Evidence dossier · candidate cand-hpv-caesarean-section · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that HPV vaccine causes Caesarean section, and not an incidence or legal finding. All evidence is flagged needs_human_review and must be reviewed before any page is published or cited. Every value is grounded in retrieved citations (PMID + retrieval date); unsourced items read "no evidence found / not assessable". Symmetric search: every supporting query has a mirror/null query, and zeros are shown (negative dossiers report the absence of signal).
Claim matrix (C1–C6, computed)
Claim
Label
Status
Missing nodes
C1
Coherent clinical object exists
insufficient_data
missing: A1 A2
C2
Consistent temporal window
insufficient_data
missing: A5
C3
Epidemiologic excess risk
insufficient_data
missing: B2 B3
C4
Consistency / replication
insufficient_data
missing: B5 B6
C5
Specificity (product / dose)
insufficient_data
missing: C1n C2n
C6
Biological mechanism
insufficient_data
missing: E1
Two evidentiary bars apply to the epi nodes/claims (C3, C4): · VICP — preponderance of the evidence. · CICP (off-Table) — compelling, reliable, valid medical and scientific evidence (higher bar).
Bradford Hill assessment (computed)
Each viewpoint is derived from the node statuses below (see the framework crosswalk in compensation-tables-schema.md §8). Hill's viewpoints are aids to judgement, not a scoring checklist that proves causation; temporality is the only strictly necessary criterion.
Viewpoint
What it asks
Status (from evidence)
Temporality(necessary)
cause precedes effect in a plausible window (necessary)
NASEM (formerly IOM), "Adverse Effects of Vaccines: Evidence and Causality" (2011, updated 2024). Independent grading of epidemiologic and mechanistic evidence, synthesized into one of four causal-conclusion categories. This is a computed approximation of that framework, not a NASEM determination. See compensation-tables-schema.md §8bis.
Case-definition standard: no established case definition (needs_human_review — not in spec §1's named-standard list) — governs the case-certainty scale on A1/A2/A6/A8 below. See compensation-tables-schema.md §8ter.
Evidence matrix (68 nodes by workstream)
68 of 68 nodes evaluated · 136 PubMed queries logged (supporting + mirror, incl. zeros). Statuses are computed from retrieved citations; not hand-set.
Definition & attribution 24/24 evaluated
A1 · Case reportsno_data
Measure: New definite object in risk window T Comparator: Pre-vaccination baseline Hit rule: Definite object present, onset in window, competing causes considered
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series Case reports pubmed · 66197 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
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: HPV vaccine Caesarean section case report OR case series Series with objective confirmation pubmed · 5647 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
does_not_resolve 7114977 · Archives of internal medicine (1982) — Vaccine-related poliomyelitis.
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 evidence retrieved directly links HPV vaccine to Caesarean section or provides onset histogram data for such an association.
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series Onset histogram pubmed · 3 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
Measure: Onset latency vs object pathophysiology Comparator: Object's known natural latency Hit rule: Onset latency consistent with the object's pathophysiology
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series Temporal plausibility pubmed · 32 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
ambiguous 7114977 · Archives of internal medicine (1982) — Vaccine-related poliomyelitis.
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: HPV vaccine Caesarean section case report OR case series Differential diagnosis excluded pubmed · 428 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
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 an association between HPV vaccine and Caesarean section.
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series Adjudicated by criteria pubmed · 40 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
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 evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series Natural-history consistency pubmed · 104 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
ambiguous 30000765 · (2006) — Human Papillomavirus Vaccines.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
ambiguous 7114977 · Archives of internal medicine (1982) — Vaccine-related poliomyelitis.
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 evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section case report OR case series No confounding object pubmed · 20 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section alternative diagnosis OR not vaccine-related pubmed · 4053 hits · run 2026-09-09
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.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
ambiguous 32809680 · (2026) — Rubella Vaccine.
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: HPV vaccine Caesarean section anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
mirror: HPV vaccine Caesarean section Predicted site of injury not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D2 · Spared structuresno_data
Measure: Structures the mechanism should spare are spared Comparator: Structures predicted unaffected Hit rule: Structures predicted spared by the mechanism are indeed spared
mirror: HPV vaccine Caesarean section Spared structures not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
mirror: HPV vaccine Caesarean section Local vs systemic distribution not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D4 · Kinetics classno_data
Measure: Onset/offset kinetics match the mechanism Comparator: Expected kinetic class (acute vs chronic) Hit rule: Onset and offset kinetics are in the class the mechanism predicts
mirror: HPV vaccine Caesarean section Kinetics class not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D5 · Platform-mechanism matchno_data
Measure: Mechanism is consistent with the platform Comparator: Mechanistic expectation for the platform Hit rule: The proposed mechanism is biologically consistent with the vaccine platform
mirror: HPV vaccine Caesarean section Platform-mechanism match not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
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: HPV vaccine Caesarean section No internal contradiction coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section No internal contradiction inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
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: HPV vaccine Caesarean section Analogy to a known object coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Analogy to a known object inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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: HPV vaccine Caesarean section Latency coherence coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Latency coherence inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 8550283 · International journal of epidemiology (1995) — Minimum attack rate for measuring measles vaccine efficacy.
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
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 retrieved evidence addresses pre-specification of risk windows or hit rules for HPV vaccine and Caesarean section.
Cited: (none)
supporting: HPV vaccine Caesarean section Pre-specification pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Pre-specification post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
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
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: HPV vaccine Caesarean section Contrary-evidence log pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
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: HPV vaccine Caesarean section No temporality-only claim pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
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
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 does not mention HPV vaccine, Caesarean section, or passive surveillance; it focuses on immune checkpoint inhibitors and drug-induced acute kidney injury, with no relevance to the specified pair or node.
Cited: (none)
supporting: HPV vaccine Caesarean section Passive-surveillance role pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
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
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: HPV vaccine Caesarean section Dose mapping pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Dose mapping post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
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
Measure: RR/IRR vs unexposed or prior window Comparator: Unvaccinated person-time or pre-vaccination window Hit rule: RR/IRR > 1 with CI excluding 1 after pre-specified confounders
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Excess vs baseline pubmed · 88504 hits · run 2026-09-09
refutes_node 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 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 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: 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 addresses an association between HPV vaccine and Caesarean section using a self-controlled case series design.
Cited: (none)
supporting: HPV vaccine Caesarean section SCCS incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk SCCS pubmed · 88614 hits · run 2026-09-09
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 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 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: 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 20643726 · Pediatrics (2010) — Lack of association between acellular pertussis vaccine and seizures in early childhood.
B3 · Cohort / risk-intervalno_data
Measure: Incidence rate ratio in defined window Comparator: Pre-specified risk vs comparison interval Hit rule: IRR > 1 in the pre-specified window, CI excluding 1, stratified by age/sex
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Cohort / risk-interval pubmed · 88113 hits · run 2026-09-09
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
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 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.
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 directly addresses a meta-analysis or pooled estimate for the association between HPV vaccine and Caesarean section. The retrieved studies focus on shingles after Shingrix, SCCS methodology, rotavirus vaccine safety, COVID-19 vaccine safety, fall-risk drugs, bisphosphonates and lung cancer, and GSTT1 genotype and nasopharyngeal carcinoma.
Cited: (none)
supporting: HPV vaccine Caesarean section Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Meta-analysis / pooling pubmed · 111971 hits · run 2026-09-09
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 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 33429726 · Medicine (2021) — Bisphosphonates and risk of lung cancer: Protocol for a systematic review and meta-analysis.
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.
B5 · Negative-control outcomesno_data
Measure: No excess for outcomes the vaccine should not cause Comparator: Negative-control outcomes (unaffected by mechanism) Hit rule: Null for negative-control outcomes while target outcome is positive (specificity)
Finding: No evidence was retrieved that directly addresses the association between HPV vaccine and Caesarean section. The retrieved studies focus on shingles after Shingrix, methodology of self-controlled case series, rotavirus vaccine safety, COVID-19 vaccine safety, and valproate use, none of which involve HPV vaccine or Caesarean section as an outcome.
Cited: (none)
supporting: HPV vaccine Caesarean section Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Negative-control outcomes pubmed · 88315 hits · run 2026-09-09
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 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.
B6 · Other-antigen comparisonno_data
Measure: Risk vs a different-antigen comparator Comparator: Comparator product with a different antigen Hit rule: Risk specific to the target antigen, not shared with the comparator antigen
Finding: The retrieved evidence includes studies on self-controlled case series (SCCS) design for vaccine safety (e.g., shingles, rotavirus, COVID-19 vaccines) and a meta-analysis on GSTT1 null genotype and nasopharyngeal carcinoma, but none address HPV vaccine or Caesarean section as an adverse event.
Cited: (none)
supporting: HPV vaccine Caesarean section Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Other-antigen comparison pubmed · 88077 hits · run 2026-09-09
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
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.
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 addresses the absolute risk of Caesarean section following HPV vaccination.
Cited: (none)
supporting: HPV vaccine Caesarean section Absolute risk incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Absolute risk pubmed · 111371 hits · run 2026-09-09
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 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.
does_not_resolve 26950145 · Nutrients (2016) — An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity.
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 addresses HPV vaccine-attributable Caesarean section risk by vaccine platform or product. All retrieved studies focus on shingles, zoster, rotavirus, or COVID-19 vaccines, using self-controlled case series designs but not HPV vaccine or Caesarean section outcomes.
Cited: (none)
supporting: HPV vaccine Caesarean section Platform split incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Platform split pubmed · 88142 hits · run 2026-09-09
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 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 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
B9 · Host-structure stratificationno_data
Measure: Risk by age / sex / host structure Comparator: Unstratified estimate Hit rule: Risk concentrated in a defined host subgroup (e.g. young males), stable across sources
Finding: No retrieved evidence addresses the question of HPV vaccine and Caesarean section risk, nor does it examine host-structure stratification for this pair.
Cited: (none)
supporting: HPV vaccine Caesarean section Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Host-structure stratification pubmed · 88075 hits · run 2026-09-09
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
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.
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change Comparator: Pre- vs post-change formulation Hit rule: Risk change tracks a documented formulation / component change over time
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no association OR null OR no increased risk Formulation / component change pubmed · 88237 hits · run 2026-09-09
does_not_resolve 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 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 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
does_not_resolve 41092926 · Lancet (London, England) (2025) — Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 su
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: The retrieved evidence discusses reversal agents for novel oral anticoagulants (NOACs) and does not mention HPV vaccine, Caesarean section, or any formulation change related to HPV vaccination.
Cited: (none)
supporting: HPV vaccine Caesarean section Formulation natural experiment intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
does_not_resolve 26937198 · Vascular health and risk management (2016) — Reversing anticoagulant effects of novel oral anticoagulants: role of ciraparantag, andexanet alfa, and idarucizumab.
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: HPV vaccine Caesarean section Policy / pause signal intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Policy / pause signal no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-09
1 retrieved record(s)
does_not_resolve 26937198 · Vascular health and risk management (2016) — Reversing anticoagulant effects of novel oral anticoagulants: role of ciraparantag, andexanet alfa, and idarucizumab.
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: HPV vaccine Caesarean section Infection coherence coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Infection coherence inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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: HPV vaccine Caesarean section Dose strength gradient dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no dose effect OR no dose-response Dose strength gradient pubmed · 112 hits · run 2026-09-09
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 retrieved evidence addresses the relationship between HPV vaccine dose number (1st, 2nd, 3rd) and Caesarean section risk.
Cited: (none)
supporting: HPV vaccine Caesarean section Dose number gradient dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no dose effect OR no dose-response Dose number gradient pubmed · 557 hits · run 2026-09-09
3 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 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 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: HPV vaccine Caesarean section Measured-exposure tertiles dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no dose effect OR no dose-response Measured-exposure tertiles pubmed · 1 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
refutes_node 20836123 · Birth defects research. Part B, Developm (2010) — Lack of effects on male fertility from a quadrivalent HPV vaccine in Sprague-Dawley rats.
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: HPV vaccine Caesarean section Organoid concentration curve dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no dose effect OR no dose-response Organoid concentration curve pubmed · 12 hits · run 2026-09-09
2 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 20836123 · Birth defects research. Part B, Developm (2010) — Lack of effects on male fertility from a quadrivalent HPV vaccine in Sprague-Dawley rats.
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: HPV vaccine Caesarean section EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 1 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
refutes_node 20836123 · Birth defects research. Part B, Developm (2010) — Lack of effects on male fertility from a quadrivalent HPV vaccine in Sprague-Dawley rats.
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: HPV vaccine Caesarean section mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Mediator identified in cases not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Mediator in healthy vaccinees not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Infection contrast in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Transfer to recipient not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Transfer specificity in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Transfer specificity not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Add-back rescue in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Neutralization in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Neutralization not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Isotype control in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Isotype control not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Full product reproduces component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-09
does_not_resolve 15174971 · Expert opinion on biological therapy (2004) — Particle-mediated DNA vaccine delivery to the skin.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 25142448 · Current gene therapy (2014) — Improving DNA vaccine performance through vector design.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F2 · Empty vector / particleno_data
Measure: Vector/particle without antigen reproduces (or not) Comparator: Full product Hit rule: Effect attributed to (or excluded from) the vector/particle backbone alone
Finding: Retrieved abstracts discuss virus-vectored influenza vaccines, live bacterial vaccine vectors, measles vaccine, adenovirus-vectored vaccines, lentiviral vector rabies vaccines, and viral vector-based cancer vaccines, but none address HPV vaccine, Caesarean section, or adverse events attributed to an empty vector/particle backbone.
Cited: (none)
supporting: HPV vaccine Caesarean section Empty vector / particle component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 15174971 · Expert opinion on biological therapy (2004) — Particle-mediated DNA vaccine delivery to the skin.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 25142448 · Current gene therapy (2014) — Improving DNA vaccine performance through vector design.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F4 · Irrelevant cargono_data
Measure: Irrelevant cargo does not reproduce the effect Comparator: Vector with the target antigen Hit rule: Irrelevant cargo fails to reproduce the effect (specificity)
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section Irrelevant cargo component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 15174971 · Expert opinion on biological therapy (2004) — Particle-mediated DNA vaccine delivery to the skin.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 25142448 · Current gene therapy (2014) — Improving DNA vaccine performance through vector design.
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: HPV vaccine Caesarean section Infection preparation component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
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: HPV vaccine Caesarean section Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 15174971 · Expert opinion on biological therapy (2004) — Particle-mediated DNA vaccine delivery to the skin.
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 25142448 · Current gene therapy (2014) — Improving DNA vaccine performance through vector design.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F7 · Component combinationno_data
Measure: Defined component combination reproduces the effect Comparator: Single components Hit rule: A defined combination reproduces the effect that single components do not
Finding: no evidence found
Cited: (none)
supporting: HPV vaccine Caesarean section Component combination component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
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: HPV vaccine Caesarean section 2D human cells animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section 2D human cells not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Organoid / chip animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Organoid / chip not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Block in vitro / in vivo no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section mechanism Host-line dependence in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
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: HPV vaccine Caesarean section Animal, clinical route animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Animal, clinical route not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Susceptible animal animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Susceptible animal not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Replication across labs animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Replication across labs not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Blinded scoring animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Blinded scoring not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Experimental time course animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Experimental time course not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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: HPV vaccine Caesarean section Susceptibility trait coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: HPV vaccine Caesarean section Susceptibility trait inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 8550283 · International journal of epidemiology (1995) — Minimum attack rate for measuring measles vaccine efficacy.
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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.