Evidence dossier · candidate cand-rotavirus-intestinal-obstruction · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that Rotavirus vaccine causes Intestinal obstruction, 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
contested
C2
Consistent temporal window
contested
C3
Epidemiologic excess risk
contested
C4
Consistency / replication
contested
C5
Specificity (product / dose)
contested
C6
Biological mechanism
insufficient_data
missing: E1
Two evidentiary bars apply to the epi nodes/claims (C3, C4): · VICP — preponderance of the evidence. · CICP (off-Table) — compelling, reliable, valid medical and scientific evidence (higher bar).
Bradford Hill assessment (computed)
Each viewpoint is derived from the node statuses below (see the framework crosswalk in compensation-tables-schema.md §8). Hill's viewpoints are aids to judgement, not a scoring checklist that proves causation; temporality is the only strictly necessary criterion.
Viewpoint
What it asks
Status (from evidence)
Temporality(necessary)
cause precedes effect in a plausible window (necessary)
NASEM (formerly IOM), "Adverse Effects of Vaccines: Evidence and Causality" (2011, updated 2024). Independent grading of epidemiologic and mechanistic evidence, synthesized into one of four causal-conclusion categories. This is a computed approximation of that framework, not a NASEM determination. See compensation-tables-schema.md §8bis.
Case-definition standard: no established case definition (needs_human_review — not in spec §1's named-standard list) — governs the case-certainty scale on A1/A2/A6/A8 below. See compensation-tables-schema.md §8ter.
Evidence matrix (68 nodes by workstream)
68 of 68 nodes evaluated · 136 PubMed queries logged (supporting + mirror, incl. zeros). Statuses are computed from retrieved citations; not hand-set.
Definition & attribution 24/24 evaluated
A1 · Case reportssupports
Measure: New definite object in risk window T Comparator: Pre-vaccination baseline Hit rule: Definite object present, onset in window, competing causes considered
Finding: Two case series reports identified cases of intussusception (intestinal obstruction) following rotavirus vaccination: one from five African countries using RotaTeq (PMID 37596934) and one from India with 3 ICSRs causally linked to rotavirus vaccine (PMID 27641974).
Case-certainty distribution (no established case definition): 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Case reports pubmed · 66179 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
13 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
does_not_resolve 35266262 · Dermatologic therapy (2022) — The role of SARS-CoV-2 infection and its vaccines in various types of hair loss.
does_not_resolve 34222133 · Clinical and experimental vaccine resear (2021) — Acute myocarditis associated with anti-COVID-19 vaccination.
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 34862224 · Clinical medicine (London, England) (2021) — The incidence and duration of COVID-19 vaccine-related reactive lymphadenopathy on (18)F-FDG PET-CT.
A2 · Series with objective confirmationmixed
Measure: Definite object plus objective test Comparator: Reference range / diagnostic criteria Hit rule: Objective confirmation in >=1 case per the working definition
Finding: Two case reports and a case series from India (PMID 27641974) describe intussusception following rotavirus vaccine, but the study from five African countries (PMID 37596934) found only a low-level risk and did not confirm a definitive causal association with objective confirmation per the working definition.
Case-certainty distribution (no established case definition): 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
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: A pooled analysis from 5 African countries using self-controlled case-series methodology found a low-level risk of intussusception following RotaTeq vaccination, and a Pharmacovigilance Programme of India report identified 3 cases with a causal relationship between rotavirus vaccine and intussusception, with onset timing consistent with a risk window.
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Onset histogram pubmed · 17 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
16 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
supports_node 27070956 · Human vaccines & immunotherapeutics (2016) — Post-rotavirus vaccine intussusception in identical twins: A case report.
ambiguous 30029630 · BMC public health (2018) — Safety monitoring of ROTAVAC vaccine and etiological investigation of intussusception in India: study protocol.
supports_node 32271647 · Human vaccines & immunotherapeutics (2020) — Retrospective multicenter matched case-control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotaviru
ambiguous 28709556 · Vaccine (2018) — Intussusception among children less than 2years of age: Findings from pre-vaccine introduction surveillance in Pakistan.
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.
A4 · Temporal plausibilitysupports
Measure: Onset latency vs object pathophysiology Comparator: Object's known natural latency Hit rule: Onset latency consistent with the object's pathophysiology
Finding: The retrieved evidence from PMID 37596934 examines the association between RotaTeq vaccination and intussusception in African countries using self-controlled case-series analysis; PMID 27641974 reports 3 out of 10 Indian cases had a causal relationship; PMID 27070956 describes two identical twins developing intussusception approximately one week after rotavirus vaccination.
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Temporal plausibility pubmed · 46 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
12 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
supports_node 27070956 · Human vaccines & immunotherapeutics (2016) — Post-rotavirus vaccine intussusception in identical twins: A case report.
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 35266262 · Dermatologic therapy (2022) — The role of SARS-CoV-2 infection and its vaccines in various types of hair loss.
ambiguous 34222133 · Clinical and experimental vaccine resear (2021) — Acute myocarditis associated with anti-COVID-19 vaccination.
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.
A5 · Onset-interval documentationno_data
Measure: Onset interval documented in source Comparator: Dose date Hit rule: Onset interval is recorded (not imputed) in a primary source
Finding: The retrieved evidence does not include any primary source documentation of an onset interval for intestinal obstruction after rotavirus vaccination that is explicitly recorded (not imputed) from a case report form, surveillance system, or medical record.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Onset-interval documentation pubmed · 15 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
17 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
supports_node 27070956 · Human vaccines & immunotherapeutics (2016) — Post-rotavirus vaccine intussusception in identical twins: A case report.
does_not_resolve 30029630 · BMC public health (2018) — Safety monitoring of ROTAVAC vaccine and etiological investigation of intussusception in India: study protocol.
does_not_resolve 28709556 · Vaccine (2018) — Intussusception among children less than 2years of age: Findings from pre-vaccine introduction surveillance in Pakistan.
supports_node 32271647 · Human vaccines & immunotherapeutics (2020) — Retrospective multicenter matched case-control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotaviru
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.
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: Rotavirus vaccine Intestinal obstruction case report OR case series Differential diagnosis excluded pubmed · 442 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
8 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.
does_not_resolve 36381561 · Public health in practice (Oxford, Engla (2022) — Monkeypox vaccine-related stigma.
does_not_resolve 34131510 · BJR case reports (2021) — COVID-19 vaccine-related lymph node activation - patterns of uptake on PET-CT.
does_not_resolve 36441403 · Current cardiology reports (2022) — COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation.
does_not_resolve 34495822 · Human vaccines & immunotherapeutics (2021) — Revisiting the 2014-15 Disneyland measles outbreak and its influence on pediatric vaccinations.
A7 · Rechallenge / re-exposureno_data
Measure: Object recurs on a further dose Comparator: First-dose response Hit rule: Object recurs after a subsequent dose (re-exposure)
Finding: The retrieved evidence includes only case reports and surveillance data on intussusception following rotavirus vaccination, but no study specifically documents recurrence of intussusception after a subsequent dose of rotavirus vaccine (rechallenge).
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Rechallenge / re-exposure pubmed · 17 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
13 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
supports_node 27070956 · Human vaccines & immunotherapeutics (2016) — Post-rotavirus vaccine intussusception in identical twins: A case report.
ambiguous 30029630 · BMC public health (2018) — Safety monitoring of ROTAVAC vaccine and etiological investigation of intussusception in India: study protocol.
supports_node 32271647 · Human vaccines & immunotherapeutics (2020) — Retrospective multicenter matched case-control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotaviru
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: Only evidence for rotavirus vaccine and intussusception (a subtype of intestinal obstruction) is from a pooled analysis in 5 African countries (PMID 37596934) and a case series from India (PMID 27641974), both of which report possible associations but do not provide adjudication of cases as 'definite' by a published criterion set.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series Adjudicated by criteria pubmed · 54 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
12 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
ambiguous 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
does_not_resolve 35266262 · Dermatologic therapy (2022) — The role of SARS-CoV-2 infection and its vaccines in various types of hair loss.
does_not_resolve 34222133 · Clinical and experimental vaccine resear (2021) — Acute myocarditis associated with anti-COVID-19 vaccination.
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: Course matches the object's natural history Comparator: Known natural history of the object Hit rule: Clinical course (onset, peak, recovery) matches the object's natural history
Finding: The retrieved evidence includes two studies on intussusception following rotavirus vaccination (RotaTeq), but neither provides data on the clinical course, onset, peak, or recovery of intestinal obstruction in relation to the natural history of the condition. One study is a pooled analysis of risk association, and the other is a case series report; both lack the detailed temporal course information needed to assess natural-history consistency.
Measure: Not attributable to a co-occurring condition Comparator: Co-occurring illness that could produce the object Hit rule: Object not better explained by a co-occurring condition (infection, etc.)
Finding: Three case reports and a case series from India suggest a possible causal relationship between rotavirus vaccine and intussusception, but the largest pooled analysis (PMID 37596934) from 5 African countries found only a low-level risk and did not confirm an excess attributable to vaccination after competing causes were assessed.
supporting: Rotavirus vaccine Intestinal obstruction case report OR case series No confounding object pubmed · 34 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction alternative diagnosis OR not vaccine-related pubmed · 4052 hits · run 2026-09-07
16 retrieved record(s)
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
supports_node 27641974 · Indian journal of pediatrics (2017) — Risk of Intussusception with Rotavirus Vaccine.
does_not_resolve 30029630 · BMC public health (2018) — Safety monitoring of ROTAVAC vaccine and etiological investigation of intussusception in India: study protocol.
supports_node 27070956 · Human vaccines & immunotherapeutics (2016) — Post-rotavirus vaccine intussusception in identical twins: A case report.
does_not_resolve 28709556 · Vaccine (2018) — Intussusception among children less than 2years of age: Findings from pre-vaccine introduction surveillance in Pakistan.
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.
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: Rotavirus vaccine Intestinal obstruction anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Local vs systemic distribution not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
D4 · Kinetics classno_data
Measure: Onset/offset kinetics match the mechanism Comparator: Expected kinetic class (acute vs chronic) Hit rule: Onset and offset kinetics are in the class the mechanism predicts
mirror: Rotavirus vaccine Intestinal obstruction Kinetics class not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-07
D5 · Platform-mechanism matchno_data
Measure: Mechanism is consistent with the platform Comparator: Mechanistic expectation for the platform Hit rule: The proposed mechanism is biologically consistent with the vaccine platform
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction No internal contradiction coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction No internal contradiction inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
does_not_resolve 26750582 · Statistics in medicine (2016) — Quantifying risk over the life course - latency, age-related susceptibility, and other time-varying exposure metrics.
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: Rotavirus vaccine Intestinal obstruction Analogy to a known object coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Analogy to a known object inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
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: Rotavirus vaccine Intestinal obstruction Latency coherence coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Latency coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
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: Rotavirus vaccine Intestinal obstruction Pre-specification pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: The retrieved evidence describes a method for identifying immune-related adverse events using large language models and ICD codes in patients receiving immune checkpoint inhibitors; it does not mention rotavirus vaccine or intestinal obstruction.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Contrary-evidence log pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Contrary-evidence log 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
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: Rotavirus vaccine Intestinal obstruction No temporality-only claim pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1700 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: Rotavirus vaccine Intestinal obstruction Passive-surveillance role pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Passive-surveillance role 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
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: Rotavirus vaccine Intestinal obstruction Dose mapping pre-specified OR adjudicated pubmed · 13549 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Dose mapping post-hoc OR hypothesis-generating only pubmed · 1698 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
Epidemiologic chassis 13/13 evaluated
B1 · Excess vs baselineno_data
Measure: RR/IRR vs unexposed or prior window Comparator: Unvaccinated person-time or pre-vaccination window Hit rule: RR/IRR > 1 with CI excluding 1 after pre-specified confounders
Finding: No retrieved evidence addresses rotavirus vaccine and intestinal obstruction; the closest mentions are reviews noting a historical association with intussusception (PMID 31305493, 17185842, 28468712, 18202442, 18201590), but none provide RR/IRR estimates with confidence intervals for this node.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Excess vs baseline pubmed · 88649 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 41138504 · Journal of psychiatric research (2026) — Risk of anxiety disorders and insomnia following COVID-19 vaccination.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 34489307 · Gut (2022) — Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort.
does_not_resolve 42413069 · ESC heart failure (2026) — The HFpEF-ABA score predicts adverse cardiac remodelling and incident heart failure: a UK biobank study.
B2 · SCCSmixed
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: Retrieved evidence includes a 2017 meta-analysis of SCCS studies (PMID 28468712) confirming a mildly increased risk of intussusception after rotavirus vaccination, and a 2024 SCRI study (PMID 38875047) finding risk comparable to background in a 21-day window; no retrieved study reports an SCCS risk ratio >1 with CI excluding 1 for intestinal obstruction broadly defined, and no SCCS evidence specifically addresses 'intestinal obstruction' rather than intussusception.
supporting: Rotavirus vaccine Intestinal obstruction SCCS incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk SCCS pubmed · 88753 hits · run 2026-09-07
14 retrieved record(s)
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 40340265 · Epidemiology and health (2025) — Risk of new-onset seizures following immunization against COVID-19: a self-controlled case-series study.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 39795956 · International journal of molecular scien (2024) — The Potential Metalloestrogenic Effect of Aluminum on Breast Cancer Risk for Antiperspirant Users.
B3 · Cohort / risk-intervalno_data
Measure: Incidence rate ratio in defined window Comparator: Pre-specified risk vs comparison interval Hit rule: IRR > 1 in the pre-specified window, CI excluding 1, stratified by age/sex
Finding: The retrieved evidence includes studies on intussusception after rotavirus vaccination, but does not provide a specific incidence rate ratio (IRR) for intestinal obstruction in a pre-specified risk window stratified by age/sex that meets the hit rule.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Cohort / risk-interval pubmed · 88257 hits · run 2026-09-07
12 retrieved record(s)
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
does_not_resolve 17185842 · Indian journal of medical microbiology (2006) — Rotavirus vaccines.
B4 · Meta-analysis / poolingsupports
Measure: Pooled effect across studies Comparator: Pooled estimate with heterogeneity Hit rule: Pooled estimate > 1 (or < 1) with quantified heterogeneity (I2)
Finding: The retrieved evidence includes a 2017 systematic review and meta-analysis of self-controlled case series studies that summarized relative risks for intussusception after rotavirus vaccination, with pooled estimates and quantified heterogeneity, directly addressing the pair Rotavirus vaccine -> Intestinal obstruction for node B4. Other retrieved studies discuss rotavirus vaccine safety and intussusception but are not meta-analyses or pooling studies with pooled estimates and I².
supporting: Rotavirus vaccine Intestinal obstruction Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Meta-analysis / pooling pubmed · 112089 hits · run 2026-09-07
14 retrieved record(s)
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 40340265 · Epidemiology and health (2025) — Risk of new-onset seizures following immunization against COVID-19: a self-controlled case-series study.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
B5 · Negative-control outcomessupports
Measure: No excess for outcomes the vaccine should not cause Comparator: Negative-control outcomes (unaffected by mechanism) Hit rule: Null for negative-control outcomes while target outcome is positive (specificity)
Finding: The retrieved evidence includes a study on intussusception risk following rotavirus vaccination, which is an intestinal obstruction, and reports that the risk in the high-risk window (21 days after vaccination) was comparable to background risk, suggesting no excess risk for this negative-control outcome.
supporting: Rotavirus vaccine Intestinal obstruction Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Negative-control outcomes pubmed · 88460 hits · run 2026-09-07
8 retrieved record(s)
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 40340265 · Epidemiology and health (2025) — Risk of new-onset seizures following immunization against COVID-19: a self-controlled case-series study.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 38833248 · JAMA network open (2024) — Valproate Use During Spermatogenesis and Risk to Offspring.
B6 · Other-antigen comparisonno_data
Measure: Risk vs a different-antigen comparator Comparator: Comparator product with a different antigen Hit rule: Risk specific to the target antigen, not shared with the comparator antigen
Finding: No retrieved evidence directly addresses the risk of intestinal obstruction following rotavirus vaccination compared to a different-antigen comparator.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Other-antigen comparison pubmed · 88222 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 41138504 · Journal of psychiatric research (2026) — Risk of anxiety disorders and insomnia following COVID-19 vaccination.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
supports_node 17185842 · Indian journal of medical microbiology (2006) — Rotavirus vaccines.
B7 · Absolute riskno_data
Measure: Per-100k risk in window Comparator: Absolute incidence per 100k Hit rule: Absolute risk reported and stable across the window (not an artifact of rarity)
Finding: No retrieved evidence reports absolute risk (per 100k) of intestinal obstruction after rotavirus vaccination in a predefined risk window. Two retrieved studies discuss intussusception after rotavirus vaccination but do not provide a stable per-100k absolute risk estimate for this node.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Absolute risk incidence risk cohort OR self-controlled case series pubmed · 946 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Absolute risk pubmed · 111484 hits · run 2026-09-07
14 retrieved record(s)
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 29211679 · The New England journal of medicine (2017) — Contemporary Hormonal Contraception and the Risk of Breast Cancer.
does_not_resolve 23484825 · The New England journal of medicine (2013) — Risk of ischemic heart disease in women after radiotherapy for breast cancer.
B8 · Platform splitmixed
Measure: Risk by vaccine platform / product Comparator: Platform (mRNA vs viral vector, etc.) Hit rule: Risk attributable to a specific platform, not to 'a vaccine' generally
Finding: The retrieved evidence indicates that rotavirus vaccines have been associated with intussusception (a type of intestinal obstruction) in prior studies, but no retrieved study specifically attributes risk to a particular vaccine platform versus vaccines generally; one study (PMID 37815175) found no increased risk of intussusception after pentavalent rotavirus vaccination (RotaTeq) in China.
supporting: Rotavirus vaccine Intestinal obstruction Platform split incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Platform split pubmed · 88287 hits · run 2026-09-07
13 retrieved record(s)
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 40340265 · Epidemiology and health (2025) — Risk of new-onset seizures following immunization against COVID-19: a self-controlled case-series study.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
B9 · Host-structure stratificationno_data
Measure: Risk by age / sex / host structure Comparator: Unstratified estimate Hit rule: Risk concentrated in a defined host subgroup (e.g. young males), stable across sources
Finding: No retrieved evidence directly addresses the risk of intestinal obstruction (intussusception) specifically stratified by host subgroups such as age or sex following rotavirus vaccination, nor does it provide stable risk estimates across sources for such subgroups.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Host-structure stratification pubmed · 88220 hits · run 2026-09-07
13 retrieved record(s)
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 41138504 · Journal of psychiatric research (2026) — Risk of anxiety disorders and insomnia following COVID-19 vaccination.
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 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
ambiguous 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
does_not_resolve 17185842 · Indian journal of medical microbiology (2006) — Rotavirus vaccines.
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change Comparator: Pre- vs post-change formulation Hit rule: Risk change tracks a documented formulation / component change over time
Finding: The retrieved evidence does not contain any information about rotavirus vaccine formulation or component changes over time and their association with intestinal obstruction.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 945 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no association OR null OR no increased risk Formulation / component change pubmed · 88382 hits · run 2026-09-07
10 retrieved record(s)
does_not_resolve 41138504 · Journal of psychiatric research (2026) — Risk of anxiety disorders and insomnia following COVID-19 vaccination.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 40340265 · Epidemiology and health (2025) — Risk of new-onset seizures following immunization against COVID-19: a self-controlled case-series study.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 40440921 · Vaccine (2025) — Risk of Guillain-Barré syndrome after COVID-19 vaccination or SARS-CoV-2 infection: A multinational self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
ambiguous 31305493 · Current opinion in infectious diseases (2019) — Current and new rotavirus vaccines.
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: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Policy / pause signal intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Policy / pause signal no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
1 retrieved record(s)
does_not_resolve 38189107 · Expert review of vaccines (2024) — Neoadjuvant personalized cancer vaccines: the final frontier?
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: Rotavirus vaccine Intestinal obstruction Infection coherence coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Infection coherence inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
does_not_resolve 26750582 · Statistics in medicine (2016) — Quantifying risk over the life course - latency, age-related susceptibility, and other time-varying exposure metrics.
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 retrieved evidence reports dose-strength comparisons for rotavirus vaccine and intussusception; studies examine risk after vaccination but not monotonic dose-response by dose size.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Dose strength gradient dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no dose effect OR no dose-response Dose strength gradient pubmed · 203 hits · run 2026-09-07
11 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
supports_node 28468712 · Deutsches Arzteblatt international (2017) — Risk of Intussusception After Rotavirus Vaccination.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 33176083 · The New England journal of medicine (2020) — Intussusception after Rotavirus Vaccine Introduction in India.
does_not_resolve 25145068 · The Journal of communicable diseases (2012) — Rotavirus vaccine: a review.
supports_node 24335963 · Current opinion in pediatrics (2014) — Safety of second-generation rotavirus vaccines, intussusception.
refutes_node 37596934 · Clinical infectious diseases : an offici (2024) — Evaluation of Intussusception Following Pentavalent Rotavirus Vaccine (RotaTeq) Administration in 5 African Countries.
C2n · Dose number gradientno_data
Measure: Risk vs dose number (1st vs 2nd vs 3rd) Comparator: First dose Hit rule: Risk increases (or shows a defined pattern) with dose number
Finding: The retrieved evidence does not address dose number gradient for rotavirus vaccine and intestinal obstruction; studies assess overall risk post-vaccination but do not compare risk across dose numbers (1st vs 2nd vs 3rd).
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Dose number gradient dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no dose effect OR no dose-response Dose number gradient pubmed · 647 hits · run 2026-09-07
14 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 38278806 · Scientific reports (2024) — Potential impact on using aspirin as the primary prevention of adverse pregnancy outcomes in twins conceived using ART.
supports_node 28468712 · Deutsches Arzteblatt international (2017) — Risk of Intussusception After Rotavirus Vaccination.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 37815175 · Emerging microbes & infections (2023) — No increased risk of intussusception after pentavalent rotavirus vaccination in China: a retrospective birth cohort using electronic health records of Ningbo ci
refutes_node 33176083 · The New England journal of medicine (2020) — Intussusception after Rotavirus Vaccine Introduction in India.
does_not_resolve 25145068 · The Journal of communicable diseases (2012) — Rotavirus vaccine: a review.
C3n · Measured-exposure tertilesno_data
Measure: Risk vs measured exposure tertile Comparator: Lowest-exposure tertile Hit rule: Risk ordered by measured-exposure tertile (high > mid > low)
Finding: The retrieved evidence includes multiple studies on intussusception risk after rotavirus vaccination (e.g., PMID 28468712, 38875047, 37815175, 33176083, 40992076, 37596934), consistently reporting a small increased risk of intussusception, but none of these studies examine risk ordered by measured-exposure tertiles of the vaccine.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Measured-exposure tertiles dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no dose effect OR no dose-response Measured-exposure tertiles pubmed · 92 hits · run 2026-09-07
14 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 38278806 · Scientific reports (2024) — Potential impact on using aspirin as the primary prevention of adverse pregnancy outcomes in twins conceived using ART.
supports_node 28468712 · Deutsches Arzteblatt international (2017) — Risk of Intussusception After Rotavirus Vaccination.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 37815175 · Emerging microbes & infections (2023) — No increased risk of intussusception after pentavalent rotavirus vaccination in China: a retrospective birth cohort using electronic health records of Ningbo ci
refutes_node 33176083 · The New England journal of medicine (2020) — Intussusception after Rotavirus Vaccine Introduction in India.
does_not_resolve 25145068 · The Journal of communicable diseases (2012) — Rotavirus vaccine: a review.
C4n · Organoid concentration curveno_data
Measure: Effect vs antigen concentration in organoid Comparator: Vehicle / zero antigen Hit rule: Dose-dependent effect across a graded concentration curve
Finding: No retrieved evidence describes organoid concentration curves or dose-dependent effects of rotavirus vaccine on intestinal obstruction in an organoid model. The available evidence consists entirely of epidemiological studies (self-controlled case series, active surveillance) assessing intussusception risk following rotavirus vaccination in infants.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Organoid concentration curve dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no dose effect OR no dose-response Organoid concentration curve pubmed · 103 hits · run 2026-09-07
13 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 28468712 · Deutsches Arzteblatt international (2017) — Risk of Intussusception After Rotavirus Vaccination.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 37815175 · Emerging microbes & infections (2023) — No increased risk of intussusception after pentavalent rotavirus vaccination in China: a retrospective birth cohort using electronic health records of Ningbo ci
refutes_node 33176083 · The New England journal of medicine (2020) — Intussusception after Rotavirus Vaccine Introduction in India.
ambiguous 25145068 · The Journal of communicable diseases (2012) — Rotavirus vaccine: a review.
supports_node 24335963 · Current opinion in pediatrics (2014) — Safety of second-generation rotavirus vaccines, intussusception.
C5n · EC50 vs Cmax coherencesupports
Measure: Measured exposure reaches effect threshold Comparator: Pharmacokinetic Cmax vs EC50 Hit rule: Achieved exposure (Cmax/tissue) plausibly reaches the in-vitro EC50
Finding: Multiple post-licensure studies and meta-analyses consistently report a small increased risk of intussusception (a form of intestinal obstruction) within a short risk window after rotavirus vaccination, particularly following the first dose.
supporting: Rotavirus vaccine Intestinal obstruction EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299145 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 92 hits · run 2026-09-07
14 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 38278806 · Scientific reports (2024) — Potential impact on using aspirin as the primary prevention of adverse pregnancy outcomes in twins conceived using ART.
supports_node 28468712 · Deutsches Arzteblatt international (2017) — Risk of Intussusception After Rotavirus Vaccination.
supports_node 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
refutes_node 33176083 · The New England journal of medicine (2020) — Intussusception after Rotavirus Vaccine Introduction in India.
does_not_resolve 25145068 · The Journal of communicable diseases (2012) — Rotavirus vaccine: a review.
ambiguous 24335963 · Current opinion in pediatrics (2014) — Safety of second-generation rotavirus vaccines, intussusception.
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: Rotavirus vaccine Intestinal obstruction mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: The retrieved evidence does not report any studies measuring mediator signal specific to vaccination versus a comparable natural-infection control for intestinal obstruction. PMID 18201590 and PMID 33267969 describe rotavirus vaccine safety but lack a natural-infection comparator; PMID 22520130 discusses intussusception risk in post-licensure monitoring but does not provide a contrast with natural infection.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction mechanism Infection contrast in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Infection contrast not associated mechanism pubmed · 7 hits · run 2026-09-07
does_not_resolve 33267969 · Vaccine (2021) — Safety profile of rotavirus vaccines among individuals aged ≥8 months of age, United States, vaccine adverse event reporting system (VAERS), 2006-2019.
does_not_resolve 22520130 · Vaccine (2012) — Workshop on intussusception in African countries--meeting report.
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: Rotavirus vaccine Intestinal obstruction mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction mechanism Transfer specificity in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction mechanism Add-back rescue in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
Measure: Neutralizing the mediator blocks the effect Comparator: Isotype control Hit rule: Neutralization of the mediator (not an isotype control) blocks the phenotype
Finding: No evidence found
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction mechanism Neutralization in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Neutralization not associated mechanism pubmed · 1 hits · run 2026-09-07
1 retrieved record(s)
does_not_resolve 18756184 · The Pediatric infectious disease journal (2008) — Concomitant use of the oral pentavalent human-bovine reassortant rotavirus vaccine and oral poliovirus vaccine.
E9 · Isotype controlno_data
Measure: Isotype control does not reproduce the effect Comparator: Active antibody Hit rule: An isotype control fails to reproduce the block/activation
Finding: No retrieved evidence describes an isotype control experiment relevant to a vaccine adverse-event evidence matrix for rotavirus vaccine and intestinal obstruction.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction mechanism Isotype control in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Isotype control not associated mechanism pubmed · 3 hits · run 2026-09-07
3 retrieved record(s)
does_not_resolve 11757786 · Current opinion in investigational drugs (2001) — Rotavirus vaccine AVANT/GlaxoSmithKline.
refutes_node 16394299 · The New England journal of medicine (2006) — Safety and efficacy of a pentavalent human-bovine (WC3) reassortant rotavirus vaccine.
does_not_resolve 23499605 · Vaccine (2013) — Efficacy, safety and immunogenicity of a human rotavirus vaccine (RIX4414) in Hong Kong children up to three years of age: a randomized, controlled trial.
F1 · Full product reproducesno_data
Measure: Full vaccine product reproduces the effect Comparator: No-product control Hit rule: The full product (not a subcomponent) reproduces the effect
Finding: no evidence found
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Full product reproduces component OR antigen OR vector pubmed · 2045239 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-07
5 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.
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, including adenovirus and measles vectors, but none specifically address Rotavirus vaccine vectors or intestinal obstruction. No evidence links an empty vector or particle backbone of Rotavirus vaccine to intestinal obstruction.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction 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.
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 retrieved evidence discusses rotavirus vaccine, intestinal obstruction, or any adverse event related to rotavirus vaccination.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction 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: no evidence found
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction 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.
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: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction 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.
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: Rotavirus vaccine Intestinal obstruction 2D human cells animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Organoid / chip animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15141570 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Block in vitro / in vivo no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-07
1 retrieved record(s)
does_not_resolve 38189107 · Expert review of vaccines (2024) — Neoadjuvant personalized cancer vaccines: the final frontier?
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: Rotavirus vaccine Intestinal obstruction mechanism Host-line dependence in vitro OR patient-derived pubmed · 29242 hits · run 2026-09-07
Measure: Effect in animal via the clinical route of administration Comparator: Vehicle, same route Hit rule: Effect reproduced in an animal using the clinical route of administration
Finding: no evidence found
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Animal, clinical route animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Susceptible animal animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Replication across labs animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Blinded scoring animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: Rotavirus vaccine Intestinal obstruction Experimental time course animal OR organoid OR cell model pubmed · 1818526 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction 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: The retrieved evidence does not mention rotavirus vaccine, intestinal obstruction, or any host trait or marker relevant to susceptibility to intestinal obstruction following rotavirus vaccination.
Cited: (none)
supporting: Rotavirus vaccine Intestinal obstruction Susceptibility trait coherence OR latency OR susceptibility pubmed · 870030 hits · run 2026-09-07
mirror: Rotavirus vaccine Intestinal obstruction Susceptibility trait inconsistent OR contradicts pubmed · 27612 hits · run 2026-09-07
2 retrieved record(s)
does_not_resolve 2699706 · Annali italiani di chirurgia (1989) — Etiology and risk factors of melanoma.
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.