Evidence dossier · candidate cand-covid-venous-thromboembolism · CICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that COVID-19 vaccine causes Venous Thromboembolism, 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
insufficient_data
missing: B5
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: 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 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: The retrieved evidence includes several case reports describing venous thromboembolism (VTE) occurring after COVID-19 vaccination, including both mRNA and adenovirus-based vaccines, often with temporal associations and consideration of underlying risk factors such as hereditary protein S deficiency.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Case reports pubmed · 66186 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
14 retrieved record(s)
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
does_not_resolve 41306776 · Frontiers in pharmacology (2025) — HPV vaccine-related thyroid adverse events: temporal patterns and reporting trends.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
ambiguous 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
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: A single case report (PMID 36185940) describes vaccine-induced thrombotic thrombocytopaenia with venous thrombosis after the Oxford-AstraZeneca COVID-19 vaccine, providing objective confirmation (imaging/diagnostic testing) of venous thromboembolism attributed to the vaccine. No other retrieved articles address venous thromboembolism with objective confirmation.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Series with objective confirmation pubmed · 5671 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
11 retrieved record(s)
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 40902666 · Journal of the American Academy of Derma (2026) — Drug and vaccine-associated pemphigoid in patients aged 50 years and older: A pharmacovigilance study.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 35355663 · Respirology case reports (2022) — COVID-19 mRNA vaccine-related interstitial lung disease: Two case reports and literature review.
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: Several case reports describe venous thromboembolism (VTE) developing within days to weeks after COVID-19 vaccination, often with onset clustering in a post-vaccination risk window (e.g., 5–30 days), but no controlled epidemiological study or systematic histogram of onset times is provided.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Onset histogram pubmed · 32 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
19 retrieved record(s)
ambiguous 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
ambiguous 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
supports_node 38586737 · Cureus (2024) — Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome.
ambiguous 34400433 · BMJ case reports (2021) — Extensive thrombosis after COVID-19 vaccine: cause or coincidence?
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
supports_node 34615534 · Journal of medical case reports (2021) — Diffuse prothrombotic syndrome after ChAdOx1 nCoV-19 vaccine administration: a case report.
A4 · Temporal plausibilitysupports
Measure: Onset latency vs object pathophysiology Comparator: Object's known natural latency Hit rule: Onset latency consistent with the object's pathophysiology
Finding: Four case reports and two case series describe venous thromboembolism (VTE) occurring days to a few weeks after mRNA or adenovirus-vector COVID-19 vaccination, with onset latencies (e.g., 'a few days' or 'shortly after') that are temporally consistent with known vaccine-induced prothrombotic pathophysiologic mechanisms such as vaccine-induced immune thrombotic thrombocytopenia or unmasking of hereditary thrombophilia. However, the evidence is limited to a small number of uncontrolled case descriptions and does not provide a systematic temporal-risk-window analysis.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Temporal plausibility pubmed · 61 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
16 retrieved record(s)
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
supports_node 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
does_not_resolve 41306776 · Frontiers in pharmacology (2025) — HPV vaccine-related thyroid adverse events: temporal patterns and reporting trends.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
ambiguous 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
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: Three case reports document that the onset interval (time from vaccination to symptom onset) was explicitly recorded, ranging from 'a few days' to 'shortly after' vaccination, though the specific risk window is not uniformly pre-specified.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Onset-interval documentation pubmed · 30 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
18 retrieved record(s)
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
supports_node 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 38586737 · Cureus (2024) — Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome.
ambiguous 34400433 · BMJ case reports (2021) — Extensive thrombosis after COVID-19 vaccine: cause or coincidence?
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
supports_node 34615534 · Journal of medical case reports (2021) — Diffuse prothrombotic syndrome after ChAdOx1 nCoV-19 vaccine administration: a case report.
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: A single case report describes vaccine-induced thrombotic thrombocytopaenia with venous and arterial thrombosis after COVID-19 vaccination, but does not explicitly state that competing causes were assessed and excluded per the pre-specified working definition.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Differential diagnosis excluded pubmed · 457 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
11 retrieved record(s)
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
ambiguous 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 40902666 · Journal of the American Academy of Derma (2026) — Drug and vaccine-associated pemphigoid in patients aged 50 years and older: A pharmacovigilance study.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 35355663 · Respirology case reports (2022) — COVID-19 mRNA vaccine-related interstitial lung disease: Two case reports and literature review.
Measure: Object recurs on a further dose Comparator: First-dose response Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: No retrieved case reports describe recurrence of venous thromboembolism after a subsequent COVID-19 vaccine dose in the same patient.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Rechallenge / re-exposure pubmed · 32 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
18 retrieved record(s)
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
ambiguous 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
ambiguous 38586737 · Cureus (2024) — Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
ambiguous 34400433 · BMJ case reports (2021) — Extensive thrombosis after COVID-19 vaccine: cause or coincidence?
supports_node 34615534 · Journal of medical case reports (2021) — Diffuse prothrombotic syndrome after ChAdOx1 nCoV-19 vaccine administration: a case report.
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: Multiple case reports describe venous thromboembolism (VTE) after COVID-19 vaccination, but none adjudicate cases as 'definite' by a published criterion set, and the retrieved evidence does not use formal adjudication criteria to classify VTE events.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Adjudicated by criteria pubmed · 69 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
18 retrieved record(s)
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 38586737 · Cureus (2024) — Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome.
ambiguous 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
ambiguous 34400433 · BMJ case reports (2021) — Extensive thrombosis after COVID-19 vaccine: cause or coincidence?
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
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: Three case reports describe venous thromboembolism (VTE) onset occurring days after mRNA COVID-19 vaccination, consistent with a plausible post-vaccination risk window, but no controlled or population-level data on natural-history course (onset, peak, recovery) are provided.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series Natural-history consistency pubmed · 133 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
13 retrieved record(s)
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
ambiguous 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
does_not_resolve 41306776 · Frontiers in pharmacology (2025) — HPV vaccine-related thyroid adverse events: temporal patterns and reporting trends.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
ambiguous 40902666 · Journal of the American Academy of Derma (2026) — Drug and vaccine-associated pemphigoid in patients aged 50 years and older: A pharmacovigilance study.
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: Three case reports describe venous thromboembolism (VTE) after mRNA COVID-19 vaccination (n=2 for mRNA-1273, n=1 unspecified) and two after adenovirus-based vaccination. All cases appeared temporally related and occurred in patients with known risk factors (age, hereditary protein S deficiency, May-Thurner syndrome) or without clear alternative cause. Evidence is limited to case reports and case series; no controlled epidemiological studies are retrieved.
supporting: COVID-19 vaccine Venous Thromboembolism case report OR case series No confounding object pubmed · 49 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-07
18 retrieved record(s)
supports_node 37546104 · Cureus (2023) — Thrombosis Development After mRNA COVID-19 Vaccine Administration: A Case Series.
supports_node 35308698 · Cureus (2022) — Development of Venous Thromboembolism After COVID-19 mRNA-1273 Vaccine Inoculation.
ambiguous 38993740 · Journal of hematology (2024) — Venous Thromboembolism Following COVID-19 Vaccination in Patients With Hereditary Protein S Deficiency.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
supports_node 37384077 · Cureus (2023) — Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination.
supports_node 38586737 · Cureus (2024) — Post-COVID-19 Vaccine Thromboembolic Complication in the Setting of Newly Diagnosed May-Thurner Syndrome.
ambiguous 34400433 · BMJ case reports (2021) — Extensive thrombosis after COVID-19 vaccine: cause or coincidence?
does_not_resolve 41306776 · Frontiers in pharmacology (2025) — HPV vaccine-related thyroid adverse events: temporal patterns and reporting trends.
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 Venous Thromboembolism anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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
mirror: COVID-19 vaccine Venous Thromboembolism 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
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15141378 hits · run 2026-09-07
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 Venous Thromboembolism No internal contradiction coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Analogy to a known object coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Latency coherence coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Pre-specification pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Pre-specification post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
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 42474879 · Biological trace element research (2026) — Cadmium Exposure and Osteoporosis: A Spatially Contextualized Adverse Outcome Pathway Integrating Epidemiology, Toxicogenomics and Transcriptomics.
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 retrieved evidence directly addresses contrary or null findings for venous thromboembolism following COVID-19 vaccination.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Contrary-evidence log pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
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
supports_node 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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism No temporality-only claim pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
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 42474879 · Biological trace element research (2026) — Cadmium Exposure and Osteoporosis: A Spatially Contextualized Adverse Outcome Pathway Integrating Epidemiology, Toxicogenomics and Transcriptomics.
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 includes a hypothesis-generating in-silico analysis (PMID 35412949) that explores a potential mechanism for COVID-19 postvaccination thrombosis but does not provide passive-surveillance signals or population-level data on venous thromboembolism. The other two PMIDs (39226489, 26296519) are unrelated to COVID-19 vaccine and venous thromboembolism.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Passive-surveillance role pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
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 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 mention COVID-19 vaccines, venous thromboembolism, or dose mapping; it only discusses immune checkpoint inhibitors and identification of immune-related adverse events using LLMs.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Dose mapping pre-specified OR adjudicated pubmed · 13548 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Dose mapping post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
1 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
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 Venous Thromboembolism Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Excess vs baseline pubmed · 88548 hits · run 2026-09-07
8 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: 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 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 34489307 · Gut (2022) — Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort.
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.
does_not_resolve 42413069 · ESC heart failure (2026) — The HFpEF-ABA score predicts adverse cardiac remodelling and incident heart failure: a UK biobank study.
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 SCCS study reports a risk estimate for venous thromboembolism after COVID-19 vaccination that meets the hit rule (SCCS risk ratio > 1, CI excluding 1). One study on mRNA vaccines found no apparent association but was not an SCCS design; another SCCS on XBB.1.5 vaccines included coagulopathy as an outcome but the abstract does not report a risk ratio or CI for venous thromboembolism specifically.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism SCCS incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk SCCS pubmed · 88655 hits · run 2026-09-07
11 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
does_not_resolve 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 38089855 · European heart journal open (2023) — Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort 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 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 39795956 · International journal of molecular scien (2024) — The Potential Metalloestrogenic Effect of Aluminum on Breast Cancer Risk for Antiperspirant Users.
does_not_resolve 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
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: The retrieved evidence includes two studies specific to COVID-19 vaccination and venous thromboembolism (VTE): a cohort study of older US veterans (PMID 37008615) found no excess VTE risk associated with SARS-CoV-2 vaccination, and a review (PMID 40872918) notes that VTE after COVID-19 vaccination is extremely rare and primarily linked to adenoviral vector vaccines, not mRNA vaccines. No retrieved study provides an incidence rate ratio (IRR) for VTE in a pre-specified window after COVID-19 vaccination, stratified by age/sex, with a CI excluding 1, as required by the hit rule.
supporting: COVID-19 vaccine Venous Thromboembolism Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Cohort / risk-interval pubmed · 88157 hits · run 2026-09-07
14 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 37223097 · Frontiers in immunology (2023) — Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study.
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 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
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 provides a pooled estimate (meta-analysis) for venous thromboembolism after COVID-19 vaccination, nor reports quantified heterogeneity (I2) for such a pooled estimate.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Meta-analysis / pooling pubmed · 111987 hits · run 2026-09-07
8 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 29402646 · Journal of the American Medical Director (2018) — Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others.
refutes_node 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
does_not_resolve 37812417 · JAMA network open (2023) — Venous Thromboembolism After COVID-19 Infection Among People With and Without Immune-Mediated Inflammatory Diseases.
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 study directly addressing venous thromboembolism after COVID-19 vaccination; the only relevant publication (PMID 38089855) examines arrhythmia risk after COVID-19 infection, not vaccine, and multiple other studies are unrelated to COVID-19 vaccine or venous thromboembolism.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Negative-control outcomes pubmed · 88358 hits · run 2026-09-07
6 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 42371637 · JAMA internal medicine (2026) — Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts.
does_not_resolve 38833248 · JAMA network open (2024) — Valproate Use During Spermatogenesis and Risk to Offspring.
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: The retrieved evidence includes one case report and one narrative review mentioning venous thromboembolism after COVID-19 vaccines, and two observational studies reporting no apparent association with mRNA vaccines or elevated risk in older veterans; however, no retrieved study uses a different-antigen comparator to assess risk specific to the target antigen, as required by Node B6.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Other-antigen comparison pubmed · 88121 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 42204965 · British journal of clinical pharmacology (2026) — Risk of venous thromboembolism after SARS-CoV-2 vaccination-Evidence from genome-wide association study and population-based observational study.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
does_not_resolve 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
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 retrieved evidence reports absolute risk (per-100k) of venous thromboembolism after COVID-19 vaccination for the pre-specified risk window. PMID 35577622 discusses absence of association with mRNA vaccines but provides no absolute risk incidence rate; remaining PMIDs address other exposures or outcomes.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Absolute risk incidence risk cohort OR self-controlled case series pubmed · 952 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Absolute risk pubmed · 111385 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 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.
does_not_resolve 40020995 · Chest (2025) — Changes in Lung Function and Mortality Risk in Patients With Idiopathic Pulmonary Fibrosis.
B8 · Platform splitmixed
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: PMID 35577626 reports no apparent association between mRNA COVID-19 vaccination and venous thromboembolism, while PMID 36185940 and PMID 40872918 describe rare venous thromboembolism and vaccine-induced thrombotic thrombocytopenia associated with adenoviral vector vaccines, but no retrieved study provides a platform-split risk estimate for venous thromboembolism attributable specifically to any COVID-19 vaccine platform versus another.
supporting: COVID-19 vaccine Venous Thromboembolism Platform split incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Platform split pubmed · 88186 hits · run 2026-09-07
11 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
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 retrieved evidence directly examines risk of venous thromboembolism concentrated in a defined host subgroup (e.g., young males) after COVID-19 vaccination with stable findings across sources. One genome-wide association study (PMID 42204965) explores genetic variants linked to post-vaccination VTE but does not provide stratification by age/sex across stable sources; other retrieved studies are case reports or reviews without subgroup analyses, or address VTE after COVID-19 infection or other vaccines.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Host-structure stratification pubmed · 88119 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
supports_node 42204965 · British journal of clinical pharmacology (2026) — Risk of venous thromboembolism after SARS-CoV-2 vaccination-Evidence from genome-wide association study and population-based observational study.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
refutes_node 35577626 · Blood reviews (2022) — No apparent association between mRNA COVID-19 vaccination and venous thromboembolism.
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: The retrieved evidence includes one case report of thrombotic thrombocytopenia following the Oxford-AstraZeneca COVID-19 vaccine, and one population-based observational study that identified genetic variants associated with venous thromboembolism after SARS-CoV-2 vaccination, but none of the retrieved studies directly assess whether the risk of venous thromboembolism tracks a documented formulation or component change over time.
supporting: COVID-19 vaccine Venous Thromboembolism Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no association OR null OR no increased risk Formulation / component change pubmed · 88281 hits · run 2026-09-07
9 retrieved record(s)
does_not_resolve 30172612 · American journal of infection control (2019) — Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis.
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 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 41092926 · Lancet (London, England) (2025) — Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 su
supports_node 42204965 · British journal of clinical pharmacology (2026) — Risk of venous thromboembolism after SARS-CoV-2 vaccination-Evidence from genome-wide association study and population-based observational study.
supports_node 36185940 · Cureus (2022) — COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report.
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 Venous Thromboembolism Formulation natural experiment intervention OR treatment OR reversal pubmed · 15141378 hits · run 2026-09-07
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 Venous Thromboembolism Policy / pause signal intervention OR treatment OR reversal pubmed · 15141378 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Infection coherence coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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: None of the retrieved studies examine dose strength gradient (larger dose vs. smaller dose) for venous thromboembolism after COVID-19 vaccination; the available evidence compares pre- vs post-vaccination risk, or vaccinated vs unvaccinated, without stratification by dose size.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Dose strength gradient dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no dose effect OR no dose-response Dose strength gradient pubmed · 148 hits · run 2026-09-07
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 35398975 · Journal of thrombosis and haemostasis : (2022) — Risk of venous thromboembolism after COVID-19 vaccination.
refutes_node 36660880 · American journal of hematology (2023) — Venous thromboembolism after COVID-19 vaccination in patients with thrombophilia.
refutes_node 37008615 · Journal of clinical and translational sc (2023) — COVID-19 vaccination and venous thromboembolism risk in older veterans.
refutes_node 36016205 · Vaccines (2022) — Venous Thromboembolism following Two Doses of COVID-19 mRNA Vaccines in the US Population, 2020-2022.
does_not_resolve 34845662 · Cardiology and therapy (2022) — Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.
refutes_node 36634464 · Thrombosis research (2023) — Thrombotic events following the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) in Aotearoa New Zealand: A self-controlled case series study.
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: The retrieved evidence does not contain any study that reports risk of venous thromboembolism by dose number (1st vs 2nd vs 3rd) or examines a dose number gradient. Available studies compare pre- vs post-vaccination rates or vaccinated vs unvaccinated groups, but none assess a pattern across successive doses.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Dose number gradient dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no dose effect OR no dose-response Dose number gradient pubmed · 592 hits · run 2026-09-07
9 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.
refutes_node 35398975 · Journal of thrombosis and haemostasis : (2022) — Risk of venous thromboembolism after COVID-19 vaccination.
refutes_node 36660880 · American journal of hematology (2023) — Venous thromboembolism after COVID-19 vaccination in patients with thrombophilia.
refutes_node 37008615 · Journal of clinical and translational sc (2023) — COVID-19 vaccination and venous thromboembolism risk in older veterans.
refutes_node 36016205 · Vaccines (2022) — Venous Thromboembolism following Two Doses of COVID-19 mRNA Vaccines in the US Population, 2020-2022.
ambiguous 34845662 · Cardiology and therapy (2022) — Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.
refutes_node 36634464 · Thrombosis research (2023) — Thrombotic events following the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) in Aotearoa New Zealand: A self-controlled case series study.
does_not_resolve 42488947 · Hypertension (Dallas, Tex. : 1979) (2026) — Clinical Modifiers of Salt Sensitivity: A Meta-Regression and Risk Translation Study.
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 does not contain any study that examines the risk of venous thromboembolism stratified by measured-exposure tertile of the COVID-19 vaccine.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Measured-exposure tertiles dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no dose effect OR no dose-response Measured-exposure tertiles pubmed · 37 hits · run 2026-09-07
11 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 35398975 · Journal of thrombosis and haemostasis : (2022) — Risk of venous thromboembolism after COVID-19 vaccination.
refutes_node 36660880 · American journal of hematology (2023) — Venous thromboembolism after COVID-19 vaccination in patients with thrombophilia.
refutes_node 37008615 · Journal of clinical and translational sc (2023) — COVID-19 vaccination and venous thromboembolism risk in older veterans.
refutes_node 36016205 · Vaccines (2022) — Venous Thromboembolism following Two Doses of COVID-19 mRNA Vaccines in the US Population, 2020-2022.
ambiguous 34845662 · Cardiology and therapy (2022) — Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.
refutes_node 36634464 · Thrombosis research (2023) — Thrombotic events following the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) in Aotearoa New Zealand: A self-controlled case series study.
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 a dose-dependent effect of COVID-19 vaccine on venous thromboembolism across a graded concentration curve in organoid models.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Organoid concentration curve dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no dose effect OR no dose-response Organoid concentration curve pubmed · 48 hits · run 2026-09-07
10 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 35398975 · Journal of thrombosis and haemostasis : (2022) — Risk of venous thromboembolism after COVID-19 vaccination.
refutes_node 36660880 · American journal of hematology (2023) — Venous thromboembolism after COVID-19 vaccination in patients with thrombophilia.
refutes_node 37008615 · Journal of clinical and translational sc (2023) — COVID-19 vaccination and venous thromboembolism risk in older veterans.
refutes_node 36016205 · Vaccines (2022) — Venous Thromboembolism following Two Doses of COVID-19 mRNA Vaccines in the US Population, 2020-2022.
ambiguous 34845662 · Cardiology and therapy (2022) — Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.
supports_node 37495490 · Vaccine (2023) — Re-evaluation of the risk of venous thromboembolism after COVID-19 vaccination using haematological criteria.
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 directly addresses whether achieved exposure (Cmax/tissue) plausibly reaches the in-vitro EC50 for COVID-19 vaccine-related venous thromboembolism. The available studies examine epidemiological VTE risk after vaccination but do not report or reference pharmacokinetic or pharmacodynamic data such as EC50 or Cmax.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 37 hits · run 2026-09-07
9 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.
refutes_node 36660880 · American journal of hematology (2023) — Venous thromboembolism after COVID-19 vaccination in patients with thrombophilia.
refutes_node 35398975 · Journal of thrombosis and haemostasis : (2022) — Risk of venous thromboembolism after COVID-19 vaccination.
refutes_node 37008615 · Journal of clinical and translational sc (2023) — COVID-19 vaccination and venous thromboembolism risk in older veterans.
refutes_node 36016205 · Vaccines (2022) — Venous Thromboembolism following Two Doses of COVID-19 mRNA Vaccines in the US Population, 2020-2022.
supports_node 34845662 · Cardiology and therapy (2022) — Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.
refutes_node 36634464 · Thrombosis research (2023) — Thrombotic events following the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech) in Aotearoa New Zealand: A self-controlled case series study.
ambiguous 39279662 · BJOG : an international journal of obste (2024) — COVID-19 Vaccine Safety in Pregnancy, A Nested Case-Control Study in Births From April 2021 to March 2022, England.
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 Venous Thromboembolism mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Mediator in healthy vaccinees not associated mechanism pubmed · 1 hits · 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 Venous Thromboembolism mechanism Infection contrast in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Infection contrast not associated mechanism pubmed · 2 hits · run 2026-09-07
E4 · Transfer to recipientmixed
Measure: Phenotype/mediator transferred to a recipient system Comparator: Control transfer Hit rule: The effect / mediator transfers to a naive recipient system
Finding: A single case report describes a 52-year-old man who developed venous thromboembolism and disseminated intravascular coagulation after receiving the Johnson & Johnson COVID-19 vaccine, suggesting a possible transfer of the thrombotic phenotype to the recipient.
supporting: COVID-19 vaccine Venous Thromboembolism mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Transfer to recipient not associated mechanism pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
supports_node 34408937 · Cureus (2021) — A COVID-Positive 52-Year-Old Man Presented With Venous Thromboembolism and Disseminated Intravascular Coagulation Following Johnson & Johnson Vaccination: A Cas
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: A single case report describes venous thromboembolism and disseminated intravascular coagulation following Johnson & Johnson vaccination, but does not involve a transfer experiment or removal of a specific mediator.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism mechanism Transfer specificity in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Transfer specificity not associated mechanism pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
ambiguous 34408937 · Cureus (2021) — A COVID-Positive 52-Year-Old Man Presented With Venous Thromboembolism and Disseminated Intravascular Coagulation Following Johnson & Johnson Vaccination: A Cas
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 Venous Thromboembolism mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
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 Venous Thromboembolism mechanism Add-back rescue in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
Measure: Neutralizing the mediator blocks the effect Comparator: Isotype control Hit rule: Neutralization of the mediator (not an isotype control) blocks the phenotype
Finding: In a case report of a patient with thrombotic thrombocytopenia after Ad26.COV2.S vaccination, multiple thrombotic events including venous and arterial thrombi were observed, but the report does not test neutralization of a mediator to block the phenotype.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism mechanism Neutralization in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Neutralization not associated mechanism pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
ambiguous 34547677 · Journal of stroke and cerebrovascular di (2021) — Vaccine-Induced Immune Thrombotic Thrombocytopenia with Concurrent Arterial and Venous Thrombi Following Ad26.COV2.S Vaccination.
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: The retrieved evidence does not mention any isotype control experiments; it describes that half of the patients fulfilling clinical VITT criteria tested positive on PF4/polyanion ELISA and another third on platelet activation assays, but no isotype control data are reported.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism mechanism Isotype control in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Isotype control not associated mechanism pubmed · 2 hits · run 2026-09-07
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 Venous Thromboembolism Full product reproduces component OR antigen OR vector pubmed · 2045214 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Full product reproduces 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.
does_not_resolve 40276512 · Frontiers in immunology (2025) — Development of a novel adenovirus type 4 vector as a promising respiratory vaccine vehicle.
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: The retrieved evidence discusses virus-vectored and bacterial-vectored vaccine platforms in general (influenza, measles, cancer vaccines, adenovirus vectors) but does not address venous thromboembolism as an adverse event attributed to an empty vector or particle backbone.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Empty vector / particle component OR antigen OR vector pubmed · 2045214 hits · 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.
does_not_resolve 40276512 · Frontiers in immunology (2025) — Development of a novel adenovirus type 4 vector as a promising respiratory vaccine vehicle.
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 Venous Thromboembolism Antigen alone reproduces component OR antigen OR vector pubmed · 2045214 hits · 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.
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: no evidence found
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Irrelevant cargo component OR antigen OR vector pubmed · 2045214 hits · 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.
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: The retrieved evidence describes viral-vector and bacterial-vector vaccine platforms for influenza, measles, cancer, and respiratory diseases, but does not address venous thromboembolism or any adverse event following COVID-19 vaccination.
Cited: (none)
supporting: COVID-19 vaccine Venous Thromboembolism Infection preparation component OR antigen OR vector pubmed · 2045214 hits · 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.
does_not_resolve 40276512 · Frontiers in immunology (2025) — Development of a novel adenovirus type 4 vector as a promising respiratory vaccine vehicle.
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 Venous Thromboembolism Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045214 hits · 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.
does_not_resolve 40276512 · Frontiers in immunology (2025) — Development of a novel adenovirus type 4 vector as a promising respiratory vaccine vehicle.
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: The retrieved evidence includes a review discussing vaccine-associated thrombocytopenia and thrombosis, including venous thromboembolism, in the context of COVID-19 vaccines, but does not specifically address whether a defined component combination reproduces the effect that single components do not.
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 40276512 · Frontiers in immunology (2025) — Development of a novel adenovirus type 4 vector as a promising respiratory vaccine vehicle.
ambiguous 34833382 · Medicina (Kaunas, Lithuania) (2021) — Vaccine-Associated Thrombocytopenia and Thrombosis: Venous Endotheliopathy Leading to Venous Combined Micro-Macrothrombosis.
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 Venous Thromboembolism 2D human cells animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Organoid / chip animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15141378 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism mechanism Host-line dependence in vitro OR patient-derived pubmed · 29239 hits · run 2026-09-07
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 Venous Thromboembolism Animal, clinical route animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Susceptible animal animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Replication across labs animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Blinded scoring animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism Blinded scoring not reproduced model pubmed · 1 hits · 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 Venous Thromboembolism Experimental time course animal OR organoid OR cell model pubmed · 1818474 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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 Venous Thromboembolism Susceptibility trait coherence OR latency OR susceptibility pubmed · 870020 hits · run 2026-09-07
mirror: COVID-19 vaccine Venous Thromboembolism 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.