37692656 · Cureus (2023) — Takotsubo Cardiomyopathy Following COVID-19 Vaccine Booster Dose: A Case Report.
does_not_resolve 39077131 · Reviews in cardiovascular medicine (2022) — CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine.
supports_node 35718694 · Cardiovascular revascularization medicin (2023) — A Case of ST Segment Elevation Myocardial Infarction Within 24 h of a Third Dose of COVID-19 mRNA Vaccine.
does_not_resolve 39244425 · Vaccine (2024) — Association of SARS-CoV-2 immunoserology and vaccination status with myocardial infarction severity and outcome.
E1 · Mediator identified in casesno_data
Measure: Mediator present in affected tissue/cells Comparator: Unaffected tissue / control Hit rule: The hypothesized mediator is detected in the affected compartment and not (or less) in control
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Mediator identified in cases not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
E2 · Mediator in healthy vaccineesno_data
Measure: Mediator detectable after vaccination Comparator: Pre-vaccination baseline Hit rule: Mediator appears after vaccination and tracks the exposure window
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Mediator in healthy vaccinees not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
E3 · Infection contrastno_data
Measure: Mediator absent/low after natural infection Comparator: Recovered natural infection Hit rule: Mediator signal is specific to vaccination vs a comparable natural-infection control
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Infection contrast in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Infection contrast not associated mechanism pubmed · 1 hits · run 2026-09-06
E4 · Transfer to recipientno_data
Measure: Phenotype/mediator transferred to a recipient system Comparator: Control transfer Hit rule: The effect / mediator transfers to a naive recipient system
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Transfer to recipient not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
E5 · Transfer specificityno_data
Measure: Transfer requires the specific mediator Comparator: Transfer with mediator present Hit rule: Transfer effect is lost when the specific mediator is removed
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Transfer specificity in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Transfer specificity not associated mechanism pubmed · 1 hits · run 2026-09-06
E6 · Depletion / knockdownno_data
Measure: Removing the mediator reduces the effect Comparator: Non-targeted knockdown Hit rule: Knockdown / depletion of the mediator reduces the phenotype
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
Measure: Adding the mediator restores the effect Comparator: Add-back of a control protein Hit rule: Adding back the mediator (not a control) restores the phenotype
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Add-back rescue in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
Measure: Neutralizing the mediator blocks the effect Comparator: Isotype control Hit rule: Neutralization of the mediator (not an isotype control) blocks the phenotype
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Neutralization in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
Measure: Isotype control does not reproduce the effect Comparator: Active antibody Hit rule: An isotype control fails to reproduce the block/activation
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Isotype control in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Isotype control not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-06
F1 · Full product reproducesno_data
Measure: Full vaccine product reproduces the effect Comparator: No-product control Hit rule: The full product (not a subcomponent) reproduces the effect
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Full product reproduces component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F2 · Empty vector / particleno_data
Measure: Vector/particle without antigen reproduces (or not) Comparator: Full product Hit rule: Effect attributed to (or excluded from) the vector/particle backbone alone
Finding: No evidence found that directly addresses Acute Myocardial Infarction attributed to a vaccine vector/particle backbone without antigen.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Empty vector / particle component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F4 · Irrelevant cargono_data
Measure: Irrelevant cargo does not reproduce the effect Comparator: Vector with the target antigen Hit rule: Irrelevant cargo fails to reproduce the effect (specificity)
Finding: The retrieved evidence discusses virus-vectored influenza vaccines, live bacterial vaccine vectors, measles vaccine, adenovirus-vectored influenza vaccines, viral vector-based cancer vaccines, and Newcastle disease virus vaccine vectors; none of these publications address COVID-19 vaccination, acute myocardial infarction, or any adverse cardiac event.
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Irrelevant cargo component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F5 · Infection preparationno_data
Measure: Infection preparation vs product comparison Comparator: Product-derived preparation Hit rule: Effect compares correctly between infection and product preparations
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Infection preparation component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F6 · Cytokine / adjuvant mixno_data
Measure: Cytokine/adjuvant mix alone reproduces (or not) Comparator: Individual components Hit rule: The effect is (or is not) reproducible by the cytokine/adjuvant mix alone
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F7 · Component combinationno_data
Measure: Defined component combination reproduces the effect Comparator: Single components Hit rule: A defined combination reproduces the effect that single components do not
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Component combination component OR antigen OR vector pubmed · 2045211 hits · run 2026-09-06
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
G1 · 2D human cellsno_data
Measure: Effect reproduced in 2D human cell culture Comparator: Untreated / control cells Hit rule: Effect reproduced in 2D primary human cells
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction 2D human cells animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction 2D human cells not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
G2 · Organoid / chipno_data
Measure: Effect reproduced in organoid / organ-on-chip Comparator: Unexposed organoid Hit rule: Effect reproduced in a 3D organoid / organ-on-chip system
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Organoid / chip animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Organoid / chip not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
H1 · Block in vitro / in vivono_data
Measure: Blocking the mediator/mechanism prevents the effect Comparator: Control intervention Hit rule: Blocking the mechanism prevents or reverses the effect (not with a control intervention)
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15141300 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Block in vitro / in vivo no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-06
Clinical / animal / host 7/7 evaluated
E10 · Host-line dependenceno_data
Measure: Effect depends on host line/cell type Comparator: Susceptible host line Hit rule: Effect is restricted to a defined host line / genotype, not universal
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction mechanism Host-line dependence in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-06
Measure: Effect in animal via the clinical route of administration Comparator: Vehicle, same route Hit rule: Effect reproduced in an animal using the clinical route of administration
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Animal, clinical route animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Animal, clinical route not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
G4 · Susceptible animalno_data
Measure: Effect in a susceptible animal model Comparator: Non-susceptible model Hit rule: Effect in a defined susceptible animal model
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Susceptible animal animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Susceptible animal not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
G5 · Replication across labsno_data
Measure: Effect replicated in an independent lab Comparator: Original result Hit rule: The key effect is replicated in an independent laboratory
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Replication across labs animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Replication across labs not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
G6 · Blinded scoringno_data
Measure: Outcomes scored blinded Comparator: Unblinded reference Hit rule: Primary outcomes scored by a blinded assessor
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Blinded scoring animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Blinded scoring not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
G7 · Experimental time courseno_data
Measure: Effect follows a defined experimental time course Comparator: No-exposure time course Hit rule: The effect's onset/offset follows a defined experimental time course
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Experimental time course animal OR organoid OR cell model pubmed · 1818469 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Experimental time course not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-06
I4 · Susceptibility traitno_data
Measure: A host trait / marker defines susceptibility Comparator: Trait-negative hosts Hit rule: A defined host trait / marker enriches for susceptibility
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Acute Myocardial Infarction Susceptibility trait coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-06
mirror: COVID-19 vaccine Acute Myocardial Infarction Susceptibility trait inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-06
How this was built
Per node: a supporting and a mirror PubMed query built from the node's measure / population / comparator / hit_rule; top hits fetched (title + abstract); each record classified (supports / refutes / ambiguous) by xAI with a heuristic fallback; a per-node synthesis is generated strictly from the retrieved PMIDs; the node status is then rolled up to C1–C6. Full query provenance is shown per node above. Reproduce the build: python -m evidence_run. Data: data/evidence_run/state.json.