Evidence dossier · candidate cand-covid-menstrual-disorder · CICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that COVID-19 vaccine causes Menstrual Disorder, 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
insufficient_data
missing: B1 B2 B3
C4
Consistency / replication
insufficient_data
missing: B5 B6
C5
Specificity (product / dose)
insufficient_data
missing: C2n
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: no established case definition (needs_human_review — not in spec §1's named-standard list) — 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 reportsno_data
Measure: New definite object in risk window T Comparator: Pre-vaccination baseline Hit rule: Definite object present, onset in window, competing causes considered
Finding: No retrieved evidence directly describes case reports or clinical data linking COVID-19 vaccine to menstrual disorder as a definite new object with onset in a risk window after competing causes assessment.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Case reports pubmed · 66174 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
9 retrieved record(s)
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
supports_node 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
A2 · Series with objective confirmationno_data
Measure: Definite object plus objective test Comparator: Reference range / diagnostic criteria Hit rule: Objective confirmation in >=1 case per the working definition
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Series with objective confirmation pubmed · 5646 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
9 retrieved record(s)
ambiguous 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 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
supports_node 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
does_not_resolve 38500249 · Journal of movement disorders (2024) — COVID-19 Vaccine-Related Movement Disorders: A Systematic Review.
A3 · Onset histogramno_data
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: The only directly relevant evidence is [PMID 36517325 2023], which reports menstrual disturbances in 12- to 15-year-old girls after one dose of COVID-19 Comirnaty vaccine, based on a population-based cohort study in Norway, but the abstract is not provided, so no onset histogram data or clustering details are available for this node. Other retrieved evidence (e.g., [PMID 40927603 2024]) mentions menstrual irregularities post-vaccination but does not provide onset timing distribution data.
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Onset histogram pubmed · 5 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 36517325 · Vaccine (2023) — Menstrual disturbances in 12- to 15-year-old girls after one dose of COVID-19 Comirnaty vaccine: Population-based cohort study in Norway.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
A4 · Temporal plausibilityno_data
Measure: Onset latency vs object pathophysiology Comparator: Object's known natural latency Hit rule: Onset latency consistent with the object's pathophysiology
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Temporal plausibility pubmed · 34 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
does_not_resolve 41295454 · Vaccines (2025) — Observations of Wart Clearance Following COVID-19 Vaccination: Coincidence or Missed Immunologic Signals?
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
ambiguous 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
A5 · Onset-interval documentationno_data
Measure: Onset interval documented in source Comparator: Dose date Hit rule: Onset interval is recorded (not imputed) in a primary source
Finding: No retrieved evidence addresses whether the onset interval of menstrual disorder after COVID-19 vaccination was recorded (not imputed) in a primary source. The only relevant study (PMID 36517325) is a population-based cohort, but its abstract is empty, providing no information on onset-interval documentation.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Onset-interval documentation pubmed · 3 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 36517325 · Vaccine (2023) — Menstrual disturbances in 12- to 15-year-old girls after one dose of COVID-19 Comirnaty vaccine: Population-based cohort study in Norway.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
A6 · Differential diagnosis excludedno_data
Measure: Competing causes assessed and excluded Comparator: Likely alternative diagnoses Hit rule: Pre-specified competing causes ruled out per the working definition
Finding: The sole retrieved evidence concerning COVID-19 vaccines and menstrual disorders is a study (PMID 40927603) that reports menstrual irregularities post-vaccination, but it does not specifically address exclusion of competing causes as required for this node.
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Differential diagnosis excluded pubmed · 430 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
9 retrieved record(s)
ambiguous 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 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
ambiguous 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
does_not_resolve 33661194 · Clinical nuclear medicine (2021) — COVID-19 Vaccine-Related Local FDG Uptake.
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: No retrieved evidence describes a rechallenge scenario where menstrual disorder recurs after a subsequent dose of COVID-19 vaccine. The available studies and reviews address first-dose associations or adverse events other than menstrual disorder.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Rechallenge / re-exposure pubmed · 5 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 36517325 · Vaccine (2023) — Menstrual disturbances in 12- to 15-year-old girls after one dose of COVID-19 Comirnaty vaccine: Population-based cohort study in Norway.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
ambiguous 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
A8 · Adjudicated by criteria (no established case definition)no_data
Measure: Object adjudicated by published criteria Comparator: Published clinical / Brighton criteria Hit rule: Cases adjudicated to 'definite' by a published criterion set
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Adjudicated by criteria pubmed · 42 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
9 retrieved record(s)
ambiguous 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 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
supports_node 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
ambiguous 38500249 · Journal of movement disorders (2024) — COVID-19 Vaccine-Related Movement Disorders: A Systematic Review.
A9 · Natural-history consistencyno_data
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: No retrieved evidence directly addresses natural-history consistency of menstrual disorder following COVID-19 vaccination. One abstract (PMID 40927603) mentions menstrual irregularities post-vaccination but does not describe clinical course (onset, peak, recovery) or natural history.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series Natural-history consistency pubmed · 106 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
9 retrieved record(s)
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37058349 · Journal of medical Internet research (2023) — COVID-19 Vaccine-Related Information on the WeChat Public Platform: Topic Modeling and Content Analysis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
supports_node 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
A10 · No confounding objectno_data
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: No retrieved evidence addresses menstrual disorder after COVID-19 vaccination; the only retrieved abstract mentioning menstruation ([PMID 40927603]) discusses a study design and research gaps but does not provide a case-level or epidemiologic finding that would count as a hit for this node.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") case report OR case series No confounding object pubmed · 22 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
does_not_resolve 34312836 · Clinical pharmacology and therapeutics (2022) — Angiotensin-Converting Enzyme Inhibitors Used Concomitantly with Insulin Secretagogues and the Risk of Serious Hypoglycemia.
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 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
ambiguous 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Predicted site of injury not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") anatomic localization Spared structures mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Spared structures not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Local vs systemic distribution not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") anatomic localization Kinetics class mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Kinetics class not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") anatomic localization Platform-mechanism match mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Platform-mechanism match not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15142392 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Targeted treatment reverses no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
I1 · No internal contradictionno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") No internal contradiction coherence OR latency OR susceptibility pubmed · 870068 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") No internal contradiction inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Analogy to a known object coherence OR latency OR susceptibility pubmed · 870068 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Analogy to a known object inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Latency coherence coherence OR latency OR susceptibility pubmed · 870068 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Latency coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Pre-specification pre-specified OR adjudicated pubmed · 13550 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Pre-specification post-hoc OR hypothesis-generating only pubmed · 1700 hits · run 2026-09-07
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Contrary-evidence log pre-specified OR adjudicated pubmed · 13550 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1700 hits · run 2026-09-07
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") No temporality-only claim pre-specified OR adjudicated pubmed · 13550 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1700 hits · run 2026-09-07
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Passive-surveillance role pre-specified OR adjudicated pubmed · 13550 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1700 hits · run 2026-09-07
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: No evidence found.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Dose mapping pre-specified OR adjudicated pubmed · 13550 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Dose mapping post-hoc OR hypothesis-generating only pubmed · 1700 hits · run 2026-09-07
2 retrieved record(s)
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 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
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 evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Excess vs baseline pubmed · 88593 hits · run 2026-09-07
8 retrieved record(s)
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 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 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 37806668 · Human vaccines & immunotherapeutics (2023) — Response to Dr. Somovilla del Saz's letter to the editor regarding "Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-a
does_not_resolve 40604264 · npj metabolic health and disease (2023) — Fasting mimicking diet cycles versus a Mediterranean diet and cardiometabolic risk in overweight and obese hypertensive subjects: a randomized clinical trial.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
does_not_resolve 42297539 · Atherosclerosis (2026) — Standard modifiable cardiovascular risk factors and acute coronary syndrome free survival.
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: No retrieved evidence studies the association between COVID-19 vaccine and menstrual disorder using a self-controlled case series design; the only SCCS studies retrieved address Guillain-Barré syndrome, arrhythmias, herpes zoster vaccine safety, mortality, and gut microbiota, none mentioning menstrual disorder.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") SCCS incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk SCCS pubmed · 88700 hits · run 2026-09-07
8 retrieved record(s)
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 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
does_not_resolve 41843497 · PLoS medicine (2026) — Circulating gut microbial metabolites and risk of coronary heart disease: A prospective multi-stage metabolomics study.
does_not_resolve 40585116 · medRxiv : the preprint server for health (2025) — Circulating gut microbial metabolites and risk of coronary heart disease: a prospective, multi-stage study.
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 evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Cohort / risk-interval pubmed · 88202 hits · run 2026-09-07
6 retrieved record(s)
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 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 37806668 · Human vaccines & immunotherapeutics (2023) — Response to Dr. Somovilla del Saz's letter to the editor regarding "Risk of all-cause and cardiac-related mortality after vaccination against COVID-19: A meta-a
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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: No retrieved evidence addresses a meta-analysis or pooled estimate for menstrual disorder after COVID-19 vaccination; the retrieved studies cover Guillain-Barré syndrome, arrhythmias, rotavirus vaccine, XBB.1.5 COVID-19 mRNA vaccine safety, milk fever in dairy cattle, placenta-mediated adverse pregnancy outcomes, and bisphosphonates and lung cancer.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Meta-analysis / pooling pubmed · 112038 hits · run 2026-09-07
7 retrieved record(s)
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 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 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 1661751 · Journal of dairy science (1991) — Meta-analysis of nutritional risk factors for milk fever in dairy cattle.
ambiguous 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
does_not_resolve 33429726 · Medicine (2021) — Bisphosphonates and risk of lung cancer: Protocol for a systematic review and meta-analysis.
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: No evidence found for menstrual disorder as a negative-control outcome for COVID-19 vaccine in the retrieved literature.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Negative-control outcomes pubmed · 88404 hits · run 2026-09-07
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 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 38833248 · JAMA network open (2024) — Valproate Use During Spermatogenesis and Risk to Offspring.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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 for an association between COVID-19 vaccine and menstrual disorder using a different-antigen comparator. The retrieved studies address shingles after Shingrix, Guillain-Barré after COVID-19 vaccination, arrhythmias after COVID-19, rotavirus vaccine safety, and placenta-mediated outcomes after COVID-19 vaccination around conception; none examine menstrual disorder or use a different-antigen comparator for that outcome.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Other-antigen comparison pubmed · 88166 hits · run 2026-09-07
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 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Absolute risk incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Absolute risk pubmed · 111440 hits · run 2026-09-07
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 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 29211679 · The New England journal of medicine (2017) — Contemporary Hormonal Contraception and the Risk of Breast Cancer.
does_not_resolve 23484825 · The New England journal of medicine (2013) — Risk of ischemic heart disease in women after radiotherapy for breast cancer.
ambiguous 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Platform split incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Platform split pubmed · 88231 hits · run 2026-09-07
5 retrieved record(s)
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 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 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 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Host-structure stratification pubmed · 88164 hits · run 2026-09-07
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 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.
ambiguous 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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 evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no association OR null OR no increased risk Formulation / component change pubmed · 88326 hits · run 2026-09-07
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 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
ambiguous 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Formulation natural experiment intervention OR treatment OR reversal pubmed · 15142392 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Formulation natural experiment no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
H4 · Policy / pause signalno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Policy / pause signal intervention OR treatment OR reversal pubmed · 15142392 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Policy / pause signal no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Infection coherence coherence OR latency OR susceptibility pubmed · 870068 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Infection coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Dose strength gradient dose-response OR dose effect pubmed · 1299193 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no dose effect OR no dose-response Dose strength gradient pubmed · 173 hits · run 2026-09-07
3 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 36808367 · European review for medical and pharmaco (2023) — The COVID-19 vaccines and menstrual disorders.
refutes_node 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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 evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Dose number gradient dose-response OR dose effect pubmed · 1299193 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no dose effect OR no dose-response Dose number gradient pubmed · 617 hits · run 2026-09-07
3 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.
ambiguous 36808367 · European review for medical and pharmaco (2023) — The COVID-19 vaccines and menstrual disorders.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
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: The retrieved evidence includes no study that examines COVID-19 vaccine dose–response or measured-exposure tertiles in relation to menstrual disorders; the available studies report either no discernible connection or temporary changes without stratified exposure analysis.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Measured-exposure tertiles dose-response OR dose effect pubmed · 1299193 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no dose effect OR no dose-response Measured-exposure tertiles pubmed · 62 hits · run 2026-09-07
4 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.
supports_node 36808367 · European review for medical and pharmaco (2023) — The COVID-19 vaccines and menstrual disorders.
ambiguous 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
ambiguous 36623727 · Journal of infection and chemotherapy : (2023) — Association between COVID-19 vaccines and the menstrual cycle in young Japanese women.
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: No retrieved evidence addresses organoid concentration curves or dose-dependent effects of COVID-19 vaccine antigen concentration on menstrual disorder in an organoid model.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Organoid concentration curve dose-response OR dose effect pubmed · 1299193 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no dose effect OR no dose-response Organoid concentration curve pubmed · 73 hits · run 2026-09-07
4 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.
supports_node 36808367 · European review for medical and pharmaco (2023) — The COVID-19 vaccines and menstrual disorders.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
ambiguous 36623727 · Journal of infection and chemotherapy : (2023) — Association between COVID-19 vaccines and the menstrual cycle in young Japanese women.
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: No retrieved evidence addresses in-vitro EC50 versus Cmax/tissue exposure for COVID-19 vaccine and menstrual disorder.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299193 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 62 hits · run 2026-09-07
4 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.
supports_node 36808367 · European review for medical and pharmaco (2023) — The COVID-19 vaccines and menstrual disorders.
does_not_resolve 40747952 · Acta obstetricia et gynecologica Scandin (2025) — COVID-19 vaccination around the time of conception and risk of placenta-mediated adverse pregnancy outcomes.
ambiguous 36623727 · Journal of infection and chemotherapy : (2023) — Association between COVID-19 vaccines and the menstrual cycle in young Japanese women.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Mediator identified in cases not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Mediator in healthy vaccinees not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Infection contrast in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Infection contrast not associated mechanism pubmed · 4 hits · run 2026-09-07
1 retrieved record(s)
supports_node 34692740 · Frontiers in medicine (2021) — BNT162b2 and ChAdOx1 SARS-CoV-2 Post-vaccination Side-Effects Among Saudi Vaccinees.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Transfer to recipient not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Transfer specificity in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Transfer specificity not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Depletion / knockdown not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E7 · Add-back rescueno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Add-back rescue in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Add-back rescue not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E8 · Neutralizationno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Neutralization in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Neutralization not associated mechanism pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
ambiguous 39889733 · The Pediatric infectious disease journal (2025) — Long-term Response to SARS-CoV-2 mRNA Vaccine in Adolescents.
E9 · Isotype controlno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Isotype control in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Isotype control not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Full product reproduces component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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: The retrieved evidence discusses various viral and bacterial vaccine vectors, but none of the retrieved abstracts mention menstrual disorder, COVID-19 vaccines, or any reproductive adverse events associated with empty vector/particle backbones.
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Empty vector / particle component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Empty vector / particle no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20656032 · Vaccine (2010) — The effects of preexisting immunity to influenza on responses to influenza vectors in mice.
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.
F3 · Antigen alone reproducesno_data
Measure: Isolated antigen reproduces the effect Comparator: Vehicle Hit rule: The isolated antigen (not the full product) reproduces the effect
Finding: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Antigen alone reproduces component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Antigen alone reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20656032 · Vaccine (2010) — The effects of preexisting immunity to influenza on responses to influenza vectors in mice.
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.
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Irrelevant cargo component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Irrelevant cargo no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20656032 · Vaccine (2010) — The effects of preexisting immunity to influenza on responses to influenza vectors in mice.
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.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Infection preparation component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Infection preparation no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 20600388 · Virus research (2010) — Vectored vaccines to protect against PRRSV.
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.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Cytokine / adjuvant mix no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Component combination component OR antigen OR vector pubmed · 2045311 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Component combination no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20656032 · Vaccine (2010) — The effects of preexisting immunity to influenza on responses to influenza vectors in mice.
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.
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") 2D human cells animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") 2D human cells not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Organoid / chip animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Organoid / chip not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15142392 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Block in vitro / in vivo no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") mechanism Host-line dependence in vitro OR patient-derived pubmed · 29244 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Host-line dependence not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G3 · Animal, clinical routeno_data
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Animal, clinical route animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Animal, clinical route not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Susceptible animal animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Susceptible animal not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Replication across labs animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Replication across labs not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Blinded scoring animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Blinded scoring not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Experimental time course animal OR organoid OR cell model pubmed · 1818663 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Experimental time course not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-07
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 (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Susceptibility trait coherence OR latency OR susceptibility pubmed · 870068 hits · run 2026-09-07
mirror: COVID-19 vaccine (menstrual OR menstruation OR "menstrual cycle" OR "menstrual changes" OR "abnormal uterine bleeding" OR "heavy menstrual bleeding" OR "intermenstrual bleeding" OR "cycle length") Susceptibility trait inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
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.