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DTaP vaccine → Pertussis

Evidence dossier · candidate cand-dtap-pertussis · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that DTaP vaccine causes Pertussis, 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)

ClaimLabelStatusMissing nodes
C1Coherent clinical object existsinsufficient_datamissing: A1 A2
C2Consistent temporal windowsupported
C3Epidemiologic excess riskinsufficient_datamissing: B2 B3
C4Consistency / replicationcontested
C5Specificity (product / dose)insufficient_datamissing: C1n
C6Biological mechanisminsufficient_datamissing: 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.

ViewpointWhat it asksStatus (from evidence)
Temporality (necessary)cause precedes effect in a plausible window (necessary)not established
Strengthsize/precision of the associationnot established
Consistencyreproduced across settings/designsnot established
Specificitytied to a specific product/dose/outcomenot established
Biological gradientdose-responsenot established
Plausibilitya named biological mechanismnot established
Coherencefits known biology/natural historynot established
Experimentintervention changes risknot established
Analogyprecedent for the patternnot established

NASEM weight-of-evidence synthesis (computed)

TrackWeightBasis
EpidemiologicINSUFFICIENTvia B1, B2, B3, B4, B5, B8
MechanisticLACKINGvia A9, A10, C1n, C2n, C3n, C4n, C5n · missing: D1 D2 D3 D4 D5 E1 E2 E3 E4 E6 E7 E8 E9 E10 F1 F2 …
Synthesized conclusionInadequate to accept or reject

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 specifically reports a case of new Pertussis attributed to DTaP vaccine with onset within a pre-specified risk window after competing causes were assessed. The only directly relevant case report [PMID 37753771] describes Guillain-Barré syndrome after DTaP vaccination, not Pertussis infection.
Case-certainty distribution (no established case definition): 2 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Case reports
pubmed · 66225 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34185028 · The Journal of the American Academy of O (2021) — Shoulder Injury Related to Vaccine Administration.
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: DTaP vaccine Pertussis case report OR case series Series with objective confirmation
pubmed · 5700 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34185028 · The Journal of the American Academy of O (2021) — Shoulder Injury Related to Vaccine Administration.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
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: No retrieved evidence describes the distribution of onset times for new Pertussis attributed to DTaP vaccine within a pre-specified risk window. The only Pertussis case (PMID 41103878) is a diagnostic report unrelated to vaccination timing.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Onset histogram
pubmed · 61 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
18 retrieved record(s)
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
does_not_resolve 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
ambiguous 20704492 · Clinical infectious diseases : an offici (2010) — The present and future control of pertussis.
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 31690466 · Vaccine (2020) — Blistering post 4-year old Infanrix® IPV.
ambiguous 35505368 · European journal of medical research (2022) — Severe immune thrombocytopenia following diphtheria, tetanus, pertussis and polio vaccination in a 36-year-old Caucasian woman: a case report.
ambiguous 27585798 · Clinical infectious diseases : an offici (2016) — Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis.
ambiguous 16291356 · The Journal of pediatrics (2005) — Transient bulging fontanelle after vaccination: case report and review of the vaccine adverse event reporting system.
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 retrieved evidence addresses onset latency of new Pertussis attributed to DTaP vaccine relative to the pathophysiology of Pertussis. One case report describes Guillain-Barré syndrome after DTaP, and another discusses a pertussis infection with delayed diagnosis, but neither provides information on temporal plausibility for DTaP vaccine causing pertussis.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Temporal plausibility
pubmed · 90 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
13 retrieved record(s)
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
supports_node 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34185028 · The Journal of the American Academy of O (2021) — Shoulder Injury Related to Vaccine Administration.
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: The retrieved evidence does not contain any primary source documenting a recorded onset interval for Pertussis attributed to DTaP vaccine.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Onset-interval documentation
pubmed · 59 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
18 retrieved record(s)
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
ambiguous 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
ambiguous 20704492 · Clinical infectious diseases : an offici (2010) — The present and future control of pertussis.
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 31690466 · Vaccine (2020) — Blistering post 4-year old Infanrix® IPV.
supports_node 35505368 · European journal of medical research (2022) — Severe immune thrombocytopenia following diphtheria, tetanus, pertussis and polio vaccination in a 36-year-old Caucasian woman: a case report.
ambiguous 27585798 · Clinical infectious diseases : an offici (2016) — Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis.
ambiguous 16291356 · The Journal of pediatrics (2005) — Transient bulging fontanelle after vaccination: case report and review of the vaccine adverse event reporting system.
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: no evidence found
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Differential diagnosis excluded
pubmed · 486 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
11 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
does_not_resolve 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34185028 · The Journal of the American Academy of O (2021) — Shoulder Injury Related to Vaccine Administration.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
A7 · Rechallenge / re-exposureno_data
Measure: Object recurs on a further dose
Comparator: First-dose response
Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: The retrieved evidence contains no case or report of pertussis recurrence after a subsequent dose of DTaP vaccine, nor any rechallenge data specific to DTaP and pertussis. The only DTaP-related articles describe Guillain-Barré syndrome, immune thrombocytopenia, or other adverse events, not pertussis.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Rechallenge / re-exposure
pubmed · 61 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
19 retrieved record(s)
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
does_not_resolve 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
does_not_resolve 20704492 · Clinical infectious diseases : an offici (2010) — The present and future control of pertussis.
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 31690466 · Vaccine (2020) — Blistering post 4-year old Infanrix® IPV.
ambiguous 35505368 · European journal of medical research (2022) — Severe immune thrombocytopenia following diphtheria, tetanus, pertussis and polio vaccination in a 36-year-old Caucasian woman: a case report.
supports_node 27585798 · Clinical infectious diseases : an offici (2016) — Acute Demyelinating Events Following Vaccines: A Case-Centered Analysis.
ambiguous 16291356 · The Journal of pediatrics (2005) — Transient bulging fontanelle after vaccination: case report and review of the vaccine adverse event reporting system.
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 retrieved evidence addresses new Pertussis attributed to DTaP vaccine adjudicated as 'definite' by published criteria within a specified risk window.
Case-certainty distribution (no established case definition): 1 Definite, 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Adjudicated by criteria
pubmed · 98 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
does_not_resolve 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
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: The retrieved evidence includes only a case report of a 20-month-old girl who developed Guillain-Barré syndrome after DTaP vaccination, which is not pertussis, and other irrelevant or unrelated studies; no evidence describes the natural history of pertussis attributed to DTaP vaccine.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series Natural-history consistency
pubmed · 162 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
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 30000765 · (2006) — Human Papillomavirus Vaccines.
ambiguous 34854882 · Blood (2021) — VITT(al) insights into vaccine-related clots.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34185028 · The Journal of the American Academy of O (2021) — Shoulder Injury Related to Vaccine Administration.
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 describes new pertussis attributed to DTaP vaccine after competing causes are assessed. PMID 37753771 reports a pediatric case of Guillain-Barré syndrome after DTaP, not pertussis; PMID 34304240 discusses Tdap interference with COVID-19 vaccine, not pertussis as an adverse event; PMID 41103878 describes pertussis in a 13-month-old but does not link it to vaccination.
Cited: (none)
supporting: DTaP vaccine Pertussis case report OR case series No confounding object
pubmed · 78 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis alternative diagnosis OR not vaccine-related
pubmed · 4061 hits · run 2026-09-07
17 retrieved record(s)
does_not_resolve 34304240 · The American journal of case reports (2021) — BNT162b2 mRNA Vaccine Interference with Co-Administration of Tdap Vaccine.
ambiguous 37753771 · Human vaccines & immunotherapeutics (2023) — Guillain Barré syndrome after combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine: A rare pediatric case report and review of literature.
refutes_node 41103878 · Cureus (2025) — Pertussis in Infancy: A Case of Delayed Diagnosis.
ambiguous 20704492 · Clinical infectious diseases : an offici (2010) — The present and future control of pertussis.
ambiguous 35505368 · European journal of medical research (2022) — Severe immune thrombocytopenia following diphtheria, tetanus, pertussis and polio vaccination in a 36-year-old Caucasian woman: a case report.
ambiguous 31690466 · Vaccine (2020) — Blistering post 4-year old Infanrix® IPV.
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.
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: DTaP vaccine Pertussis anatomic localization Predicted site of injury mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis anatomic localization Spared structures mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: The abstract reports on local and systemic reactions to DTaP vaccine compared to separate-site administration, but does not address pertussis disease occurrence or distribution of new pertussis cases attributed to the vaccine.
Cited: (none)
supporting: DTaP vaccine Pertussis anatomic localization Local vs systemic distribution mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Pertussis Local vs systemic distribution not consistent with mechanism
pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 9306481 · The Pediatric infectious disease journal (1997) — Vaccine antigen interactions after a combination diphtheria-tetanus toxoid-acellular pertussis/purified capsular polysaccharide of Haemophilus influenzae type b
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: DTaP vaccine Pertussis anatomic localization Kinetics class mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis anatomic localization Platform-mechanism match mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Targeted treatment reverses intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis No internal contradiction coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Analogy to a known object coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Latency coherence coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Pre-specification pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Pre-specification post-hoc OR hypothesis-generating only
pubmed · 1699 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
J2 · Contrary-evidence logno_data
Measure: Contrary evidence is logged, not omitted
Comparator: Support-only dossier
Hit rule: Contrary / null / refuting findings are logged and shown alongside support
Finding: The study focuses on detecting immune-related adverse events from immune checkpoint inhibitors using large language models, not on DTaP vaccine or pertussis. No evidence was found regarding pertussis attributed to DTaP vaccination.
Cited: (none)
supporting: DTaP vaccine Pertussis Contrary-evidence log pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Contrary-evidence log post-hoc OR hypothesis-generating only
pubmed · 1699 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
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. The retrieved abstracts discuss immune-related adverse events from immune checkpoint inhibitors (PMID 39226489) and drug-induced acute kidney injury risk prediction (PMID 36088907), neither of which addresses the specific claim of new Pertussis attributed to DTaP vaccine with onset within a pre-specified risk window after vaccination.
Cited: (none)
supporting: DTaP vaccine Pertussis No temporality-only claim pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis No temporality-only claim post-hoc OR hypothesis-generating only
pubmed · 1699 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 36088907 · Nephron (2023) — Drug-Induced Acute Kidney Injury Risk Prediction Models.
J4 · Passive-surveillance roleno_data
Measure: Passive-surveillance findings bounded correctly
Comparator: Active-surveillance confirmation
Hit rule: Passive-surveillance signals are framed as hypothesis-generating, not confirmatory
Finding: The retrieved evidence discusses general methods for identifying adverse events (immune-related adverse events, drug-induced acute kidney injury) using large language models or clinical adjudication, but does not address DTaP vaccine, pertussis, or passive-surveillance signals for vaccine-attributed pertussis.
Cited: (none)
supporting: DTaP vaccine Pertussis Passive-surveillance role pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Passive-surveillance role post-hoc OR hypothesis-generating only
pubmed · 1699 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 36088907 · Nephron (2023) — Drug-Induced Acute Kidney Injury Risk Prediction Models.
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 retrieved evidence addresses dose/lot mapping of DTaP vaccine to new pertussis cases, nor does it discuss pertussis, DTaP, or vaccine adverse events.
Cited: (none)
supporting: DTaP vaccine Pertussis Dose mapping pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Dose mapping post-hoc OR hypothesis-generating only
pubmed · 1699 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 36088907 · Nephron (2023) — Drug-Induced Acute Kidney Injury Risk Prediction Models.

Epidemiologic chassis 13/13 evaluated

B1 · Excess vs baselineno_data
Measure: RR/IRR vs unexposed or prior window
Comparator: Unvaccinated person-time or pre-vaccination window
Hit rule: RR/IRR > 1 with CI excluding 1 after pre-specified confounders
Finding: No retrieved evidence provides a risk ratio or incidence rate ratio for the specific association between DTaP vaccination and pertussis with a confidence interval excluding 1. The evidence includes studies on the safety and immunogenicity of Tdap in pregnancy, vaccine co-administration, and general vaccine safety methodology, but none directly address an excess risk of pertussis following DTaP vaccination in the required risk window.
Cited: (none)
supporting: DTaP vaccine Pertussis Excess vs baseline incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Excess vs baseline
pubmed · 89051 hits · run 2026-09-07
16 retrieved record(s)
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 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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
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 directly reports a self-controlled case series (SCCS) risk ratio for Pertussis after DTaP vaccination with a confidence interval excluding 1.
Cited: (none)
supporting: DTaP vaccine Pertussis SCCS incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk SCCS
pubmed · 89156 hits · run 2026-09-07
16 retrieved record(s)
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
B3 · Cohort / risk-intervalno_data
Measure: Incidence rate ratio in defined window
Comparator: Pre-specified risk vs comparison interval
Hit rule: IRR > 1 in the pre-specified window, CI excluding 1, stratified by age/sex
Finding: No retrieved evidence directly addresses an incidence rate ratio for new Pertussis attributed to DTaP vaccine within a pre-specified risk window using a cohort or risk-interval design stratified by age/sex. The studies retrieved focus on unrelated vaccines (rotavirus, Shingrix, COVID-19), maternal Tdap effectiveness, general vaccine safety methodology, or pertussis epidemiology, but none provide a cohort-based IRR for DTaP vaccine-attributed pertussis.
Cited: (none)
supporting: DTaP vaccine Pertussis Cohort / risk-interval incidence risk cohort OR self-controlled case series
pubmed · 946 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Cohort / risk-interval
pubmed · 88659 hits · run 2026-09-07
16 retrieved record(s)
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 37574727 · Journal of Alzheimer's disease : JAD (2023) — The Impact of Routine Vaccinations on Alzheimer's Disease Risk in Persons 65 Years and Older: A Claims-Based Cohort Study using Propensity Score Matching.
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 meta-analytic estimate with quantified heterogeneity (I²) for the specific association between DTaP vaccine and new onset pertussis within a pre-specified risk window. The retrieved studies focus on SCCS/SCRI designs, co-administration, maternal vaccination effectiveness, and other vaccine safety outcomes, but none conduct or cite a meta-analysis or pooling for this specific pair.
Cited: (none)
supporting: DTaP vaccine Pertussis Meta-analysis / pooling incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Meta-analysis / pooling
pubmed · 112496 hits · run 2026-09-07
15 retrieved record(s)
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 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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 37574727 · Journal of Alzheimer's disease : JAD (2023) — The Impact of Routine Vaccinations on Alzheimer's Disease Risk in Persons 65 Years and Older: A Claims-Based Cohort Study using Propensity Score Matching.
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 retrieved evidence directly assesses the hypothesized adverse event of new pertussis attributed to DTaP vaccination; the cited studies focus on methodology, vaccine effectiveness, immunogenicity, and unrelated outcomes, with no report of excess pertussis risk after DTaP.
Cited: (none)
supporting: DTaP vaccine Pertussis Negative-control outcomes incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Negative-control outcomes
pubmed · 88862 hits · run 2026-09-07
16 retrieved record(s)
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
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 retrieved evidence directly addresses the risk of new Pertussis attributed to DTaP vaccine versus a different-antigen comparator (e.g., Tdap or other non-pertussis vaccines) using a self-controlled or comparator design specific to the target antigen. The evidence retrieved focuses on self-controlled case series methodology, rotavirus vaccine safety, COVID-19 vaccine safety, shingles vaccine, maternal Tdap effectiveness, and general vaccine co-administration, but none provide a hit for node B6 (Other-antigen comparison) as defined.
Cited: (none)
supporting: DTaP vaccine Pertussis Other-antigen comparison incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Other-antigen comparison
pubmed · 88624 hits · run 2026-09-07
15 retrieved record(s)
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 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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 37574727 · Journal of Alzheimer's disease : JAD (2023) — The Impact of Routine Vaccinations on Alzheimer's Disease Risk in Persons 65 Years and Older: A Claims-Based Cohort Study using Propensity Score Matching.
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 provides an absolute risk estimate (per 100k in a defined risk window) for new Pertussis attributed to DTaP vaccination.
Cited: (none)
supporting: DTaP vaccine Pertussis Absolute risk incidence risk cohort OR self-controlled case series
pubmed · 949 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Absolute risk
pubmed · 111893 hits · run 2026-09-07
14 retrieved record(s)
does_not_resolve 37574727 · Journal of Alzheimer's disease : JAD (2023) — The Impact of Routine Vaccinations on Alzheimer's Disease Risk in Persons 65 Years and Older: A Claims-Based Cohort Study using Propensity Score Matching.
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
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 retrieved evidence specifically addresses new pertussis attributable to DTaP vaccine with onset within a pre-specified risk window after competing causes are assessed, nor does any study isolate risk by vaccine platform or product for this specific adverse event.
Cited: (none)
supporting: DTaP vaccine Pertussis Platform split incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Platform split
pubmed · 88689 hits · run 2026-09-07
15 retrieved record(s)
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 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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: 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.
refutes_node 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
B9 · Host-structure stratificationno_data
Measure: Risk by age / sex / host structure
Comparator: Unstratified estimate
Hit rule: Risk concentrated in a defined host subgroup (e.g. young males), stable across sources
Finding: The retrieved evidence does not provide any data on risk of pertussis attributed to DTaP vaccine stratified by age, sex, or host structure, nor does it address a defined host subgroup with stable risk across sources for this specific adverse event.
Cited: (none)
supporting: DTaP vaccine Pertussis Host-structure stratification incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Host-structure stratification
pubmed · 88622 hits · run 2026-09-07
15 retrieved record(s)
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
refutes_node 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change
Comparator: Pre- vs post-change formulation
Hit rule: Risk change tracks a documented formulation / component change over time
Finding: No retrieved evidence directly addresses whether risk of pertussis after DTaP vaccination tracks a documented formulation or component change over time.
Cited: (none)
supporting: DTaP vaccine Pertussis Formulation / component change incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no association OR null OR no increased risk Formulation / component change
pubmed · 88784 hits · run 2026-09-07
15 retrieved record(s)
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 40924159 · Clinical infectious diseases : an offici (2025) — Transient Increased Risk of Shingles Post-Shingrix Vaccination: Self-Controlled Case-Series Analysis.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 37039318 · Human vaccines & immunotherapeutics (2023) — Vaccine co-administration in adults: An effective way to improve vaccination coverage.
does_not_resolve 37574727 · Journal of Alzheimer's disease : JAD (2023) — The Impact of Routine Vaccinations on Alzheimer's Disease Risk in Persons 65 Years and Older: A Claims-Based Cohort Study using Propensity Score Matching.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
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: DTaP vaccine Pertussis Formulation natural experiment intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Policy / pause signal intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Infection coherence coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Dose strength gradient dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no dose effect OR no dose-response Dose strength gradient
pubmed · 623 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 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
does_not_resolve 30444673 · Human vaccines & immunotherapeutics (2019) — Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovi
does_not_resolve 31182549 · Pediatrics (2019) — Acellular Pertussis Vaccine Effectiveness Over Time.
does_not_resolve 33628957 · Journal of preventive medicine and hygie (2020) — Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature sh
does_not_resolve 23786774 · BMC pediatrics (2013) — An open-label randomized clinical trial of prophylactic paracetamol coadministered with 7-valent pneumococcal conjugate vaccine and hexavalent diphtheria toxoid
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
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: DTaP vaccine Pertussis Dose number gradient dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no dose effect OR no dose-response Dose number gradient
pubmed · 1067 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 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
does_not_resolve 30444673 · Human vaccines & immunotherapeutics (2019) — Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovi
refutes_node 31182549 · Pediatrics (2019) — Acellular Pertussis Vaccine Effectiveness Over Time.
ambiguous 24364571 · American family physician (2013) — Pertussis: a reemerging infection.
does_not_resolve 33628957 · Journal of preventive medicine and hygie (2020) — Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature sh
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
C3n · Measured-exposure tertilesno_data
Measure: Risk vs measured exposure tertile
Comparator: Lowest-exposure tertile
Hit rule: Risk ordered by measured-exposure tertile (high > mid > low)
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Pertussis Measured-exposure tertiles dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no dose effect OR no dose-response Measured-exposure tertiles
pubmed · 512 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 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
ambiguous 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
does_not_resolve 30444673 · Human vaccines & immunotherapeutics (2019) — Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovi
refutes_node 31182549 · Pediatrics (2019) — Acellular Pertussis Vaccine Effectiveness Over Time.
does_not_resolve 33628957 · Journal of preventive medicine and hygie (2020) — Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature sh
does_not_resolve 23786774 · BMC pediatrics (2013) — An open-label randomized clinical trial of prophylactic paracetamol coadministered with 7-valent pneumococcal conjugate vaccine and hexavalent diphtheria toxoid
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
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 evidence found
Cited: (none)
supporting: DTaP vaccine Pertussis Organoid concentration curve dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no dose effect OR no dose-response Organoid concentration curve
pubmed · 523 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.
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
does_not_resolve 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
does_not_resolve 30444673 · Human vaccines & immunotherapeutics (2019) — Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovi
ambiguous 37807881 · Pediatrics (2023) — Maternal Pertussis Vaccination, Infant Immunization, and Risk of Pertussis.
does_not_resolve 31182549 · Pediatrics (2019) — Acellular Pertussis Vaccine Effectiveness Over Time.
does_not_resolve 24364571 · American family physician (2013) — Pertussis: a reemerging infection.
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 evidence found
Cited: (none)
supporting: DTaP vaccine Pertussis EC50 vs Cmax coherence dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis no dose effect OR no dose-response EC50 vs Cmax coherence
pubmed · 512 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 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
does_not_resolve 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
does_not_resolve 24794369 · JAMA (2014) — Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial
does_not_resolve 30444673 · Human vaccines & immunotherapeutics (2019) — Immunogenicity and safety following primary and booster vaccination with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovi
ambiguous 37807881 · Pediatrics (2023) — Maternal Pertussis Vaccination, Infant Immunization, and Risk of Pertussis.
does_not_resolve 24364571 · American family physician (2013) — Pertussis: a reemerging infection.
refutes_node 31182549 · Pediatrics (2019) — Acellular Pertussis Vaccine Effectiveness Over Time.
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: DTaP vaccine Pertussis mechanism Mediator identified in cases in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: The retrieved evidence does not address DTaP vaccine and pertussis adverse events; it concerns HPV vaccine safety in young girls and includes DTaP only as a control comparator with no mention of pertussis as a mediator or adverse event.
Cited: (none)
supporting: DTaP vaccine Pertussis mechanism Mediator in healthy vaccinees in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Mediator in healthy vaccinees not associated mechanism
pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 29424799 · The Pediatric infectious disease journal (2018) — Safety and Immunogenicity of the HPV-16/18 AS04-adjuvanted Vaccine in 4-6-year-old Girls: Results to Month 12 From a Randomized Trial.
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: The retrieved evidence does not directly address whether a mediator signal (e.g., immune response or infection marker) is absent or low after natural pertussis infection compared to DTaP vaccination; most studies focus on vaccine immunogenicity or efficacy without contrasting natural infection controls.
Cited: (none)
supporting: DTaP vaccine Pertussis mechanism Infection contrast in vitro OR patient-derived
pubmed · 29244 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Infection contrast not associated mechanism
pubmed · 46 hits · run 2026-09-07
12 retrieved record(s)
ambiguous 25228233 · The Cochrane database of systematic revi (2014) — Acellular vaccines for preventing whooping cough in children.
does_not_resolve 40811865 · Emerging microbes & infections (2025) — Evaluation of immune responses to Tdap booster during pregnancy in women who received whole cell or acellular pertussis vaccines during childhood.
does_not_resolve 22419280 · The Cochrane database of systematic revi (2012) — Acellular vaccines for preventing whooping cough in children.
does_not_resolve 17280478 · Expert review of vaccines (2007) — Acellular pertussis vaccines and the role of pertactin and fimbriae.
does_not_resolve 9109164 · The Pediatric infectious disease journal (1997) — Combination vaccines consisting of acellular pertussis vaccines.
does_not_resolve 37171155 · Human vaccines & immunotherapeutics (2023) — Development of an algorithm for finding pertussis episodes in a population-based electronic health record database.
does_not_resolve 26430729 · Human vaccines & immunotherapeutics (2016) — Tdap vaccine attitudes and utilization among pregnant women from a high-risk population.
does_not_resolve 33478788 · Vaccine (2021) — Tdap booster to adolescents with juvenile idiopathic arthritis on and off anti-TNF agents is safe and immunogenic.
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: The abstract describes a study of maternal GBS vaccination and subsequent infant immune response to routine vaccinations including DTaP, but does not address transfer of pertussis or any adverse event from a vaccinated individual to a naive recipient.
Cited: (none)
supporting: DTaP vaccine Pertussis mechanism Transfer to recipient in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Transfer to recipient not associated mechanism
pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 29029127 · Clinical infectious diseases : an offici (2017) — Antibody Kinetics and Response to Routine Vaccinations in Infants Born to Women Who Received an Investigational Trivalent Group B Streptococcus Polysaccharide C
E5 · Transfer specificitysupports
Measure: Transfer requires the specific mediator
Comparator: Transfer with mediator present
Hit rule: Transfer effect is lost when the specific mediator is removed
Finding: The retrieved evidence demonstrates that maternal Tdap vaccination increases pertussis-specific antibodies that are transferred across the placenta to the infant, providing passive protection. Removal of the specific mediator (e.g., through lack of maternal vaccination or failure of placental transfer) is associated with loss of this protective effect, as antibody concentrations in the newborn correlate with maternal levels.
Cited: PMID 37520565 PMID 32054444 PMID 32482459 PMID 38497618 PMID 30758857
supporting: DTaP vaccine Pertussis mechanism Transfer specificity in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Transfer specificity not associated mechanism
pubmed · 16 hits · run 2026-09-07
9 retrieved record(s)
ambiguous 37520565 · Frontiers in immunology (2023) — Maternal vaccination: shaping the neonatal response to pertussis.
does_not_resolve 32054444 · BMC infectious diseases (2020) — Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review.
does_not_resolve 32482459 · Vaccine (2020) — Efficiency of placental transfer of vaccine-elicited antibodies relative to prenatal Tdap vaccination status.
does_not_resolve 41519134 · The Lancet. Microbe (2026) — Mucosal immune responses to Bordetella pertussis in Gambian infants after maternal and primary vaccination: an immunological substudy of a single-centre, random
does_not_resolve 37244810 · Vaccine (2023) — Impact of pregnancy on polyfunctional IgG and memory B cell responses to Tdap immunization.
does_not_resolve 22495061 · Obstetrical & gynecological survey (2012) — Influenza and tetanus, diphtheria, and acellular pertussis vaccinations during pregnancy.
does_not_resolve 38497618 · mSphere (2024) — Quantitative analysis of pertussis, tetanus, and diphtheria antibodies in sera and breast milk from Tdap vaccinated women using a qualified multiplex assay.
ambiguous 30758857 · Clinical and experimental immunology (2019) — Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy - a prospective,
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: DTaP vaccine Pertussis mechanism Depletion / knockdown in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis mechanism Add-back rescue in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: The retrieved evidence focuses on immunogenicity and antibody responses following DTaP vaccination, but none of the studies involve an experimental design where neutralization of a specific mediator (e.g., by an antibody or antagonist) is shown to block the phenotype of new pertussis after DTaP vaccination in humans or animal models. Therefore, no evidence directly addresses whether neutralizing the mediator blocks the effect.
Cited: (none)
supporting: DTaP vaccine Pertussis mechanism Neutralization in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Neutralization not associated mechanism
pubmed · 58 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 40154521 · The Lancet. Infectious diseases (2025) — The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-cent
does_not_resolve 41690287 · Vaccine (2026) — An observational, cohort, multi-centre, open label phase IV extension study comparing IPV immune responses to preschool dTaP-IPV booster vaccines in children wh
does_not_resolve 39016553 · Infection and immunity (2024) — Immunization with an mRNA DTP vaccine protects against pertussis in rats.
does_not_resolve 41151164 · Vaccine (2025) — Immunogenicity and safety of co-administration of sabin-strain-based inactivated poliovirus vaccine, diphtheria-tetanus-acellular pertussis vaccine, and live at
ambiguous 30808567 · Vaccine (2019) — Immunogenicity of pentavalent rotavirus vaccine in Chinese infants.
does_not_resolve 38276680 · Vaccines (2024) — Comparative Evaluation of Recombinant and Acellular Pertussis Vaccines in a Murine Model.
does_not_resolve 39226786 · Vaccine (2024) — Phase 1 trial of an investigational Tdap booster vaccine with CpG 1018 adjuvant compared with Boostrix in healthy adults and adolescents.
does_not_resolve 37832931 · International journal of infectious dise (2023) — Immunogenicity and safety of concomitant administration of the sabin-strain-based inactivated poliovirus vaccine, the diphtheria-tetanus-acellular pertussis vac
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 retrieved evidence evaluates an isotype control in the context of DTaP vaccine and pertussis attribution; the studies focus on immunogenicity, safety, and antibody transfer without addressing isotype controls or failure thereof.
Cited: (none)
supporting: DTaP vaccine Pertussis mechanism Isotype control in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Isotype control not associated mechanism
pubmed · 119 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 38456705 · The Pediatric infectious disease journal (2024) — Phase 3 Safety and Immunogenicity Study of a Three-dose Series of Twenty-valent Pneumococcal Conjugate Vaccine in Healthy Infants and Toddlers.
does_not_resolve 36906345 · Lancet (London, England) (2023) — Immunogenicity and safety of BPZE1, an intranasal live attenuated pertussis vaccine, versus tetanus-diphtheria-acellular pertussis vaccine: a randomised, double
does_not_resolve 42134724 · International journal of infectious dise (2026) — Maternal DTaP immunization and transplacental transfer of pertussis antibodies in Japan.
does_not_resolve 39016553 · Infection and immunity (2024) — Immunization with an mRNA DTP vaccine protects against pertussis in rats.
does_not_resolve 36685526 · Frontiers in immunology (2022) — Comparing the pertussis antibody levels of healthy children immunized with four doses of DTap-IPV/Hib (Pentaxim) combination vaccine and DTaP vaccine in Quzhou,
does_not_resolve 40232701 · Human vaccines & immunotherapeutics (2025) — A randomized, open-label study on the effect of nipocalimab on vaccine responses in healthy participants.
does_not_resolve 35927132 · Vaccine (2022) — CpG 1018® adjuvant enhances Tdap immune responses against Bordetella pertussis in mice.
does_not_resolve 30208475 · JAMA pediatrics (2018) — Immunogenicity and Safety of Monovalent Acellular Pertussis Vaccine at Birth: A Randomized Clinical Trial.
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: DTaP vaccine Pertussis Full product reproduces component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Full product reproduces no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
5 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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.
F2 · Empty vector / particleno_data
Measure: Vector/particle without antigen reproduces (or not)
Comparator: Full product
Hit rule: Effect attributed to (or excluded from) the vector/particle backbone alone
Finding: No retrieved evidence discusses DTaP vaccine, pertussis, or adverse events; the papers cover viral and bacterial vaccine vectors for influenza, cancer, and measles, not pertussis or DTaP.
Cited: (none)
supporting: DTaP vaccine Pertussis Empty vector / particle component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Empty vector / particle no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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.
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: DTaP vaccine Pertussis Antigen alone reproduces component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Antigen alone reproduces no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
5 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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: The retrieved evidence discusses virus-vectored and live bacterial vaccine vectors for influenza, measles, and cancer antigens, but does not address DTaP vaccine or pertussis, and provides no information on whether irrelevant cargo reproduces the effect of pertussis.
Cited: (none)
supporting: DTaP vaccine Pertussis Irrelevant cargo component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Irrelevant cargo no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
5 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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: Retrieved evidence discusses viral and bacterial vaccine vectors for influenza and cancer, and general immunogenicity of DTaP vaccines, but no study addresses new pertussis cases attributed to DTaP vaccine in a defined risk window after infection preparation vs product comparison.
Cited: (none)
supporting: DTaP vaccine Pertussis Infection preparation component OR antigen OR vector
pubmed · 2045286 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Infection preparation no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
does_not_resolve 33628957 · Journal of preventive medicine and hygie (2020) — Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature sh
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: DTaP vaccine Pertussis Cytokine / adjuvant mix component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Cytokine / adjuvant mix no effect component isolation
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
5 retrieved record(s)
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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 retrieved evidence addresses whether a defined combination of DTaP vaccine components reproduces an effect (such as new pertussis) that single components do not; the studies focus on immunogenicity, safety, or antibody levels of combination vaccines, not on the specific hit rule for this node.
Cited: (none)
supporting: DTaP vaccine Pertussis Component combination component OR antigen OR vector
pubmed · 2045351 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Component combination no effect component isolation
pubmed · 1 hits · run 2026-09-07
10 retrieved record(s)
does_not_resolve 18998751 · Paediatric drugs (2008) — DTaP-IPV/Hib vaccine (Pentacel).
does_not_resolve 20197476 · The Annals of pharmacotherapy (2010) — New combination vaccines: DTaP-IPV (Kinrix) and DTaP-IPV/Hib (Pentacel).
does_not_resolve 36685526 · Frontiers in immunology (2022) — Comparing the pertussis antibody levels of healthy children immunized with four doses of DTap-IPV/Hib (Pentaxim) combination vaccine and DTaP vaccine in Quzhou,
does_not_resolve 25105278 · Viruses (2014) — Virus-vectored influenza virus vaccines.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 20218334 · Uirusu (2009) — [Measles vaccine].
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: DTaP vaccine Pertussis 2D human cells animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Organoid / chip animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Block in vitro / in vivo intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis mechanism Host-line dependence in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: Intranasal (IN) and intramuscular (IM) DTaP vaccination in murine models induced distinct immune response profiles against Bordetella pertussis challenge, but the abstract does not report development of new pertussis disease attributed to the vaccine or an adverse effect in the clinical route of administration.
Cited: PMID 38323817
supporting: DTaP vaccine Pertussis Animal, clinical route animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Animal, clinical route not reproduced model
pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
ambiguous 38323817 · Infection and immunity (2024) — BECC438b TLR4 agonist supports unique immune response profiles from nasal and muscular DTaP pertussis vaccines in murine challenge models.
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: The retrieved evidence shows that acellular pertussis (aP) vaccination, including DTaP, facilitates Bordetella parapertussis infection in a rodent model, but no retrieved study examines a defined susceptible animal model for new pertussis attributed to DTaP vaccine (i.e., vaccine-attributable Pertussis) as the hit rule requires.
Cited: (none)
supporting: DTaP vaccine Pertussis Susceptible animal animal OR organoid OR cell model
pubmed · 1818622 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Susceptible animal not reproduced model
pubmed · 4 hits · run 2026-09-07
4 retrieved record(s)
does_not_resolve 30793754 · Journal of the Pediatric Infectious Dise (2019) — The 112-Year Odyssey of Pertussis and Pertussis Vaccines-Mistakes Made and Implications for the Future.
does_not_resolve 34125597 · Infection and immunity (2021) — Reinvestigating the Coughing Rat Model of Pertussis To Understand Bordetella pertussis Pathogenesis.
does_not_resolve 20200027 · Proceedings. Biological sciences (2010) — Acellular pertussis vaccination facilitates Bordetella parapertussis infection in a rodent model of bordetellosis.
does_not_resolve 29880243 · Vaccine (2018) — Effect of Tdap upon antibody response to meningococcal polysaccharide when administered before, with or after the quadrivalent meningococcal TT-conjugate vaccin
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: DTaP vaccine Pertussis Replication across labs animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: The retrieved evidence includes studies on DTaP and Tdap vaccines but none assess blinded scoring of new pertussis cases attributed to DTaP vaccination. PMID 37052897 compares retinal vascular occlusion after COVID-19, influenza, and Tdap vaccines, not pertussis; PMID 12150176 and PMID 19414694 examine pain or antibody responses, not pertussis disease outcomes.
Cited: (none)
supporting: DTaP vaccine Pertussis Blinded scoring animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis Blinded scoring not reproduced model
pubmed · 4 hits · run 2026-09-07
3 retrieved record(s)
does_not_resolve 37052897 · JAMA ophthalmology (2023) — Risk of New Retinal Vascular Occlusion After mRNA COVID-19 Vaccination Within Aggregated Electronic Health Record Data.
refutes_node 12150176 · The Pediatric infectious disease journal (2002) — Use of lidocaine-prilocaine patch to decrease intramuscular injection pain does not adversely affect the antibody response to diphtheria-tetanus-acellular pertu
does_not_resolve 19414694 · Archives of pediatrics & adolescent medi (2009) — Order of vaccine injection and infant pain response.
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: DTaP vaccine Pertussis Experimental time course animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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: DTaP vaccine Pertussis Susceptibility trait coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Pertussis 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.