Evidence dossier · candidate cand-varicella-herpes-zoster · VICP program · · DRAFT — not a determination
This is a draft research-tracking dossier, not a determination that Varicella (chickenpox) vaccine causes Herpes Zoster (Shingles), 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
supported
C2
Consistent temporal window
supported
C3
Epidemiologic excess risk
insufficient_data
missing: B1 B2
C4
Consistency / replication
contested
C5
Specificity (product / dose)
insufficient_data
missing: C1n
C6
Biological mechanism
contested
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: Retrieved evidence includes several case reports of herpes zoster (shingles) or varicella zoster virus reactivation following varicella vaccination, including disseminated Oka-strain (vaccine-strain) reactivation in immunocompromised hosts (e.g., PMID 39543470, PMID 37286085, PMID 37395442) and a case of infantile zoster-like rash (PMID 36027973). These reports indicate that vaccine-strain VZV can reactivate to cause herpes zoster within a risk window, consistent with the case report node definition.
Case-certainty distribution (no established case definition): 2 Definite, 3 Probable, 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Case reports pubmed · 66302 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
A2 · Series with objective confirmationsupports
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 confirm vaccine-strain varicella-zoster virus (vOka) reactivation as disseminated herpes zoster in immunocompromised patients (adolescent with Hodgkin's lymphoma, kidney transplant recipient), with PCR/genotyping confirmation providing objective confirmation of the adverse event.
Case-certainty distribution (no established case definition): 1 Definite, 2 Probable, 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Series with objective confirmation pubmed · 5756 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
15 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
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.
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: Several case reports, primarily in immunocompromised individuals, document vaccine-strain varicella-zoster virus reactivation manifesting as herpes zoster (shingles) after varicella vaccination, with onset times often within weeks of vaccination.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Onset histogram pubmed · 112 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
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: Several case reports describe vaccine-strain varicella-zoster virus reactivation presenting as herpes zoster (shingles) within weeks to months after varicella vaccination, particularly in immunocompromised individuals, consistent with the known pathophysiology of latency and reactivation.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Temporal plausibility pubmed · 141 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
A5 · Onset-interval documentationmixed
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 includes multiple case reports documenting herpes zoster (shingles) following varicella vaccination, but none of the abstracts explicitly state whether the onset interval (e.g., days or weeks post-vaccination) was recorded or imputed in the primary source. For example, PMID 37286085 notes rash onset '3 weeks after receiving a varicella vaccine,' but the abstract does not clarify if this interval was directly documented in the source or derived.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Onset-interval documentation pubmed · 110 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
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: Two case reports describe Oka vaccine-strain varicella-zoster virus reactivation presenting as herpes zoster after varicella vaccination: one in an immunocompromised adolescent (PMID 39543470) and one in an infant (PMID 36027973). Neither report explicitly mentions or documents exclusion of competing causes such as wild-type VZV reactivation or other differential diagnoses.
Case-certainty distribution (no established case definition): 1 Definite, 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Differential diagnosis excluded pubmed · 537 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
13 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
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 29047317 · Expert review of vaccines (2017) — Varicella and herpes zoster vaccine development: lessons learned.
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: Retrieved evidence includes case reports of herpes zoster (shingles) occurring after varicella vaccination, but none describe recurrence of shingles after a subsequent (second) vaccine dose (rechallenge), which is the specific hit condition for Node A7.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Rechallenge / re-exposure pubmed · 112 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
A8 · Adjudicated by criteria (no established case definition)supports
Measure: Object adjudicated by published criteria Comparator: Published clinical / Brighton criteria Hit rule: Cases adjudicated to 'definite' by a published criterion set
Finding: Two retrieved case reports describe herpes zoster caused by vaccine-strain varicella-zoster virus (Oka strain) in immunocompromised patients (a 16-year-old with Hodgkin's lymphoma and a 33-year-old kidney transplant recipient). A third report describes herpes zoster triggered by a non-live varicella vaccine (Shingrix) in an immunocompetent patient. All cases are clinically adjudicated as vaccine-strain or vaccine-triggered zoster, though none explicitly cite a predefined published criterion set for 'definite' adjudication.
Case-certainty distribution (no established case definition): 2 Definite, 2 Probable, 1 Possible/unclassifiable. Transparency layer — does not change this node's status or feed C1–C6.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Adjudicated by criteria pubmed · 149 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
19 retrieved record(s)
supports_node 39543470 · BMC infectious diseases (2024) — Disseminated vaccine-strain varicella-zoster virus reactivation in an adolescent with secondary immunodeficiency: a case report and literature review.
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
A9 · Natural-history consistencymixed
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: Only one retrieved article (PMID 36027973) reports a case of varicella vaccine-induced infantile zoster-like rash, which matches the clinical course of natural herpes zoster; the other retrieved articles are unrelated to the varicella vaccine–herpes zoster pair.
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series Natural-history consistency pubmed · 213 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
15 retrieved record(s)
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
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: Two case reports (PMID 36027973 and PMID 25962929) describe herpes zoster-like rashes or vaccine-associated herpes zoster following varicella vaccination, but no evidence assesses whether the outcome is attributable specifically to the vaccine after controlling for co-occurring conditions. Other retrieved articles involve unrelated vaccines (COVID-19, HPV, monkeypox) or are reviews not directly testing the node's no-confounding criterion.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) case report OR case series No confounding object pubmed · 129 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) alternative diagnosis OR not vaccine-related pubmed · 4058 hits · run 2026-09-09
18 retrieved record(s)
ambiguous 36027973 · The Journal of pediatrics (2022) — Varicella Vaccine-Induced Infantile Zoster-Like Skin Rash.
ambiguous 34222134 · Clinical and experimental vaccine resear (2021) — A rare case of shingles after COVID-19 vaccine: is it a possible adverse effect?
ambiguous 25962929 · The Journal of pediatrics (2015) — Vaccine-Associated Herpes Zoster.
supports_node 37220294 · Dermatology online journal (2023) — A rare case of herpes zoster triggered by a non-live varicella vaccine.
supports_node 37395442 · Pediatric transplantation (2023) — Varicella vaccine meningoencephalitis in a child receiving autologous bone marrow transplantation.
supports_node 37286085 · American journal of transplantation : of (2023) — Disseminated vaccine-induced varicella infection in a kidney transplant recipient.
ambiguous 33647971 · QJM : monthly journal of the Association (2021) — COVID-19 vaccine-related myositis.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) anatomic localization Predicted site of injury mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Predicted site of injury not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D2 · Spared structuresno_data
Measure: Structures the mechanism should spare are spared Comparator: Structures predicted unaffected Hit rule: Structures predicted spared by the mechanism are indeed spared
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Spared structures not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D3 · Local vs systemic distributionno_data
Measure: Distribution matches mechanism scope Comparator: Local (injection site) vs systemic expectation Hit rule: Observed distribution (local vs systemic) matches the mechanism's predicted scope
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) anatomic localization Local vs systemic distribution mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Local vs systemic distribution not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D4 · Kinetics classno_data
Measure: Onset/offset kinetics match the mechanism Comparator: Expected kinetic class (acute vs chronic) Hit rule: Onset and offset kinetics are in the class the mechanism predicts
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Kinetics class not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
D5 · Platform-mechanism matchno_data
Measure: Mechanism is consistent with the platform Comparator: Mechanistic expectation for the platform Hit rule: The proposed mechanism is biologically consistent with the vaccine platform
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Platform-mechanism match not consistent with mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
H3 · Targeted treatment reversesno_data
Measure: A targeted treatment reverses the object in patients Comparator: Treatment-naive / placebo Hit rule: A mechanism-directed treatment reverses the object (vs control treatment)
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Targeted treatment reverses intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
Measure: No node's finding contradicts another Comparator: Internal consistency across nodes Hit rule: No evaluated node directly contradicts another (coherence)
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) No internal contradiction coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) No internal contradiction inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Analogy to a known object coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Analogy to a known object inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 8550283 · International journal of epidemiology (1995) — Minimum attack rate for measuring measles vaccine efficacy.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Latency coherence coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Latency coherence inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Pre-specification pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Pre-specification post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Contrary-evidence log pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Contrary-evidence log post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
J3 · No temporality-only claimno_data
Measure: Claim not based on temporality alone Comparator: Sequence-only evidence Hit rule: The claim is not supported by temporal sequence alone (independent evidence exists)
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) No temporality-only claim pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) No temporality-only claim post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
J4 · Passive-surveillance roleno_data
Measure: Passive-surveillance findings bounded correctly Comparator: Active-surveillance confirmation Hit rule: Passive-surveillance signals are framed as hypothesis-generating, not confirmatory
Finding: The retrieved evidence discusses the use of large language models to identify immune-related adverse events and artificial intelligence to adjudicate major adverse cardiovascular events, but does not address herpes zoster (shingles) following varicella (chickenpox) vaccine or any passive-surveillance signal for that specific vaccine-adverse event pair.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Passive-surveillance role pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Passive-surveillance role post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 41493293 · Journal of the American College of Cardi (2026) — Using Artificial Intelligence to Adjudicate Major Adverse Cardiovascular Events in Clinical Trials.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Dose mapping pre-specified OR adjudicated pubmed · 13562 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Dose mapping post-hoc OR hypothesis-generating only pubmed · 1719 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 39226489 · Journal of clinical oncology : official (2024) — Enhancing Precision in Detecting Severe Immune-Related Adverse Events: Comparative Analysis of Large Language Models and International Classification of Disease
does_not_resolve 41493293 · Journal of the American College of Cardi (2026) — Using Artificial Intelligence to Adjudicate Major Adverse Cardiovascular Events in Clinical Trials.
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 directly addresses an excess risk of herpes zoster following varicella (chickenpox) vaccination; the retrieved studies focus on shingles risk after recombinant zoster vaccine (RZV), methodological reviews of self-controlled case series, rotavirus vaccine safety, COVID-19 vaccine safety, live attenuated varicella vaccine efficacy against varicella and zoster, diabetes and herpes zoster risk, and zoster vaccine trials in older adults.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Excess vs baseline incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Excess vs baseline pubmed · 88769 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 15930418 · The New England journal of medicine (2005) — A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
B2 · SCCSno_data
Measure: Self-controlled case series risk ratio Comparator: Individuals' own risk intervals (no-event) Hit rule: SCCS risk ratio > 1 in the post-vaccination window, CI excluding 1
Finding: No retrieved evidence directly addresses the risk of herpes zoster following varicella (chickenpox) vaccination using a self-controlled case series design; the only SCCS study on shingles post-vaccination (PMID 40924159) evaluates the recombinant zoster vaccine (Shingrix), not the varicella vaccine.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) SCCS incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk SCCS pubmed · 88879 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 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 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 15930418 · The New England journal of medicine (2005) — A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
B3 · Cohort / risk-intervalno_data
Measure: Incidence rate ratio in defined window Comparator: Pre-specified risk vs comparison interval Hit rule: IRR > 1 in the pre-specified window, CI excluding 1, stratified by age/sex
Finding: No retrieved evidence directly addresses an increased incidence rate ratio (IRR) for new Herpes Zoster attributed to Varicella (chickenpox) vaccine within a pre-specified risk window, stratified by age/sex. The available studies focus on shingles risk after Shingrix (recombinant zoster vaccine) or zoster vaccine live, rotavirus vaccine, COVID-19 mRNA vaccines, or the association between zoster and stroke, not the varicella vaccine as the exposure.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Cohort / risk-interval incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Cohort / risk-interval pubmed · 88378 hits · run 2026-09-09
refutes_node 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
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 study provides a pooled estimate of the effect of varicella (chickenpox) vaccine on the risk of herpes zoster (shingles) with quantified heterogeneity (I²). The papers focus on diabetes and herpes zoster risk, shingles after shingles (not varicella) vaccination, post-zoster stroke, and general vaccine reviews.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Meta-analysis / pooling incidence risk cohort OR self-controlled case series pubmed · 949 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Meta-analysis / pooling pubmed · 112235 hits · run 2026-09-09
10 retrieved record(s)
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
refutes_node 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
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 new Herpes Zoster (Shingles) following varicella (chickenpox) vaccination. The retrieved studies focus on shingles risk after recombinant zoster vaccine (RZV), COVID-19 vaccines, or rotavirus vaccine, or discuss diabetes mellitus and zoster risk, but none evaluate varicella vaccine as an exposure for shingles outcomes.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Negative-control outcomes incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Negative-control outcomes pubmed · 88580 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
ambiguous 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
ambiguous 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 15930418 · The New England journal of medicine (2005) — A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
B6 · Other-antigen comparisonno_data
Measure: Risk vs a different-antigen comparator Comparator: Comparator product with a different antigen Hit rule: Risk specific to the target antigen, not shared with the comparator antigen
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Other-antigen comparison incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Other-antigen comparison pubmed · 88342 hits · run 2026-09-09
refutes_node 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
B7 · Absolute riskno_data
Measure: Per-100k risk in window Comparator: Absolute incidence per 100k Hit rule: Absolute risk reported and stable across the window (not an artifact of rarity)
Finding: No retrieved evidence directly reports absolute risk per 100,000 of new Herpes Zoster attributed to Varicella (chickenpox) vaccine in a defined risk window.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Absolute risk incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Absolute risk pubmed · 111635 hits · run 2026-09-09
refutes_node 37468475 · Nature communications (2023) — Herpes zoster vaccine safety in the Aotearoa New Zealand population: a self-controlled case series study.
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 24700656 · Clinical infectious diseases : an offici (2014) — Risk of stroke following herpes zoster: a self-controlled case-series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
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: The retrieved evidence includes a 2021 review article on live attenuated varicella vaccine that discusses varicella and zoster prevention, but no study specifically examines the risk of new herpes zoster attributed to varicella (chickenpox) vaccine by vaccine platform or product, as required by Node B8.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Platform split incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Platform split pubmed · 88407 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 38388239 · Vaccine (2024) — Mortality risk after COVID-19 vaccination: A self-controlled case series study.
does_not_resolve 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
refutes_node 15930418 · The New England journal of medicine (2005) — A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
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 risk of new Herpes Zoster (Shingles) following Varicella (chickenpox) vaccine, stratified by age, sex, or host structure. The available studies focus on recombinant zoster vaccine (RZV), COVID-19 vaccines, rotavirus vaccine, or general zoster risk in diabetes, not varicella vaccine.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Host-structure stratification incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Host-structure stratification pubmed · 88340 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 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 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 15930418 · The New England journal of medicine (2005) — A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.
B10 · Formulation / component changeno_data
Measure: Risk tracks a formulation change Comparator: Pre- vs post-change formulation Hit rule: Risk change tracks a documented formulation / component change over time
Finding: No retrieved study examined a formulation or component change of varicella vaccine and its association with herpes zoster risk. The evidence retrieved focuses on shingles risk after recombinant zoster vaccine (Shingrix), not varicella vaccine, and does not address formulation or component changes over time.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Formulation / component change incidence risk cohort OR self-controlled case series pubmed · 948 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no association OR null OR no increased risk Formulation / component change pubmed · 88502 hits · run 2026-09-09
does_not_resolve 34937500 · Expert review of vaccines (2022) — Self-controlled case series design in vaccine safety: a systematic review.
does_not_resolve 38875047 · The International journal of risk & safe (2024) — Self-controlled risk interval study of rotavirus vaccine safety: Findings and implications.
does_not_resolve 40664645 · Nature communications (2025) — Evaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study.
does_not_resolve 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 34590140 · The Journal of infectious diseases (2021) — Live Attenuated Varicella Vaccine: Prevention of Varicella and of Zoster.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Formulation natural experiment intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Policy / pause signal intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Policy / pause signal no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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 retrieved evidence addresses whether the post-vaccine pattern of Herpes Zoster after Varicella vaccination is coherent with or distinct from the natural infection pattern.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Infection coherence coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Infection coherence inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
2 retrieved record(s)
does_not_resolve 8550283 · International journal of epidemiology (1995) — Minimum attack rate for measuring measles vaccine efficacy.
does_not_resolve 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
Mediator & biological gradient 24/24 evaluated
C1n · Dose strength gradientno_data
Measure: Risk vs dose strength (dose size) Comparator: Lower dose strength Hit rule: Monotonic dose-response in dose strength (larger dose -> higher risk)
Finding: No retrieved evidence addresses a dose-strength gradient for varicella vaccine and subsequent herpes zoster risk; the available studies focus on other vaccines or unrelated risk factors.
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no dose effect OR no dose-response Dose strength gradient pubmed · 223 hits · run 2026-09-09
9 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 37967254 · Human vaccines & immunotherapeutics (2023) — Effectiveness and safety of recombinant zoster vaccine: A review of real-world evidence.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
ambiguous 37781954 · The Cochrane database of systematic revi (2023) — Vaccines for preventing herpes zoster in older adults.
ambiguous 16462966 · Revista chilena de infectologia : organo (2006) — [Varicella vaccine].
ambiguous 28644696 · Expert review of vaccines (2017) — Varicella vaccination - the global experience.
does_not_resolve 22890288 · Bone marrow transplantation (2013) — Live (vaccines) from New York.
C2n · Dose number gradientno_data
Measure: Risk vs dose number (1st vs 2nd vs 3rd) Comparator: First dose Hit rule: Risk increases (or shows a defined pattern) with dose number
Finding: No retrieved evidence addresses a dose-number gradient for Varicella vaccine and Herpes Zoster risk. The only retrieved evidence relevant to varicella vaccine safety (PMID 28174201) describes adverse events after a second dose but does not mention Herpes Zoster. Other retrieved studies (e.g., PMID 37967254, PMID 37781954, PMID 40916263) evaluate the recombinant zoster vaccine (RZV) rather than varicella vaccine.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Dose number gradient dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no dose effect OR no dose-response Dose number gradient pubmed · 668 hits · run 2026-09-09
10 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 37967254 · Human vaccines & immunotherapeutics (2023) — Effectiveness and safety of recombinant zoster vaccine: A review of real-world evidence.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 37781954 · The Cochrane database of systematic revi (2023) — Vaccines for preventing herpes zoster in older adults.
ambiguous 16462966 · Revista chilena de infectologia : organo (2006) — [Varicella vaccine].
does_not_resolve 28644696 · Expert review of vaccines (2017) — Varicella vaccination - the global experience.
does_not_resolve 22890288 · Bone marrow transplantation (2013) — Live (vaccines) from New York.
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 retrieved evidence directly addresses the relationship between measured-exposure tertiles of varicella vaccine and the risk of herpes zoster.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Measured-exposure tertiles dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no dose effect OR no dose-response Measured-exposure tertiles pubmed · 112 hits · run 2026-09-09
10 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 37967254 · Human vaccines & immunotherapeutics (2023) — Effectiveness and safety of recombinant zoster vaccine: A review of real-world evidence.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 37781954 · The Cochrane database of systematic revi (2023) — Vaccines for preventing herpes zoster in older adults.
ambiguous 16462966 · Revista chilena de infectologia : organo (2006) — [Varicella vaccine].
does_not_resolve 28644696 · Expert review of vaccines (2017) — Varicella vaccination - the global experience.
does_not_resolve 22890288 · Bone marrow transplantation (2013) — Live (vaccines) from New York.
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 addresses a dose-dependent effect of varicella vaccine across a graded concentration curve in organoids, or any organoid-based experimental data on varicella vaccine and herpes zoster.
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no dose effect OR no dose-response Organoid concentration curve pubmed · 123 hits · run 2026-09-09
10 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 37967254 · Human vaccines & immunotherapeutics (2023) — Effectiveness and safety of recombinant zoster vaccine: A review of real-world evidence.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 37781954 · The Cochrane database of systematic revi (2023) — Vaccines for preventing herpes zoster in older adults.
ambiguous 16462966 · Revista chilena de infectologia : organo (2006) — [Varicella vaccine].
does_not_resolve 28644696 · Expert review of vaccines (2017) — Varicella vaccination - the global experience.
does_not_resolve 22890288 · Bone marrow transplantation (2013) — Live (vaccines) from New York.
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 retrieved evidence addresses whether achieved exposure (Cmax/tissue) of the varicella vaccine plausibly reaches the in-vitro EC50 for herpes zoster. The retrieved studies focus on vaccine effectiveness against herpes zoster (e.g., recombinant zoster vaccine, live attenuated varicella vaccine), risk factors such as diabetes, and general safety/immunogenicity, but none provide pharmacokinetic or pharmacodynamic data linking varicella vaccine exposure levels to in-vitro EC50 thresholds.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) EC50 vs Cmax coherence dose-response OR dose effect pubmed · 1299586 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) no dose effect OR no dose-response EC50 vs Cmax coherence pubmed · 112 hits · run 2026-09-09
10 retrieved record(s)
does_not_resolve 39082700 · The Journal of infectious diseases (2025) — Effectiveness of MenB-4C Vaccine Against Gonorrhea: A Systematic Review and Meta-analysis.
does_not_resolve 37967254 · Human vaccines & immunotherapeutics (2023) — Effectiveness and safety of recombinant zoster vaccine: A review of real-world evidence.
does_not_resolve 34536279 · The Journal of clinical endocrinology an (2022) — Association Between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis.
does_not_resolve 37781954 · The Cochrane database of systematic revi (2023) — Vaccines for preventing herpes zoster in older adults.
ambiguous 16462966 · Revista chilena de infectologia : organo (2006) — [Varicella vaccine].
refutes_node 28644696 · Expert review of vaccines (2017) — Varicella vaccination - the global experience.
does_not_resolve 22890288 · Bone marrow transplantation (2013) — Live (vaccines) from New York.
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 retrieved evidence directly addresses the detection of a hypothetical mediator (e.g., vaccine-strain VZV) in affected tissue of patients with herpes zoster after varicella vaccination, compared to controls.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Mediator identified in cases in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Mediator identified in cases not associated mechanism pubmed · 3 hits · run 2026-09-09
2 retrieved record(s)
refutes_node 41081504 · Journal of medical virology (2025) — Epidemiology and Clinical Profile of Herpes Zoster in the Varicella Vaccine Era: A Case Series Study.
does_not_resolve 28162821 · Vaccine (2017) — Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marro
E2 · Mediator in healthy vaccineesno_data
Measure: Mediator detectable after vaccination Comparator: Pre-vaccination baseline Hit rule: Mediator appears after vaccination and tracks the exposure window
Finding: The study reports on safety and immunogenicity of varicella vaccine in VZV-seropositive HIV-infected adults, but does not provide evidence of a new Herpes Zoster (Shingles) case attributed to the vaccine occurring within a pre-specified risk window after vaccination in healthy vaccinees.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Mediator in healthy vaccinees in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Mediator in healthy vaccinees not associated mechanism pubmed · 2 hits · run 2026-09-09
1 retrieved record(s)
does_not_resolve 20372089 · Human vaccines (2010) — Safety and immunogenicity of a live attenuated varicella vaccine in VZV-seropositive HIV-infected adults.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Infection contrast in vitro OR patient-derived pubmed · 29267 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Infection contrast not associated mechanism pubmed · 23 hits · run 2026-09-09
5 retrieved record(s)
does_not_resolve 32963118 · Current issues in molecular biology (2021) — Alphaherpesvirus Vaccines.
refutes_node 37400282 · Vaccine (2023) — Impacts of routine varicella vaccination program and COVID-19 pandemic on varicella and herpes zoster incidence and health resource use among children in Japan.
ambiguous 18419409 · The Journal of infectious diseases (2008) — Vaccine Oka variants and sequence variability in vaccine-related skin lesions.
does_not_resolve 40592255 · Vaccine (2025) — AS01-adjuvanted vaccine alters baseline correlates of T cell response to varicella zoster virus in older adults.
does_not_resolve 12627494 · Journal of medical virology (2003) — Varicella-zoster virus isolates, but not the vaccine strain OKA, induce sensitivity to alpha-1 and beta-1 adrenergic stimulation of sensory neurones in culture.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Transfer to recipient in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Transfer to recipient not associated mechanism pubmed · 0 hits (0 hits — negative) · run 2026-09-09
E5 · Transfer specificityno_data
Measure: Transfer requires the specific mediator Comparator: Transfer with mediator present Hit rule: Transfer effect is lost when the specific mediator is removed
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Transfer specificity in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Transfer specificity not associated mechanism pubmed · 1 hits · run 2026-09-09
E6 · Depletion / knockdownno_data
Measure: Removing the mediator reduces the effect Comparator: Non-targeted knockdown Hit rule: Knockdown / depletion of the mediator reduces the phenotype
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Depletion / knockdown in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
Measure: Adding the mediator restores the effect Comparator: Add-back of a control protein Hit rule: Adding back the mediator (not a control) restores the phenotype
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Add-back rescue in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
Measure: Neutralizing the mediator blocks the effect Comparator: Isotype control Hit rule: Neutralization of the mediator (not an isotype control) blocks the phenotype
Finding: No retrieved evidence addresses neutralization of a mediator blocking a phenotype relevant to the Varicella vaccine causing Herpes Zoster.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Neutralization in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Neutralization not associated mechanism pubmed · 23 hits · run 2026-09-09
6 retrieved record(s)
does_not_resolve 38006010 · Vaccines (2023) — Pre-Clinical Development of an Adenovirus Vector Based RSV and Shingles Vaccine Candidate.
does_not_resolve 35658899 · BMC immunology (2022) — Immunological characteristics of MAV/06 strain of varicella-zoster virus vaccine in an animal model.
does_not_resolve 39460278 · Vaccines (2024) — Structures of the Varicella Zoster Virus Glycoprotein E and Epitope Mapping of Vaccine-Elicited Antibodies.
does_not_resolve 26873057 · Vaccine (2016) — A highly conserved epitope-vaccine candidate against varicella-zoster virus induces neutralizing antibodies in mice.
does_not_resolve 32167678 · Immunity, inflammation and disease (2020) — Evaluation of glycoprotein E subunit and live attenuated varicella-zoster virus vaccines formulated with a single-strand RNA-based adjuvant.
does_not_resolve 25787138 · Clinical and vaccine immunology : CVI (2015) — High-level cellular and humoral immune responses in Guinea pigs immunized intradermally with a heat-inactivated varicella-zoster virus 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 evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Isotype control in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Isotype control not associated mechanism pubmed · 23 hits · run 2026-09-09
6 retrieved record(s)
ambiguous 40916263 · Vaccine (2025) — Safety, immunogenicity and efficacy of the Shingrix vaccine in immunocompromised varicella zoster virus naïve pediatric patients.
does_not_resolve 36631357 · Vaccine (2023) — Anti-varicella-zoster virus antibody titers and seroprotection status from before the first dose of varicella vaccination to before entering elementary school i
does_not_resolve 26873057 · Vaccine (2016) — A highly conserved epitope-vaccine candidate against varicella-zoster virus induces neutralizing antibodies in mice.
does_not_resolve 12097537 · The New England journal of medicine (2002) — Use of an inactivated varicella vaccine in recipients of hematopoietic-cell transplants.
refutes_node 34570596 · Annals of internal medicine (2021) — The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy : A Randomized Contr
ambiguous 41703694 · The Pediatric infectious disease journal (2026) — Immunogenicity and Safety of Two-dose Schedules With Different Intervals of an ORF7-deficient Live Vaccine Candidate for Varicella: A Randomized, Double-blind,
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Full product reproduces component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Full product reproduces no effect component isolation pubmed · 0 hits (0 hits — negative) · run 2026-09-09
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 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
F2 · Empty vector / particleno_data
Measure: Vector/particle without antigen reproduces (or not) Comparator: Full product Hit rule: Effect attributed to (or excluded from) the vector/particle backbone alone
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Empty vector / particle component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
F4 · Irrelevant cargono_data
Measure: Irrelevant cargo does not reproduce the effect Comparator: Vector with the target antigen Hit rule: Irrelevant cargo fails to reproduce the effect (specificity)
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Irrelevant cargo component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Infection preparation component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
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: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Cytokine / adjuvant mix component OR antigen OR vector pubmed · 2045722 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
F7 · Component combinationno_data
Measure: Defined component combination reproduces the effect Comparator: Single components Hit rule: A defined combination reproduces the effect that single components do not
Finding: No retrieved evidence addresses the capacity of a defined component combination of varicella vaccine to reproduce herpes zoster when single components do not.
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Component combination component OR antigen OR vector pubmed · 2045723 hits · run 2026-09-09
does_not_resolve 25876176 · Human vaccines & immunotherapeutics (2015) — Progress on adenovirus-vectored universal influenza vaccines.
does_not_resolve 40857335 · PLoS neglected tropical diseases (2025) — Novel rabies vaccine candidates development based on pseudotyped lentiviral vectors with rabies virus glycoprotein.
does_not_resolve 21952287 · Cancer journal (Sudbury, Mass.) (2011) — Viral vector-based therapeutic cancer vaccines.
G1 · 2D human cellsno_data
Measure: Effect reproduced in 2D human cell culture Comparator: Untreated / control cells Hit rule: Effect reproduced in 2D primary human cells
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) 2D human cells animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) 2D human cells not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
G2 · Organoid / chipno_data
Measure: Effect reproduced in organoid / organ-on-chip Comparator: Unexposed organoid Hit rule: Effect reproduced in a 3D organoid / organ-on-chip system
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Organoid / chip animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Organoid / chip not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
H1 · Block in vitro / in vivono_data
Measure: Blocking the mediator/mechanism prevents the effect Comparator: Control intervention Hit rule: Blocking the mechanism prevents or reverses the effect (not with a control intervention)
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Block in vitro / in vivo intervention OR treatment OR reversal pubmed · 15146614 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Block in vitro / in vivo no effect intervention pubmed · 0 hits (0 hits — negative) · run 2026-09-09
Clinical / animal / host 7/7 evaluated
E10 · Host-line dependenceno_data
Measure: Effect depends on host line/cell type Comparator: Susceptible host line Hit rule: Effect is restricted to a defined host line / genotype, not universal
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) mechanism Host-line dependence in vitro OR patient-derived pubmed · 29266 hits · run 2026-09-09
Measure: Effect in animal via the clinical route of administration Comparator: Vehicle, same route Hit rule: Effect reproduced in an animal using the clinical route of administration
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Animal, clinical route animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Animal, clinical route not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
G4 · Susceptible animalno_data
Measure: Effect in a susceptible animal model Comparator: Non-susceptible model Hit rule: Effect in a defined susceptible animal model
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Susceptible animal animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Susceptible animal not reproduced model pubmed · 1 hits · run 2026-09-09
G5 · Replication across labsno_data
Measure: Effect replicated in an independent lab Comparator: Original result Hit rule: The key effect is replicated in an independent laboratory
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Replication across labs animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Replication across labs not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
G6 · Blinded scoringno_data
Measure: Outcomes scored blinded Comparator: Unblinded reference Hit rule: Primary outcomes scored by a blinded assessor
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Blinded scoring animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Blinded scoring not reproduced model pubmed · 0 hits (0 hits — negative) · run 2026-09-09
G7 · Experimental time courseno_data
Measure: Effect follows a defined experimental time course Comparator: No-exposure time course Hit rule: The effect's onset/offset follows a defined experimental time course
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Experimental time course animal OR organoid OR cell model pubmed · 1819354 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Experimental time course not reproduced model pubmed · 1 hits · run 2026-09-09
I4 · Susceptibility traitno_data
Measure: A host trait / marker defines susceptibility Comparator: Trait-negative hosts Hit rule: A defined host trait / marker enriches for susceptibility
Finding: no evidence found
Cited: (none)
supporting: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Susceptibility trait coherence OR latency OR susceptibility pubmed · 870416 hits · run 2026-09-09
mirror: Varicella (chickenpox) vaccine Herpes Zoster (Shingles) Susceptibility trait inconsistent OR contradicts pubmed · 27618 hits · run 2026-09-09
1 retrieved record(s)
ambiguous 15578364 · Clinical infectious diseases : an offici (2004) — Varicella vaccine for susceptible adults: do it today.
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.