Evidence dossier · candidate cand-mmr-arthralgia · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that MMR vaccine causes Arthralgia, 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: B1 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: MMR vaccine Arthralgia case report OR case series Case reports pubmed · 66161 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
A2 · Series with objective confirmationno_data
Measure: Definite object plus objective test Comparator: Reference range / diagnostic criteria Hit rule: Objective confirmation in >=1 case per the working definition
Finding: No evidence found for MMR vaccine-related arthralgia with objective confirmation in the retrieved set.
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Series with objective confirmation pubmed · 5642 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
A3 · Onset histogramno_data
Measure: Distribution of onset times after dose Comparator: Pre-specified risk window Hit rule: Onset clusters inside the pre-specified window (not uniform/flat)
Finding: No retrieved evidence addresses MMR vaccine and arthralgia, or provides an onset histogram for arthralgia after MMR vaccination.
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Onset histogram pubmed · 3 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
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: The retrieved evidence contains no studies that address onset latency of arthralgia after MMR vaccination; the only relevant abstract (PMID 15638050) concerns hepatitis B vaccine and arthritis, not MMR or arthralgia, and no other cited PMIDs provide data on MMR vaccine and arthralgia.
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Temporal plausibility pubmed · 32 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
12 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
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
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 retrieved evidence addresses MMR vaccine-related arthralgia or the exclusion of competing causes for this outcome.
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Differential diagnosis excluded pubmed · 428 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
A7 · Rechallenge / re-exposureno_data
Measure: Object recurs on a further dose Comparator: First-dose response Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: No retrieved evidence addresses rechallenge or re-exposure of arthralgia following MMR vaccination. The retrieved studies pertain to COVID-19 vaccine-related myositis, myocarditis, pericarditis, menstrual changes, autoimmune hepatitis, and other vaccines (HPV, monkeypox, rubella, polio) but do not report on MMR vaccine rechallenge or recurrence of arthralgia after a subsequent dose.
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Rechallenge / re-exposure pubmed · 3 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
does_not_resolve 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
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: MMR vaccine Arthralgia case report OR case series Adjudicated by criteria pubmed · 40 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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 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 40927603 · Journal of healthcare, science and the h (2024) — The Effects of Covid-19 Vaccination on Menstruation: Are women with underlying reproductive health conditions, particularly black women at a higher risk for vac
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 evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia case report OR case series Natural-history consistency pubmed · 104 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 23041539 · Clinical gastroenterology and hepatology (2012) — Association between nonalcoholic fatty liver disease and risk for hepatocellular cancer, based on systematic 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.
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: MMR vaccine Arthralgia case report OR case series No confounding object pubmed · 20 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia alternative diagnosis OR not vaccine-related pubmed · 4052 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.
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.
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: MMR vaccine Arthralgia anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: MMR vaccine Arthralgia Predicted site of injury not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
D2 · Spared structuresno_data
Measure: Structures the mechanism should spare are spared Comparator: Structures predicted unaffected Hit rule: Structures predicted spared by the mechanism are indeed spared
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia anatomic localization Kinetics class mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia anatomic localization Platform-mechanism match mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
Measure: No node's finding contradicts another Comparator: Internal consistency across nodes Hit rule: No evaluated node directly contradicts another (coherence)
Finding: no evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia No internal contradiction coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Analogy to a known object coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Latency coherence coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Pre-specification pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia Pre-specification post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
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: MMR vaccine Arthralgia Contrary-evidence log pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 40742144 · Journal of clinical sleep medicine : JCS (2025) — Association of weekend catch-up sleep with the atherosclerotic cardiovascular disease risk score: a hypothesis-generating study from US and Korean National Heal
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: MMR vaccine Arthralgia No temporality-only claim pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
J4 · Passive-surveillance roleno_data
Measure: Passive-surveillance findings bounded correctly Comparator: Active-surveillance confirmation Hit rule: Passive-surveillance signals are framed as hypothesis-generating, not confirmatory
Finding: no evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia Passive-surveillance role pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 40742144 · Journal of clinical sleep medicine : JCS (2025) — Association of weekend catch-up sleep with the atherosclerotic cardiovascular disease risk score: a hypothesis-generating study from US and Korean National Heal
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: MMR vaccine Arthralgia Dose mapping pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia Dose mapping post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 40742144 · Journal of clinical sleep medicine : JCS (2025) — Association of weekend catch-up sleep with the atherosclerotic cardiovascular disease risk score: a hypothesis-generating study from US and Korean National Heal
Epidemiologic chassis 13/13 evaluated
B1 · Excess vs baselineno_data
Measure: RR/IRR vs unexposed or prior window Comparator: Unvaccinated person-time or pre-vaccination window Hit rule: RR/IRR > 1 with CI excluding 1 after pre-specified confounders
Finding: no evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Excess vs baseline pubmed · 88469 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 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 42264391 · Diabetes research and clinical practice (2026) — The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
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.
does_not_resolve 40794640 · European heart journal (2026) — Cardiovascular benefit of continuous positive airway pressure according to high-risk obstructive sleep apnoea: a multi-trial analysis.
does_not_resolve 33627370 · Pediatrics (2021) — A Prevention Program for Insomnia in At-risk Adolescents: A Randomized Controlled Study.
B2 · SCCSno_data
Measure: Self-controlled case series risk ratio Comparator: Individuals' own risk intervals (no-event) Hit rule: SCCS risk ratio > 1 in the post-vaccination window, CI excluding 1
Finding: no evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia SCCS incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk SCCS pubmed · 88577 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 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 42264391 · Diabetes research and clinical practice (2026) — The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
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 42661284 · Expert review of vaccines (2026) — Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.
does_not_resolve 27882625 · Head & neck (2017) — Review of high-risk features of cutaneous squamous cell carcinoma and discrepancies between the American Joint Committee on Cancer and NCCN Clinical Practice Gu
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 study directly addresses the MMR vaccine-arthralgia pair or provides an incidence rate ratio with a confidence interval excluding 1 in a pre-specified risk window stratified by age/sex. The retrieved evidence includes methodological reviews and SCCS studies of other vaccines (shingles, COVID-19, rotavirus) but not MMR vaccine or arthralgia.
Cited: (none)
supporting: MMR vaccine Arthralgia Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Cohort / risk-interval pubmed · 88078 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 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
ambiguous 22709951 · Vaccine (2012) — Vaccine and Immunization Surveillance in Ontario (VISION) - using linked health administrative databases to monitor vaccine safety.
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 provides a pooled estimate with quantified heterogeneity (I2) for the association between MMR vaccine and arthralgia.
Cited: (none)
supporting: MMR vaccine Arthralgia Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Meta-analysis / pooling pubmed · 111909 hits · run 2026-09-07
10 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 42264391 · Diabetes research and clinical practice (2026) — The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 42661284 · Expert review of vaccines (2026) — Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.
does_not_resolve 34933893 · BMJ (Clinical research ed.) (2021) — Respiratory tract infection and risk of bleeding in oral anticoagulant users: self-controlled case series.
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 29402646 · Journal of the American Medical Director (2018) — Fall-Risk-Increasing Drugs: A Systematic Review and Meta-analysis: III. Others.
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 the risk of arthralgia after MMR vaccination; the available studies focus on other vaccines and outcomes such as intussusception, stroke, shingles, type 1 diabetes, and hair loss.
Cited: (none)
supporting: MMR vaccine Arthralgia Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Negative-control outcomes pubmed · 88280 hits · run 2026-09-07
8 retrieved record(s)
ambiguous 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 42264391 · Diabetes research and clinical practice (2026) — The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 42661284 · Expert review of vaccines (2026) — Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.
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 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: The retrieved evidence does not provide any data on the risk of arthralgia specifically following MMR vaccination compared with a different-antigen comparator. The studies focus on self-controlled case series methodology, COVID-19 mRNA vaccines, shingles vaccine, and genetic associations with diabetes and cancer, none of which address the MMR vaccine or arthralgia.
Cited: (none)
supporting: MMR vaccine Arthralgia Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Other-antigen comparison pubmed · 88042 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 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 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 22622525 · Journal of assisted reproduction and gen (2012) — GSTM1 null genotype contributes to increased risk of male infertility: 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 evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia Absolute risk incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Absolute risk pubmed · 111309 hits · run 2026-09-07
14 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 34933893 · BMJ (Clinical research ed.) (2021) — Respiratory tract infection and risk of bleeding in oral anticoagulant users: self-controlled case series.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 22709951 · Vaccine (2012) — Vaccine and Immunization Surveillance in Ontario (VISION) - using linked health administrative databases to monitor vaccine safety.
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 addresses arthralgia after MMR vaccination or any risk attributable to a vaccine platform. The retrieved studies focus on self-controlled case series methodology and outcomes unrelated to MMR vaccine or arthralgia (e.g., type 1 diabetes, intussusception, shingles, stroke, bleeding, cancer).
Cited: (none)
supporting: MMR vaccine Arthralgia Platform split incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Platform split pubmed · 88107 hits · run 2026-09-07
10 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 42264391 · Diabetes research and clinical practice (2026) — The risk of type 1 diabetes mellitus after COVID-19 and influenza infection: A nationwide cohort and self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 42661284 · Expert review of vaccines (2026) — Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.
does_not_resolve 34933893 · BMJ (Clinical research ed.) (2021) — Respiratory tract infection and risk of bleeding in oral anticoagulant users: self-controlled case series.
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 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: No retrieved evidence addresses risk of arthralgia after MMR vaccination stratified by host structure (age, sex, or other subgroup). The available studies focus on unrelated vaccines or outcomes (e.g., shingles, bleeding, intussusception, COVID-19 mRNA vaccine adverse events, and genetic associations with diabetes or cancer).
Cited: (none)
supporting: MMR vaccine Arthralgia Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Host-structure stratification pubmed · 88040 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 34933893 · BMJ (Clinical research ed.) (2021) — Respiratory tract infection and risk of bleeding in oral anticoagulant users: self-controlled case series.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 22709951 · Vaccine (2012) — Vaccine and Immunization Surveillance in Ontario (VISION) - using linked health administrative databases to monitor vaccine safety.
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.
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: MMR vaccine Arthralgia Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no association OR null OR no increased risk Formulation / component change pubmed · 88202 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 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 22709951 · Vaccine (2012) — Vaccine and Immunization Surveillance in Ontario (VISION) - using linked health administrative databases to monitor vaccine safety.
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
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.
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: MMR vaccine Arthralgia Formulation natural experiment intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
does_not_resolve 38189107 · Expert review of vaccines (2024) — Neoadjuvant personalized cancer vaccines: the final frontier?
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: MMR vaccine Arthralgia Policy / pause signal intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Infection coherence coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Dose strength gradient dose-response OR dose effect pubmed · 1299132 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Dose number gradient dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no dose effect OR no dose-response Dose number gradient pubmed · 556 hits · run 2026-09-07
3 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 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: MMR vaccine Arthralgia Measured-exposure tertiles dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no dose effect OR no dose-response Measured-exposure tertiles pubmed · 1 hits · run 2026-09-07
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.
supports_node 11061799 · Pediatrics (2000) — Day-to-day reactogenicity and the healthy vaccinee effect of measles-mumps-rubella vaccination.
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: MMR vaccine Arthralgia Organoid concentration curve dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no dose effect OR no dose-response Organoid concentration curve pubmed · 12 hits · run 2026-09-07
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.
supports_node 11061799 · Pediatrics (2000) — Day-to-day reactogenicity and the healthy vaccinee effect of measles-mumps-rubella vaccination.
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: MMR vaccine Arthralgia EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 1 hits · run 2026-09-07
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.
supports_node 11061799 · Pediatrics (2000) — Day-to-day reactogenicity and the healthy vaccinee effect of measles-mumps-rubella vaccination.
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: MMR vaccine Arthralgia mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Infection contrast in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Transfer specificity in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
Measure: Adding the mediator restores the effect Comparator: Add-back of a control protein Hit rule: Adding back the mediator (not a control) restores the phenotype
Finding: no evidence found
Cited: (none)
supporting: MMR vaccine Arthralgia mechanism Add-back rescue in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Neutralization in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Isotype control in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Full product reproduces component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
6 retrieved record(s)
does_not_resolve 29550258 · Immunology letters (2018) — Live bacterial vaccine vector and delivery strategies of heterologous antigen: A review.
does_not_resolve 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.
F2 · Empty vector / particleno_data
Measure: Vector/particle without antigen reproduces (or not) Comparator: Full product Hit rule: Effect attributed to (or excluded from) the vector/particle backbone alone
Finding: The retrieved evidence discusses live bacterial and viral vaccine vectors (e.g., NDV, adenovirus) for delivering heterologous antigens, but none of the abstracts address MMR vaccine, arthralgia, or whether the vector/particle backbone alone can reproduce the adverse event of arthralgia.
Cited: (none)
supporting: MMR vaccine Arthralgia Empty vector / particle component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F4 · Irrelevant cargono_data
Measure: Irrelevant cargo does not reproduce the effect Comparator: Vector with the target antigen Hit rule: Irrelevant cargo fails to reproduce the effect (specificity)
Finding: The retrieved evidence discusses live bacterial and viral vaccine vectors, but contains no mention of arthralgia or joint-related adverse events following MMR vaccination.
Cited: (none)
supporting: MMR vaccine Arthralgia Irrelevant cargo component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
F5 · Infection preparationno_data
Measure: Infection preparation vs product comparison Comparator: Product-derived preparation Hit rule: Effect compares correctly between infection and product preparations
Finding: The retrieved evidence describes live bacterial and viral vectors for vaccine delivery, but does not address the specific comparison between infection preparation and product preparation for arthralgia following MMR vaccination.
Cited: (none)
supporting: MMR vaccine Arthralgia Infection preparation component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
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: The retrieved evidence discusses live bacterial vaccine vectors, viral vector-based vaccines, and general vaccine development strategies, but none of the cited abstracts address the ability of a cytokine/adjuvant mix alone to reproduce arthralgia following MMR vaccination.
Cited: (none)
supporting: MMR vaccine Arthralgia Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
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: MMR vaccine Arthralgia Component combination component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 27384578 · Viruses (2016) — Newcastle Disease Virus as a Vaccine Vector for Development of Human and Veterinary Vaccines.
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: MMR vaccine Arthralgia 2D human cells animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Organoid / chip animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia mechanism Host-line dependence in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Animal, clinical route animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Susceptible animal animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Replication across labs animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Blinded scoring animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Experimental time course animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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: MMR vaccine Arthralgia Susceptibility trait coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: MMR vaccine Arthralgia 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.