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DTaP vaccine → Syncope (Fainting)

Evidence dossier · candidate cand-dtap-syncope · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that DTaP vaccine causes Syncope (Fainting), 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 windowinsufficient_datamissing: A5
C3Epidemiologic excess riskinsufficient_datamissing: B1 B2 B3
C4Consistency / replicationinsufficient_datamissing: B5 B6
C5Specificity (product / dose)insufficient_datamissing: C1n C2n
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 E5 E6 E7 E8 E9 E10 F1 …
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 new Syncope (Fainting) attributed to DTaP vaccine with onset within a pre-specified risk window after competing causes assessment. One abstract (PMID 16871116) mentions syncope as a general vaccine-related adverse event in children but does not address DTaP specifically, onset timing, or competing causes.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Case reports
pubmed · 66169 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
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.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
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
Case-certainty distribution (no established case definition): 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Series with objective confirmation
pubmed · 5642 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
11 retrieved record(s)
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
ambiguous 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
ambiguous 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.
ambiguous 32809680 · (2026) — Rubella Vaccine.
A3 · Onset histogramno_data
Measure: Distribution of onset times after dose
Comparator: Pre-specified risk window
Hit rule: Onset clusters inside the pre-specified window (not uniform/flat)
Finding: The only retrieved evidence mentioning syncope is a general review of vaccination-related adverse events in children (PMID 16871116), which lists syncope as a possible event shortly after routine immunizations, but does not specifically address DTaP vaccine or provide onset timing data. No retrieved evidence directly supports or refutes the onset histogram node for DTaP-associated syncope.
Cited: PMID 16871116
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Onset histogram
pubmed · 3 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 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.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 32809680 · (2026) — Rubella Vaccine.
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 specifically addresses DTaP vaccine and syncope (fainting) or provides onset latency data for this pair.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Temporal plausibility
pubmed · 32 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 15638050 · Clinical and experimental rheumatology (2004) — A case-series of adverse events, positive re-challenge of symptoms, and events in identical twins following hepatitis B vaccination: analysis of the Vaccine Adv
does_not_resolve 23754771 · Human psychopharmacology (2013) — Quality of case reports of adverse drug reactions with psychotropic drugs: a 25-year review.
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.
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.
A5 · Onset-interval documentationno_data
Measure: Onset interval documented in source
Comparator: Dose date
Hit rule: Onset interval is recorded (not imputed) in a primary source
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Onset-interval documentation
pubmed · 1 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
ambiguous 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.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 32809680 · (2026) — Rubella Vaccine.
A6 · Differential diagnosis excludedno_data
Measure: Competing causes assessed and excluded
Comparator: Likely alternative diagnoses
Hit rule: Pre-specified competing causes ruled out per the working definition
Finding: The retrieved evidence includes a general review of vaccination-related adverse events that mentions syncope as a common post-vaccination event in children, but it does not provide any specific evidence for DTaP vaccine causing syncope with competing causes excluded, nor does it address the node's requirement for differential diagnosis exclusion.
Case-certainty distribution (no established case definition): 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Differential diagnosis excluded
pubmed · 428 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
11 retrieved record(s)
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 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.
ambiguous 32809680 · (2026) — Rubella Vaccine.
A7 · Rechallenge / re-exposureno_data
Measure: Object recurs on a further dose
Comparator: First-dose response
Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Rechallenge / re-exposure
pubmed · 3 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
11 retrieved record(s)
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.
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.
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.
ambiguous 32809680 · (2026) — Rubella Vaccine.
A8 · Adjudicated by criteria (no established case definition)no_data
Measure: Object adjudicated by published criteria
Comparator: Published clinical / Brighton criteria
Hit rule: Cases adjudicated to 'definite' by a published criterion set
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Adjudicated by criteria
pubmed · 40 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
does_not_resolve 37775180 · Clinical medicine (London, England) (2023) — SARS-CoV-2 vaccines and myocarditis.
does_not_resolve 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.
ambiguous 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
A9 · Natural-history consistencyno_data
Measure: Course matches the object's natural history
Comparator: Known natural history of the object
Hit rule: Clinical course (onset, peak, recovery) matches the object's natural history
Finding: No retrieved evidence addresses syncope (fainting) following DTaP vaccination. One abstract (PMID 16871116) generically mentions syncope as a possible vaccine-related adverse event in children, but does not link it to DTaP specifically or describe its natural history.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series Natural-history consistency
pubmed · 104 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
10 retrieved record(s)
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.
ambiguous 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.
ambiguous 32809680 · (2026) — Rubella Vaccine.
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: The retrieved evidence does not contain any studies or reports specifically addressing syncope (fainting) following DTaP vaccination.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) case report OR case series No confounding object
pubmed · 20 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) alternative diagnosis OR not vaccine-related
pubmed · 4053 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 34312836 · Clinical pharmacology and therapeutics (2022) — Angiotensin-Converting Enzyme Inhibitors Used Concomitantly with Insulin Secretagogues and the Risk of Serious Hypoglycemia.
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.
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.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
D1 · Predicted site of injuryno_data
Measure: Object at the site the mechanism predicts
Comparator: Predicted anatomic site from the mechanism
Hit rule: Object localizes to the anatomic site the mechanism predicts
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) anatomic localization Predicted site of injury mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) anatomic localization Spared structures mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Spared structures not consistent with mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
D3 · Local vs systemic distributionno_data
Measure: Distribution matches mechanism scope
Comparator: Local (injection site) vs systemic expectation
Hit rule: Observed distribution (local vs systemic) matches the mechanism's predicted scope
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) anatomic localization Local vs systemic distribution mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Local vs systemic distribution not consistent with mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
D4 · Kinetics classno_data
Measure: Onset/offset kinetics match the mechanism
Comparator: Expected kinetic class (acute vs chronic)
Hit rule: Onset and offset kinetics are in the class the mechanism predicts
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) anatomic localization Kinetics class mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) anatomic localization Platform-mechanism match mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Targeted treatment reverses intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) No internal contradiction coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Analogy to a known object coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Latency coherence coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Pre-specification pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Contrary-evidence log pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) No temporality-only claim pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) No temporality-only claim 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
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 study focuses on identifying immune-related adverse events from immune checkpoint inhibitors using large language models and ICD codes; it does not address DTaP vaccination or syncope as an adverse event.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Passive-surveillance role pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Passive-surveillance role 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
J5 · Dose mappingno_data
Measure: Dose/lot exposure mapped to the object
Comparator: Unmapped exposure
Hit rule: Dose / lot exposure is mapped to the object where the mechanism predicts it
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Dose mapping pre-specified OR adjudicated
pubmed · 13550 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Dose mapping 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

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 direct evidence was retrieved regarding the association between DTaP vaccine and syncope (fainting). The retrieved studies focus on other vaccines (rotavirus, shingles, COVID-19, etc.) or unrelated conditions, and none report RR/IRR estimates for syncope following DTaP vaccination.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Excess vs baseline incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Excess vs baseline
pubmed · 88468 hits · run 2026-09-07
9 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 34672967 · Lancet (London, England) (2021) — Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, pha
does_not_resolve 34489307 · Gut (2022) — Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort.
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 addresses the association between DTaP vaccine and syncope (fainting) using a self-controlled case series design.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) SCCS incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk SCCS
pubmed · 88576 hits · run 2026-09-07
7 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 39795956 · International journal of molecular scien (2024) — The Potential Metalloestrogenic Effect of Aluminum on Breast Cancer Risk for Antiperspirant Users.
does_not_resolve 36696094 · JAMA cardiology (2023) — Association of Rurality With Risk of Heart Failure.
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 investigates the incidence rate ratio of syncope (fainting) following DTaP vaccination using a cohort or risk-interval design with IRR > 1, CI excluding 1, stratified by age/sex.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Cohort / risk-interval incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Cohort / risk-interval
pubmed · 88077 hits · run 2026-09-07
8 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 41284649 · PloS one (2025) — Risk of neurologic or immune-mediated adverse events after COVID-19 diagnosis in the United States.
does_not_resolve 23296494 · Molecular biology reports (2013) — Assessment of the association between GSTM1 null genotype and risk of type 2 diabetes.
does_not_resolve 23949879 · Tumour biology : the journal of the Inte (2014) — Meta-analysis of the association between GSTT1 null genotype and risk of nasopharyngeal carcinoma in Chinese.
B4 · Meta-analysis / poolingno_data
Measure: Pooled effect across studies
Comparator: Pooled estimate with heterogeneity
Hit rule: Pooled estimate > 1 (or < 1) with quantified heterogeneity (I2)
Finding: No retrieved evidence provides a pooled estimate with quantified heterogeneity for the association between DTaP vaccine and syncope (fainting). The retrieved studies focus on self-controlled case series methodology, rotavirus vaccine safety, shingles vaccine safety, COVID-19 vaccine safety, and meta-analyses on falls, mobile phone use, and other unrelated topics, none addressing DTaP vaccine or syncope.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Meta-analysis / pooling incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Meta-analysis / pooling
pubmed · 111913 hits · run 2026-09-07
11 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 29402646 · Journal of the American Medical Director (2018) — Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others.
does_not_resolve 28230042 · Journal of cancer research and therapeut (2016) — Meta-analysis of association between mobile phone use and glioma risk.
does_not_resolve 28270112 · BMC infectious diseases (2017) — A meta-analysis of stroke risk following herpes zoster infection.
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 addresses syncope (fainting) as an adverse event after DTaP vaccination, nor does any study evaluate DTaP vaccine safety in relation to negative-control outcomes.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Negative-control outcomes incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Negative-control outcomes
pubmed · 88279 hits · run 2026-09-07
9 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 38833248 · JAMA network open (2024) — Valproate Use During Spermatogenesis and Risk to Offspring.
does_not_resolve 42486607 · BMJ (Clinical research ed.) (2026) — Risk of hair loss associated with glucagon-like peptide-1 receptor agonists in adults with type 2 diabetes: target trial emulation.
B6 · Other-antigen comparisonno_data
Measure: Risk vs a different-antigen comparator
Comparator: Comparator product with a different antigen
Hit rule: Risk specific to the target antigen, not shared with the comparator antigen
Finding: No evidence found. The retrieved studies include self-controlled case series on vaccine safety but none address syncope (fainting) after DTaP vaccination or compare risk across different antigens.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Other-antigen comparison incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Other-antigen comparison
pubmed · 88041 hits · run 2026-09-07
8 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 23296494 · Molecular biology reports (2013) — Assessment of the association between GSTM1 null genotype and risk of type 2 diabetes.
does_not_resolve 23949879 · Tumour biology : the journal of the Inte (2014) — Meta-analysis of the association between GSTT1 null genotype and risk of nasopharyngeal carcinoma in Chinese.
does_not_resolve 24136740 · Tumour biology : the journal of the Inte (2014) — Association between glutathione S-transferase M1 null genotype and risk of gallbladder cancer: a meta-analysis.
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 study reports an absolute risk (per-100k) of syncope (fainting) following DTaP vaccination within a specified risk window.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Absolute risk incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Absolute risk
pubmed · 111314 hits · run 2026-09-07
12 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 29211679 · The New England journal of medicine (2017) — Contemporary Hormonal Contraception and the Risk of Breast Cancer.
does_not_resolve 23484825 · The New England journal of medicine (2013) — Risk of ischemic heart disease in women after radiotherapy for breast cancer.
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 directly addresses the risk of syncope (fainting) following DTaP vaccination, nor does any study examine this outcome by vaccine platform or product.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Platform split incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Platform split
pubmed · 88106 hits · run 2026-09-07
7 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 36370744 · The Lancet. Child & adolescent health (2023) — Cancer risk with topical calcineurin inhibitors, pimecrolimus and tacrolimus, for atopic dermatitis: a systematic review and meta-analysis.
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 contain any studies specifically examining the association between DTaP vaccine and syncope (fainting), nor any data stratified by host structure such as age or sex for this outcome. The only epidemiologic study designs mentioned (self-controlled case series) are not applied to the DTaP-syncope pair in the provided abstracts.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Host-structure stratification incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Host-structure stratification
pubmed · 88039 hits · run 2026-09-07
6 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 23296494 · Molecular biology reports (2013) — Assessment of the association between GSTM1 null genotype and risk of type 2 diabetes.
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change
Comparator: Pre- vs post-change formulation
Hit rule: Risk change tracks a documented formulation / component change over time
Finding: The retrieved evidence includes systematic reviews and self-controlled case series studies on vaccine safety methodology and specific vaccines (rotavirus, Shingrix, COVID-19, etc.), but none of the abstracts address a formulation/component change in DTaP vaccine or any risk change for syncope (fainting) following DTaP vaccination.
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Formulation / component change incidence risk cohort OR self-controlled case series
pubmed · 945 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no association OR null OR no increased risk Formulation / component change
pubmed · 88201 hits · run 2026-09-07
8 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 21992535 · Nutrition journal (2011) — Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and
does_not_resolve 41092926 · Lancet (London, England) (2025) — Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 su
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 Syncope (Fainting) Formulation natural experiment intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Policy / pause signal intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Infection coherence coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Dose strength gradient dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no dose effect OR no dose-response Dose strength gradient
pubmed · 112 hits · run 2026-09-07
1 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.
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 Syncope (Fainting) Dose number gradient dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no dose effect OR no dose-response Dose number gradient
pubmed · 556 hits · run 2026-09-07
4 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 30316563 · Radiotherapy and oncology : journal of t (2019) — Volume effects of radiotherapy on the risk of second primary cancers: A systematic review of clinical and epidemiological studies.
does_not_resolve 37920999 · Trauma, violence & abuse (2024) — Association Between Adverse Childhood Experiences and Opioid Use-Related Behaviors: A Systematic Review.
does_not_resolve 42106826 · The international journal of behavioral (2026) — Physical activity, falls, and dementia risk in adults aged ≥ 60: evidence from three cohorts.
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 Syncope (Fainting) Measured-exposure tertiles dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no dose effect OR no dose-response Measured-exposure tertiles
pubmed · 1 hits · run 2026-09-07
1 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.
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 Syncope (Fainting) Organoid concentration curve dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no dose effect OR no dose-response Organoid concentration curve
pubmed · 12 hits · run 2026-09-07
1 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.
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 Syncope (Fainting) EC50 vs Cmax coherence dose-response OR dose effect
pubmed · 1299174 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) no dose effect OR no dose-response EC50 vs Cmax coherence
pubmed · 1 hits · run 2026-09-07
1 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.
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 Syncope (Fainting) mechanism Mediator identified in cases in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Mediator identified in cases not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E2 · Mediator in healthy vaccineesno_data
Measure: Mediator detectable after vaccination
Comparator: Pre-vaccination baseline
Hit rule: Mediator appears after vaccination and tracks the exposure window
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Mediator in healthy vaccinees in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Mediator in healthy vaccinees not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E3 · Infection contrastno_data
Measure: Mediator absent/low after natural infection
Comparator: Recovered natural infection
Hit rule: Mediator signal is specific to vaccination vs a comparable natural-infection control
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Infection contrast in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Infection contrast not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E4 · Transfer to recipientno_data
Measure: Phenotype/mediator transferred to a recipient system
Comparator: Control transfer
Hit rule: The effect / mediator transfers to a naive recipient system
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Transfer to recipient in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Transfer to recipient not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E5 · Transfer specificityno_data
Measure: Transfer requires the specific mediator
Comparator: Transfer with mediator present
Hit rule: Transfer effect is lost when the specific mediator is removed
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Transfer specificity in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Transfer specificity not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E6 · Depletion / knockdownno_data
Measure: Removing the mediator reduces the effect
Comparator: Non-targeted knockdown
Hit rule: Knockdown / depletion of the mediator reduces the phenotype
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Depletion / knockdown in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) mechanism Add-back rescue in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Add-back rescue not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E8 · Neutralizationno_data
Measure: Neutralizing the mediator blocks the effect
Comparator: Isotype control
Hit rule: Neutralization of the mediator (not an isotype control) blocks the phenotype
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Neutralization in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Neutralization not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
E9 · Isotype controlno_data
Measure: Isotype control does not reproduce the effect
Comparator: Active antibody
Hit rule: An isotype control fails to reproduce the block/activation
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) mechanism Isotype control in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Isotype control not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
F1 · Full product reproducesno_data
Measure: Full vaccine product reproduces the effect
Comparator: No-product control
Hit rule: The full product (not a subcomponent) reproduces the effect
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Full product reproduces component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Empty vector / particle component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Empty vector / particle 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.
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 Syncope (Fainting) Antigen alone reproduces component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Irrelevant cargo component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Irrelevant cargo 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.
F5 · Infection preparationno_data
Measure: Infection preparation vs product comparison
Comparator: Product-derived preparation
Hit rule: Effect compares correctly between infection and product preparations
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Infection preparation component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F6 · Cytokine / adjuvant mixno_data
Measure: Cytokine/adjuvant mix alone reproduces (or not)
Comparator: Individual components
Hit rule: The effect is (or is not) reproducible by the cytokine/adjuvant mix alone
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Cytokine / adjuvant mix component OR antigen OR vector
pubmed · 2045284 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Component combination component OR antigen OR vector
pubmed · 2045285 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Component combination 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.
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 Syncope (Fainting) 2D human cells animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Organoid / chip animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Block in vitro / in vivo intervention OR treatment OR reversal
pubmed · 15142089 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) mechanism Host-line dependence in vitro OR patient-derived
pubmed · 29243 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Host-line dependence not associated mechanism
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G3 · Animal, clinical routeno_data
Measure: Effect in animal via the clinical route of administration
Comparator: Vehicle, same route
Hit rule: Effect reproduced in an animal using the clinical route of administration
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Animal, clinical route animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Animal, clinical route not reproduced model
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G4 · Susceptible animalno_data
Measure: Effect in a susceptible animal model
Comparator: Non-susceptible model
Hit rule: Effect in a defined susceptible animal model
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Susceptible animal animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Susceptible animal not reproduced model
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G5 · Replication across labsno_data
Measure: Effect replicated in an independent lab
Comparator: Original result
Hit rule: The key effect is replicated in an independent laboratory
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Replication across labs animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Replication across labs not reproduced model
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G6 · Blinded scoringno_data
Measure: Outcomes scored blinded
Comparator: Unblinded reference
Hit rule: Primary outcomes scored by a blinded assessor
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Blinded scoring animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) Blinded scoring not reproduced model
pubmed · 0 hits (0 hits — negative) · run 2026-09-07
G7 · Experimental time courseno_data
Measure: Effect follows a defined experimental time course
Comparator: No-exposure time course
Hit rule: The effect's onset/offset follows a defined experimental time course
Finding: no evidence found
Cited: (none)
supporting: DTaP vaccine Syncope (Fainting) Experimental time course animal OR organoid OR cell model
pubmed · 1818620 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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 Syncope (Fainting) Susceptibility trait coherence OR latency OR susceptibility
pubmed · 870055 hits · run 2026-09-07
mirror: DTaP vaccine Syncope (Fainting) 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.