COVID VAX & THROMBOSIS.pdf

    COVID VAX & THROMBOSIS.pdf

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    International Journal of Innovative Research in Medical Science (IJIRMS)
Volume 09, Issue 11, November 2024, 
https://doi.org/10.23958/ijirms/vol09-i11/1982
www.ijirms.in 621
Original article
COVID-19 Vaccines: A Risk Factor for Cerebral 
Thrombotic Syndromes
Claire Rogers *
1
, James A Thorp 2, Kirstin Cosgrove 3, Peter A McCullough 4
1
Independent Researcher, Rome GA.
2The Wellness Company, Boca Raton FL.
3
Independent Researcher, Stanley NC.
4McCullough Foundation, Dallas TX.
Received 30 September 2024; Accepted 29 October 2024; Published 01 November 2024
Abstract
Introduction: This population-based retrospective cohort study assesses rates of adverse events (AEs) involving cerebral thromboembolism (CTE) 
after COVID-19 vaccines. Methods: Data were collected from the U.S. Centers for Disease Control and Prevention (CDC) and Food and Drug 
Administration (FDA) Vaccine Adverse Event Reporting System (VAERS) database from January 1, 1990 to December 31, 2023. CTE AEs after 
COVID-19 vaccines were compared to those after influenza vaccines and after all other vaccines using proportional reporting ratio (PRR) analysis 
by time. Results: There are 5137 cerebral thromboembolism AEs reported in the 3 years (36 months) after COVID-19 vaccines compared to 52 
AEs for the influenza vaccines over the past 34 years (408 months) and 282 AEs for all other vaccines (excluding COVID-19) over the past 34 
years (408 months). The PRR’s are significant when comparing AEs by time from COVID-19 vaccines to that of the influenza vaccines (p < 
0.0001) or to that of all other vaccines (p < 0.0001). The CTE AEs PRR by time (95% confidence intervals) for the COVID-19 vaccine AEs vs 
influenza AEs is 1120 (95% confidence interval (723-1730), p < 0.0001) and for COVID-19 vaccines vs all others is 207 (95% confidence interval 
(144-296), p < 0.0001). Cerebral venous thromboembolism AEs are female predominant with a female/male odds ratio of 1.63 (95% confidence 
interval (1.52-1.74), p < 0.0001). Conversely, cerebral arterial thromboembolism has a nonsignificant male preponderance. Cerebral venous 
thromboembolism is far more common than cerebral arterial thromboembolism over 36 months with an odds ratio (OR) of 14.8 (95% confidence 
interval 14.0-15.5, p < 0.0001). Atrial fibrillation, the most common identifiable cause of cerebral arterial thromboembolism, occurs far more 
commonly after the COVID-19 as compared to all other vaccines with a PRR of 123 (95% CI 88.3-172, p < 0.0001). Conclusions: There is an 
alarming breach in the safety signal threshold concerning cerebral thrombosis AEs after COVID-19 vaccines compared to that of the influenza 
vaccines and even when compared to that of all other vaccines. An immediate global moratorium on the use of COVID-19 vaccines is necessary 
with an absolute contraindication in women of reproductive age.
Keywords: thrombosis, cerebral thromboembolism, Sars-CoV-2, COVID-19 vaccine, spike protein.
Plain language title and summary
COVID-19 Vaccines: A Risk Factor for Stroke
This research sought to determine if there is an increased risk of 
stroke in patients after receiving the COVID-19 vaccine. Cerebral 
venous thrombosis was of particular interest because this rare variant 
of stroke is generally seen in younger women of child-bearing 
potential due to the physiological risk factors inherent to this patient 
population. Using the U.S. Centers for Disease Control and 
Prevention (CDC) and Food and Drug Administration (FDA) 
Vaccine Adverse Events Reporting System (VAERS), reports of 
stroke were extracted from January 1, 1990 to December 31, 2023.
VAERS case numbers after the COVID-19 vaccines were compared 
to the numbers after the influenza vaccines as well as to all vaccines 
in the database. There were 5137 cases of cerebral 
thromboembolism in 36 months after COVID-19 vaccines compared 
to 52 cases for the influenza vaccines over a period of 408 months 
and 282 cases for all other vaccines (excluding COVID-19) in 408 
months. The alarming number of reports of stroke in VAERS after 
the COVID-19 vaccines over a much shorter period of time 
demonstrate an unacceptable risk for this serious complication.
Introduction
In 1856 Rudolph Virchow, a German pathologist, recognized three 
factors that led to thromboembolism: vascular stasis, 
hypercoagulability, and vascular trauma. This has withstood the test 
of time and is commonly referred to as Virchow’s Triad [1]. The 
overall prevalence of cerebral venous thrombosis (CVT) in adults is 
estimated to be about one per 100,000 people per year although sexspecific risk factors include women, contraceptive use, pregnancy, 
puerperium, and hormone replacement therapy. A gradual increase
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in the incidence has been observed over time in women. The 
incidence of CVT in women ages 31-50 years is around three per 
100,000 people per year [2].
Many clinicians have observed a substantial increase in CTE 
since the rollout of the COVID-19 vaccines. The legally mandated 
Pfizer’s post-marketing analysis was conducted from the start of the 
public rollout on about December 10, 2020 to February 28, 2021. 
This Pfizer document noted their COVID-19 vaccine to be the most 
lethal and injurious drug ever rolled out to the public with 42,086 
casualties including 1,223 deaths in just the first 10 weeks of rollout 
[3]. Pfizer and the FDA attempted to conceal the post-market analyses 
of adverse events for 55-75 years [4,5]. The government concurrently 
invested unprecedented amounts of US tax dollars to promote the 
safety, efficacy, and necessity of the COVID-19 vaccines even in the 
most vulnerable population: pregnant women, preborns, and 
newborns. Many researchers across the globe estimate that the 
vaccine has killed far more people than it has saved [6-10].
Sir Karl Popper believed that scientific knowledge is 
provisional and refutes the “positivist account of the scientific 
method” and should be replaced by the “induction with falsification 
principle”. By using observations, as Popper stated, science 
progresses by falsification and refutation of reigning scientific 
narratives [11]. By Karl Popper’s reasoning, the reigning narrative 
that the COVID-19 vaccines are safe, effective, and necessary 
originally taken on faith by the medical community has decidedly 
been falsified and refuted. There are now 3,580 studies published in 
peer-reviewed medical journals documenting injuries, disabilities, 
and deaths after COVID-19 vaccines [12]. Additionally, Janssen and 
AstraZeneca adenoviral vaccines have been removed from markets 
globally [13,14].
The purpose of this report is to query the US Centers for 
Disease Control (CDC) and US Food and Drug Administration 
(FDA) Vaccine Adverse Event Reporting System (VAERS) for the 
safety signals of venous/arterial thromboembolism after vaccination.
Methods
The US Centers for Disease Control and Prevention (CDC) and Food 
and Drug Administration (FDA) Vaccine Adverse Event Reporting 
System (VAERS) were used to extract the data with the 
MedAlerts.org platform. VAERS uses the MedDRA (medical 
dictionary for regulatory activities), a clinically validated 
international medical terminology used for regulatory and 
biopharmaceutical purposes [15]. In VAERS we used the MedDRA 
“lowest level terms” (LLT’s) for this investigation. Noteworthy is 
that MedDRA LLT’s are in British rather than American spellings 
which results in some challenges for queries; for example, 
“ischaemic” in this particular report. The following 12 “symptoms” 
were extracted from VAERS using the MedDRA LLT’s referred to 
hereafter as cerebral thromboembolism CTE adverse events (AEs).
1) ‘cavernous sinus thrombosis’, 2) ‘cerebral artery thrombosis’, 3) 
‘cerebral infarction’, 4) ‘cerebral thrombosis’, 5) ‘cerebral venous 
sinus thrombosis’, 6) ‘cerebral venous thrombosis’, 7) ‘embolic 
cerebral infarction’, 8) ‘ischaemic cerebral infarction’, 9) ‘sigmoid 
sinus thrombosis’, 10) ‘superior sagittal sinus thrombosis’, 11) 
‘thrombotic cerebral infarction’, and 12) ‘transverse sinus 
thrombosis’.
Using the AEs above, the VAERS database was analyzed from 
January 1,1990 through December 31, 2023 thus yielding 3 years 
(36 months) of COVID-19 vaccine data and 34 years (408 months) 
for all other vaccines. 
The pathophysiological basis for these 12 CTE AEs falls into three 
clinically distinct and separate categories:
1) Cerebral venous thrombosis (CVT): ‘cavernous sinus 
thrombosis’, ‘cerebral venous sinus thrombosis’, ‘cerebral 
venous thrombosis’, ‘sigmoid sinus thrombosis’, ‘superior 
sagittal sinus thrombosis’, ‘transverse sinus thrombosis’;
2) Cerebral thrombosis undetermined as to arterial or venous 
etiology (CTU): ‘cerebral infarction’, ‘cerebral 
thrombosis’, ‘embolic cerebral infarction’, ‘ischaemic 
cerebral infarction’, thrombotic cerebral infarction’
3) Cerebral arterial thrombosis (CAT): ‘cerebral artery 
thrombosis’. 
Statistical analysis for proportional reporting ratios (PRR) based on 
AEs per time, per dose, and per individual vaccinated was performed 
in a previous publication utilizing Poisson distribution and Monte 
Carlo Simulations. Because the findings of AEs per dose and per 
individual vaccinated were similar to AEs per time, these analytics 
were not repeated [16].
Since atrial fibrillation is the most common identifiable 
cause of cerebral arterial thromboembolism, [17] MedAlerts was 
queried on 5/4/2024 to analyze atrial fibrillation cases with the last 
release of VAERS reports from 4/26/2024. We compared reports for 
atrial fibrillation following COVID-19 vaccines from December 1, 
2020 to April 26, 2024 (41 months) to all other vaccines between the 
dates of January 1, 1990 through April 26, 2024 (412 months).
The preferred methods of analytics were used according to 
the standards set forth by FDA/CDC/VAERS for what is historically 
considered a “safe vaccine” compared to that of the novel vaccine, 
thus providing a proportional reporting ratio (PRR). The COVID-19
vaccine AEs were compared to those associated after the influenza 
vaccines and to all vaccines. According to the CDC’s standard 
operating procedures for the analysis of COVID-19 vaccine AEs, a 
PRR ≥ 2 is a safety concern [18]. Standard statistical methods were 
used including reporting ratios and 95% confidence intervals using 
the MedCalc statistical software [19].
Results
Table 1: The raw data extracted from VAERS database from January 1,1990 through December 31, 2023 including 36 months of COVID19 vaccine data and 408 months for influenza as well as all other vaccines. Column 1 includes the 12 “symptoms” exactly as described in 
the VAERS lowest level terms in MedDRA.
Adverse Events (AEs) VAERS Total AEs reported 
over 408 months
COVID-19 vaccine 
AEs over 36 months
Influenza vaccine AEs 
over 408 months 
All other vaccines AEs 
over 408 months
Cavernous sinus thrombosis 24 20 3 4
Cerebral artery thrombosis 103 99 1 4
Cerebral infarction 2799 2623 35 176
Cerebral thrombosis 640 612 5 28
Cerebral venous sinus thrombosis 896 874 1 22
Cerebral venous thrombosis 372 345 1 27
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Embolic cerebral infarction 60 57 1 3
Ischaemic cerebral infarction 247 238 2 9
Sigmoid sinus thrombosis 10 10 0 0
Superior sagittal sinus thrombosis 88 86 0 2
Thrombotic cerebral infarction 47 46 0 1
Transverse sinus thrombosis 133 127 3 6
Table 1 summarizes the raw data extracted from VAERS database from January 1,1990 through December 31, 2023, including 36 months of 
COVID-19 vaccine data and 408 months for influenza as well as all other vaccines.
Table 2: Based upon the three clinically distinct pathophysiologies, the 12 “symptoms” of interest in the VAERS lowest level MedDRA 
terms were separated into three distinct categories: cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to the 
arterial/venous source (CTU), and cerebral arterial thrombosis (CAT). The raw data from Table 1 are included in these separate categories 
and totaled in the last row.
Category of Thrombosis COVID-19 vaccines over 36 
months
Influenza vaccines over 
408 months
All other vaccines over 
408 months
Cerebral Venous Thrombosis (CVT) 1462 8 61
Cerebral Thrombosis Undetermined (CTU) 3576 43 217
Cerebral Arterial Thrombosis (CAT) 99 1 4
Total Cerebral Thromboembolism (CTE) 5137 52 282
Table 2 categorizes the raw data into three clinically distinct pathophysiologic categories of the 12 “symptoms” of interest in VAERS. These 
include cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to the arterial/venous source (CTU), and cerebral arterial 
thrombosis (CAT). 
Table 3: The proportional risk ratios (PRR) of COVID-19 vaccines versus influenza vaccines (Column 2) and COVID-19 vaccines versus 
all other vaccines (Column 3) for each category CVT, CTU, CAT, CTE (by rows). There is a significant increase in cerebrovascular 
thrombosis for all categories (p < 0.0001).
Category of Thrombosis COVID-19 Vaccines over 36 Months vs 
Influenza Vaccines over 408 Months 
PRR (95% Confidence Interval) 
COVID-19 Vaccines over 36 Months vs 
Other Vaccines over 408 Months 
PRR (95% Confidence Interval) 
Cerebral Venous Thrombosis (CVT) 2070
(955 - 4490)
P < 0.0001
272
(177 - 416)
P < 0.0001
Cerebral Thrombosis Undetermined (CTU) 943
(598 - 1480)
P < 0.0001
187
(129 - 270)
P < 0.0001)
Cerebral Arterial Thrombosis (CAT) 1120
(152 - 8280)
P < 0.0001
281
(97.6 - 806)
P < 0.0001
Cerebral Thrombosis Total 
(CTE)
1120
(723 - 1730)
P < 0.0001
207
(144 - 296)
P < 0.0001
Table 3 demonstrates the proportional risk ratios (95% CI, p value) of COVID-19 vaccines versus Influenza vaccines (Column 2) and COVID-19 
vaccines versus all other vaccines (Column 3) for each category CVT, CTU, CAT, CTE (by rows). There is a significant increase in cerebrovascular 
thrombosis for all categories (p < 0.0001).
Table 4: The female / male odds ratios in the comparison of CTE AEs after COVID-19 vaccine by cerebral venous thrombosis (CVT), 
cerebral thrombosis undetermined as to venous or arterial (CTU), cerebral arterial thrombosis (CAT) and cerebral thrombosis total 
(CTE).
Adverse Events (AEs) COVID-19 Vaccine AEs over
36 Months
Female/Male
Odds Ratio (95% confidence interval)
Cerebral Venous Thrombosis (CVT) Female / Male / Unknown
11 / 9 /0
545 / 318 / 11
211 / 132 / 2
5 / 4 / 1
46 / 38 / 2
77 / 48 / 2
Totals 895 / 549 / 18
Female / Male 
1.63
(1.52 - 1.74)
Cerebral Thrombosis (undetermined 
as to venous or arterial) (CTU)
Female / Male / Unknown
1300 / 1297 / 26
314 / 292 / 6
22 / 35 / 0
Female / Male
0.99
(0.95 - 1.04)
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106 / 132 / 0
25 / 21 / 0
Total 1767 / 1777 / 32
Cerebral Arterial Thrombosis (CAT) 47 / 50 / 2 Female / Male
0.94
(0.69 - 1.25)
Cerebral Thrombosis Total (CTE) 2709 / 2376 / 52 Female / Male 
1.14
(1.10 – 1.18)
Table 4 depicts the female / male odds ratios in the comparison of CTE AEs by cerebral venous thrombosis (CVT), cerebral thrombosis 
undetermined as to venous or arterial (CTU), cerebral arterial thrombosis (CAT) and cerebral thrombosis total (CTE). As expected, CVT had the 
highest female / male ratio 1.63 (1.52 - 1.74), followed by CTE 1.14 (1.10 – 1.18), followed by CTU 0.99 (0.95 - 1.25), and lastly CAT which has 
a non-significant male preponderance 0.94 (0.69 - 1.25).
Table 5: CTE AEs after COVID-19 vaccines are stratified by age and sex dates from 1/1/1990 through 12/31/2023. The female / male ratio 
in age group 18-59 years is 1.28 (676/527) with a 95% confidence interval of 1.19 - 1.38.
Age Sex
Female Male Unknown
18-29 years 134 43 3
30-39 years 136 83 1
40-49 years 202 146 0
50-59 years 204 255 1
Total 676 527 5
Table 5 compares data in the age range of greatest prevalence for CTE cases with vaccination dates from 1/1/1990 through 12/31/2023. The sex 
disparities in AEs after COVID-19 vaccination are stratified by age and sex. The female / male ratio in age group 18 - 59 years is 1.28 (676/527) 
with a 95% confidence interval of 1.19 - 1.38.
Atrial fibrillation is the most common identifiable risk factor for 
cerebral arterial thromboembolism which is one of the leading 
causes of morbidity and mortality globally [17]. MedAlerts was 
analyzed for atrial fibrillation cases comparing COVID-19 vaccines 
from December 1, 2020 through April 26, 2024 (41 months) to all 
other vaccines between the dates of January 1, 1990 through April 
26, 2024 (412 months). There are 9,821 reports of atrial fibrillation 
after COVID-19 vaccines in 41 months compared to 797 cases 
reported in 412 months for all other vaccines combined. The 
Proportional Risk Ratio (PRR) for atrial fibrillation associated with 
COVID-19 vaccines compared to all other vaccines in the database 
is 123 with a 95% confidence interval 88.3-172, p < 0.0001.
Discussion
Cerebral venous thrombosis (CVT) is a rare disorder characterized 
by thrombus formation within the cerebral veins or dural sinuses. 
The annual incidence ranges from 1.16 to 2.02 per 100,000 and is 
encountered more predominantly in female patients. Additionally, 
CVT affects a younger patient population than what is seen in 
arterial strokes, with a median age of 37 years with one study citing 
only 8% of patients were over the age of 65 [20]. Diagnosis of this 
condition is challenging for clinicians due to the wide and variable 
clinical presentation including headache, papilledema, visual loss, 
focal or generalized seizures, focal neurologic deficits, confusion, 
altered consciousness, and coma [21,22]. Typical risk factors for the 
development of CVT include inherited prothrombotic conditions, 
brain tumors, trauma, infections, hematological diseases, 
medications, surgery, pregnancy, and puerperium, amongst others 
[23]
.
Cerebral embolisms are one of the most common causes of 
morbidity and mortality globally. The global incidence rate of 
embolic (ischemic) strokes varies widely between countries and 
regions. Rates in the United States range from 74 per 100,000 to 329 
per 100,000 people with males having the preponderance of cases 
[24]. Unlike cerebral thrombosis, a cerebral embolism occurs when a 
clot travels to the brain from elsewhere in the body, usually the heart. 
Symptoms vary greatly depending on the location of the embolus 
but often results in a painless acute neurological deficit. Risk factors 
include history of stroke, increasing age, hypertension, smoking, 
hypercholesterolemia, heart disease, diabetes, and high alcohol 
intake [25]. The most common identifiable risk factor for a cerebral 
arterial thromboembolism is atrial fibrillation [17]. Of interest, there 
were 3,554 cases of atrial fibrillation reported after COVID-19 
vaccination in the Pfizer clinical trial post-marketing documents [26].
The Sars-CoV-2 vaccines were necessarily developed 
rapidly without the standard 10-15 years of development and testing 
to establish safety [27]. The vaccines were subsequently approved 
under Emergency Use Authorization (EUA) in response to the novel 
viral pathogen, Sars-CoV-2, that rapidly spread across the globe 
leaving chaos, fear, and death in its wake. Early in the COVID 
pandemic, it became evident that there was a thrombogenic effect of 
the Sars-CoV-2 virus and it is now believed that the spike protein is 
one of the major contributors to this thrombogenic effect [28,29]. As 
expected, the same thromboembolic effects have been noted postvaccination, likely a result of the spike protein component of the 
vaccine.
During the first wave of infection with the original Wuhan 
strain of the virus, hospitalized patients experienced a variety of 
severe thromboembolic events and, over time, natural evolution may 
have resulted in less virulent strains. Subsequently, the 
hypercoagulability concerns from serious thromboembolic events 
seen in 2020 have diminished. However, fibrin-amyloid aggregates 
affecting the smaller vessels in the circulatory system known as 
“microclots” are being discussed globally as one of the main 
mechanisms driving Long COVID and vaccine injury [30]. 
Microclots circulate and deposit throughout the body having 
potential detrimental effects on every organ system, yet no 
standardized diagnostic test or treatment algorithm exists.
Although the virus alone is not driving a substantial number 
of thromboembolic events, it is now widely understood that 
cumulative exposure to the spike protein, either from the virus or
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vaccine, greatly increases prothrombotic coagulopathy risks in 
patients [31]. This is a significant factor as most of the population has 
either been infected with the Sars-CoV-2 virus or taken the COVID 
vaccine(s), while many have had both. As documented by Statista, 
up to 80.3% of the US population has taken at least one COVID 
vaccine [32].
A NIH National Library of Medicine PubMed search on 
various thrombotic diagnoses confirms the alarming trend that we 
are seeing in the general population: there was a significant increase 
in the case reports and scientific papers on this topic between 2020
and 2021 with a notable variable being the rollout of the COVID 
vaccines during this time frame. A peer-reviewed publication in 
2022 documented that there were 1,366 peer-reviewed medical 
journal articles published in just 16 months that document injuries
and deaths after COVID-19 vaccines. This manuscript published and 
categorized these 1,366 articles with the most common categories 
being myocarditis/pericarditis in 336 articles, vaccine-induced 
thrombotic thrombocytopenia in 209 articles, and 160 articles 
regarding arterial and venous thromboembolism [33]. Hisano and 
colleagues published findings of their recent study in which antiphospholipid antibodies were found in the serum of the study 
participants post-vaccination. Persistence of these antibodies are 
associated with antiphospholipid syndrome, one of the potential 
mechanisms behind various thrombotic adverse events postvaccination, including recurrent miscarriages [34]
.
There are many strengths of this study. The open-source 
VAERS database used for this investigation is regulated, owned, and 
maintained by the CDC/FDA. These entities continue promoting 
COVID-19 vaccines in all patients, even the most vulnerable 
population, pregnant women, while making fraudulent claims of 
safety and efficacy. Despite the bias of the CDC/FDA and their 
attempts to hide, conceal, and “throttle” the deaths and injuries 
caused by the COVID-19 vaccines, there remains an unprecedented 
breach of the safety signal using their own criteria [35-37].
The limitations to this study are those inherent to the 
CDC/FDA’s VAERS database. The relative underreporting factor 
(URF) in VAERS is thought to be in the range of 30-100. This factor, 
which irrefutably and substantially reduces the danger signals, 
determines that the number of adverse events associated with the 
vaccines cannot confidently be known. The URF may be attributed 
to several reasons [38-40]. It has been reported that there is tremendous 
difficulty in VAERS processing because the CDC staff are 
overwhelmed with adverse effect reports [41]. Many clinicians do not 
possess the knowledge necessary to recognize, evaluate, report, or 
treat vaccine AEs. The VAERS database is well known for its 
difficulty in entering events, making it even more challenging for 
healthcare workers to submit each event with limited time in a 
hospital or clinic setting.
This study demonstrates a significant breach in the safety 
signal threshold concerning COVID-19 vaccines’ association with 
an increased risk of cerebral venous thrombosis as compared to that 
of influenza vaccines as well as all other vaccines. Prior to the
COVID-19 vaccine rollout, the prevalence of CVT was far less 
common than CAT with a reported ratio of 1:62.5 [42]. Females 
represent a far greater proportion of the cases of cerebral venous 
thrombosis which is likely associated with the greater risk of CTE in 
pregnancy, puerperium, contraceptive use, and hormonal 
replacement therapy. 
Conclusion
This study demonstrates a significant breach in the safety signal 
threshold concerning the association of COVID-19 vaccines with an 
increased risk of cerebral venous thrombosis as compared to that of 
influenza vaccines as well as all other vaccines (excluding COVID19). The CTE AEs when analyzed using PRR by time (95% 
confidence interval) for the COVID-19 vaccine AEs vs influenza 
AEs is 1120 (95% confidence interval (723-1730), p < 0.0001) and 
for COVID-19 vaccines vs all others is 207 (95% confidence interval 
144-296, p < 0.0001). Females represent a far greater proportion of 
the cases of cerebral venous thrombosis with a female / male odds 
ratio of 1.63 (95% confidence interval 1.52-1.74, p < 0.0001), likely 
associated with the greater risk of CTE in pregnancy, puerperium, 
contraceptive use, and hormonal replacement therapy. An immediate 
global moratorium on the use of COVID-19 vaccines is necessary to 
mitigate further risk with an absolute contraindication in women of 
reproductive age.
Declarations
Acknowledgements
Not applicable
Author Contributions
CR: data curation, investigation, methodology, project 
administration, supervision, validation, writing - original draft, 
writing - review & editing.
JT: conceptualization, data curation, formal analysis, investigation, 
methodology, project administration, supervision, writing - original 
draft, writing - review & editing
KC: data curation, investigation, validation, writing - review & 
editing
PM: formal analysis, investigation, methodology, supervision, 
validation, writing - review & editing
Statements and declaration
Not applicable
Ethical considerations
Not applicable
Consent to participate
Not applicable
Consent for publication
Not applicable
Conflicting interest
The authors declared no potential conflicts of interest with respect 
to the research, authorship, and/or publication of this article.
Funding statement
Not applicable
Data availability
Raw data collected for and outlined in this paper may be obtained 
by searching the VAERS database at 
https://medalerts.org/vaersdb/index.php.
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Open Access This article is licensed under a 
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    • 1. International Journal of Innovative Research in Medical Science (IJIRMS) Volume 09, Issue 11, November 2024, https://doi.org/10.23958/ijirms/vol09-i11/1982 www.ijirms.in 621 Original article COVID-19 Vaccines: A Risk Factor for Cerebral Thrombotic Syndromes Claire Rogers * 1 , James A Thorp 2, Kirstin Cosgrove 3, Peter A McCullough 4 1 Independent Researcher, Rome GA. 2The Wellness Company, Boca Raton FL. 3 Independent Researcher, Stanley NC. 4McCullough Foundation, Dallas TX. Received 30 September 2024; Accepted 29 October 2024; Published 01 November 2024 Abstract Introduction: This population-based retrospective cohort study assesses rates of adverse events (AEs) involving cerebral thromboembolism (CTE) after COVID-19 vaccines. Methods: Data were collected from the U.S. Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) Vaccine Adverse Event Reporting System (VAERS) database from January 1, 1990 to December 31, 2023. CTE AEs after COVID-19 vaccines were compared to those after influenza vaccines and after all other vaccines using proportional reporting ratio (PRR) analysis by time. Results: There are 5137 cerebral thromboembolism AEs reported in the 3 years (36 months) after COVID-19 vaccines compared to 52 AEs for the influenza vaccines over the past 34 years (408 months) and 282 AEs for all other vaccines (excluding COVID-19) over the past 34 years (408 months). The PRR’s are significant when comparing AEs by time from COVID-19 vaccines to that of the influenza vaccines (p < 0.0001) or to that of all other vaccines (p < 0.0001). The CTE AEs PRR by time (95% confidence intervals) for the COVID-19 vaccine AEs vs influenza AEs is 1120 (95% confidence interval (723-1730), p < 0.0001) and for COVID-19 vaccines vs all others is 207 (95% confidence interval (144-296), p < 0.0001). Cerebral venous thromboembolism AEs are female predominant with a female/male odds ratio of 1.63 (95% confidence interval (1.52-1.74), p < 0.0001). Conversely, cerebral arterial thromboembolism has a nonsignificant male preponderance. Cerebral venous thromboembolism is far more common than cerebral arterial thromboembolism over 36 months with an odds ratio (OR) of 14.8 (95% confidence interval 14.0-15.5, p < 0.0001). Atrial fibrillation, the most common identifiable cause of cerebral arterial thromboembolism, occurs far more commonly after the COVID-19 as compared to all other vaccines with a PRR of 123 (95% CI 88.3-172, p < 0.0001). Conclusions: There is an alarming breach in the safety signal threshold concerning cerebral thrombosis AEs after COVID-19 vaccines compared to that of the influenza vaccines and even when compared to that of all other vaccines. An immediate global moratorium on the use of COVID-19 vaccines is necessary with an absolute contraindication in women of reproductive age. Keywords: thrombosis, cerebral thromboembolism, Sars-CoV-2, COVID-19 vaccine, spike protein. Plain language title and summary COVID-19 Vaccines: A Risk Factor for Stroke This research sought to determine if there is an increased risk of stroke in patients after receiving the COVID-19 vaccine. Cerebral venous thrombosis was of particular interest because this rare variant of stroke is generally seen in younger women of child-bearing potential due to the physiological risk factors inherent to this patient population. Using the U.S. Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) Vaccine Adverse Events Reporting System (VAERS), reports of stroke were extracted from January 1, 1990 to December 31, 2023. VAERS case numbers after the COVID-19 vaccines were compared to the numbers after the influenza vaccines as well as to all vaccines in the database. There were 5137 cases of cerebral thromboembolism in 36 months after COVID-19 vaccines compared to 52 cases for the influenza vaccines over a period of 408 months and 282 cases for all other vaccines (excluding COVID-19) in 408 months. The alarming number of reports of stroke in VAERS after the COVID-19 vaccines over a much shorter period of time demonstrate an unacceptable risk for this serious complication. Introduction In 1856 Rudolph Virchow, a German pathologist, recognized three factors that led to thromboembolism: vascular stasis, hypercoagulability, and vascular trauma. This has withstood the test of time and is commonly referred to as Virchow’s Triad [1]. The overall prevalence of cerebral venous thrombosis (CVT) in adults is estimated to be about one per 100,000 people per year although sexspecific risk factors include women, contraceptive use, pregnancy, puerperium, and hormone replacement therapy. A gradual increase
    • 2. International Journal of Innovative Research in Medical Science (IJIRMS) www.ijirms.in 622 in the incidence has been observed over time in women. The incidence of CVT in women ages 31-50 years is around three per 100,000 people per year [2]. Many clinicians have observed a substantial increase in CTE since the rollout of the COVID-19 vaccines. The legally mandated Pfizer’s post-marketing analysis was conducted from the start of the public rollout on about December 10, 2020 to February 28, 2021. This Pfizer document noted their COVID-19 vaccine to be the most lethal and injurious drug ever rolled out to the public with 42,086 casualties including 1,223 deaths in just the first 10 weeks of rollout [3]. Pfizer and the FDA attempted to conceal the post-market analyses of adverse events for 55-75 years [4,5]. The government concurrently invested unprecedented amounts of US tax dollars to promote the safety, efficacy, and necessity of the COVID-19 vaccines even in the most vulnerable population: pregnant women, preborns, and newborns. Many researchers across the globe estimate that the vaccine has killed far more people than it has saved [6-10]. Sir Karl Popper believed that scientific knowledge is provisional and refutes the “positivist account of the scientific method” and should be replaced by the “induction with falsification principle”. By using observations, as Popper stated, science progresses by falsification and refutation of reigning scientific narratives [11]. By Karl Popper’s reasoning, the reigning narrative that the COVID-19 vaccines are safe, effective, and necessary originally taken on faith by the medical community has decidedly been falsified and refuted. There are now 3,580 studies published in peer-reviewed medical journals documenting injuries, disabilities, and deaths after COVID-19 vaccines [12]. Additionally, Janssen and AstraZeneca adenoviral vaccines have been removed from markets globally [13,14]. The purpose of this report is to query the US Centers for Disease Control (CDC) and US Food and Drug Administration (FDA) Vaccine Adverse Event Reporting System (VAERS) for the safety signals of venous/arterial thromboembolism after vaccination. Methods The US Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) Vaccine Adverse Event Reporting System (VAERS) were used to extract the data with the MedAlerts.org platform. VAERS uses the MedDRA (medical dictionary for regulatory activities), a clinically validated international medical terminology used for regulatory and biopharmaceutical purposes [15]. In VAERS we used the MedDRA “lowest level terms” (LLT’s) for this investigation. Noteworthy is that MedDRA LLT’s are in British rather than American spellings which results in some challenges for queries; for example, “ischaemic” in this particular report. The following 12 “symptoms” were extracted from VAERS using the MedDRA LLT’s referred to hereafter as cerebral thromboembolism CTE adverse events (AEs). 1) ‘cavernous sinus thrombosis’, 2) ‘cerebral artery thrombosis’, 3) ‘cerebral infarction’, 4) ‘cerebral thrombosis’, 5) ‘cerebral venous sinus thrombosis’, 6) ‘cerebral venous thrombosis’, 7) ‘embolic cerebral infarction’, 8) ‘ischaemic cerebral infarction’, 9) ‘sigmoid sinus thrombosis’, 10) ‘superior sagittal sinus thrombosis’, 11) ‘thrombotic cerebral infarction’, and 12) ‘transverse sinus thrombosis’. Using the AEs above, the VAERS database was analyzed from January 1,1990 through December 31, 2023 thus yielding 3 years (36 months) of COVID-19 vaccine data and 34 years (408 months) for all other vaccines. The pathophysiological basis for these 12 CTE AEs falls into three clinically distinct and separate categories: 1) Cerebral venous thrombosis (CVT): ‘cavernous sinus thrombosis’, ‘cerebral venous sinus thrombosis’, ‘cerebral venous thrombosis’, ‘sigmoid sinus thrombosis’, ‘superior sagittal sinus thrombosis’, ‘transverse sinus thrombosis’; 2) Cerebral thrombosis undetermined as to arterial or venous etiology (CTU): ‘cerebral infarction’, ‘cerebral thrombosis’, ‘embolic cerebral infarction’, ‘ischaemic cerebral infarction’, thrombotic cerebral infarction’ 3) Cerebral arterial thrombosis (CAT): ‘cerebral artery thrombosis’. Statistical analysis for proportional reporting ratios (PRR) based on AEs per time, per dose, and per individual vaccinated was performed in a previous publication utilizing Poisson distribution and Monte Carlo Simulations. Because the findings of AEs per dose and per individual vaccinated were similar to AEs per time, these analytics were not repeated [16]. Since atrial fibrillation is the most common identifiable cause of cerebral arterial thromboembolism, [17] MedAlerts was queried on 5/4/2024 to analyze atrial fibrillation cases with the last release of VAERS reports from 4/26/2024. We compared reports for atrial fibrillation following COVID-19 vaccines from December 1, 2020 to April 26, 2024 (41 months) to all other vaccines between the dates of January 1, 1990 through April 26, 2024 (412 months). The preferred methods of analytics were used according to the standards set forth by FDA/CDC/VAERS for what is historically considered a “safe vaccine” compared to that of the novel vaccine, thus providing a proportional reporting ratio (PRR). The COVID-19 vaccine AEs were compared to those associated after the influenza vaccines and to all vaccines. According to the CDC’s standard operating procedures for the analysis of COVID-19 vaccine AEs, a PRR ≥ 2 is a safety concern [18]. Standard statistical methods were used including reporting ratios and 95% confidence intervals using the MedCalc statistical software [19]. Results Table 1: The raw data extracted from VAERS database from January 1,1990 through December 31, 2023 including 36 months of COVID19 vaccine data and 408 months for influenza as well as all other vaccines. Column 1 includes the 12 “symptoms” exactly as described in the VAERS lowest level terms in MedDRA. Adverse Events (AEs) VAERS Total AEs reported over 408 months COVID-19 vaccine AEs over 36 months Influenza vaccine AEs over 408 months All other vaccines AEs over 408 months Cavernous sinus thrombosis 24 20 3 4 Cerebral artery thrombosis 103 99 1 4 Cerebral infarction 2799 2623 35 176 Cerebral thrombosis 640 612 5 28 Cerebral venous sinus thrombosis 896 874 1 22 Cerebral venous thrombosis 372 345 1 27
    • 3. International Journal of Innovative Research in Medical Science (IJIRMS) www.ijirms.in 623 Embolic cerebral infarction 60 57 1 3 Ischaemic cerebral infarction 247 238 2 9 Sigmoid sinus thrombosis 10 10 0 0 Superior sagittal sinus thrombosis 88 86 0 2 Thrombotic cerebral infarction 47 46 0 1 Transverse sinus thrombosis 133 127 3 6 Table 1 summarizes the raw data extracted from VAERS database from January 1,1990 through December 31, 2023, including 36 months of COVID-19 vaccine data and 408 months for influenza as well as all other vaccines. Table 2: Based upon the three clinically distinct pathophysiologies, the 12 “symptoms” of interest in the VAERS lowest level MedDRA terms were separated into three distinct categories: cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to the arterial/venous source (CTU), and cerebral arterial thrombosis (CAT). The raw data from Table 1 are included in these separate categories and totaled in the last row. Category of Thrombosis COVID-19 vaccines over 36 months Influenza vaccines over 408 months All other vaccines over 408 months Cerebral Venous Thrombosis (CVT) 1462 8 61 Cerebral Thrombosis Undetermined (CTU) 3576 43 217 Cerebral Arterial Thrombosis (CAT) 99 1 4 Total Cerebral Thromboembolism (CTE) 5137 52 282 Table 2 categorizes the raw data into three clinically distinct pathophysiologic categories of the 12 “symptoms” of interest in VAERS. These include cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to the arterial/venous source (CTU), and cerebral arterial thrombosis (CAT). Table 3: The proportional risk ratios (PRR) of COVID-19 vaccines versus influenza vaccines (Column 2) and COVID-19 vaccines versus all other vaccines (Column 3) for each category CVT, CTU, CAT, CTE (by rows). There is a significant increase in cerebrovascular thrombosis for all categories (p < 0.0001). Category of Thrombosis COVID-19 Vaccines over 36 Months vs Influenza Vaccines over 408 Months PRR (95% Confidence Interval) COVID-19 Vaccines over 36 Months vs Other Vaccines over 408 Months PRR (95% Confidence Interval) Cerebral Venous Thrombosis (CVT) 2070 (955 - 4490) P < 0.0001 272 (177 - 416) P < 0.0001 Cerebral Thrombosis Undetermined (CTU) 943 (598 - 1480) P < 0.0001 187 (129 - 270) P < 0.0001) Cerebral Arterial Thrombosis (CAT) 1120 (152 - 8280) P < 0.0001 281 (97.6 - 806) P < 0.0001 Cerebral Thrombosis Total (CTE) 1120 (723 - 1730) P < 0.0001 207 (144 - 296) P < 0.0001 Table 3 demonstrates the proportional risk ratios (95% CI, p value) of COVID-19 vaccines versus Influenza vaccines (Column 2) and COVID-19 vaccines versus all other vaccines (Column 3) for each category CVT, CTU, CAT, CTE (by rows). There is a significant increase in cerebrovascular thrombosis for all categories (p < 0.0001). Table 4: The female / male odds ratios in the comparison of CTE AEs after COVID-19 vaccine by cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to venous or arterial (CTU), cerebral arterial thrombosis (CAT) and cerebral thrombosis total (CTE). Adverse Events (AEs) COVID-19 Vaccine AEs over 36 Months Female/Male Odds Ratio (95% confidence interval) Cerebral Venous Thrombosis (CVT) Female / Male / Unknown 11 / 9 /0 545 / 318 / 11 211 / 132 / 2 5 / 4 / 1 46 / 38 / 2 77 / 48 / 2 Totals 895 / 549 / 18 Female / Male 1.63 (1.52 - 1.74) Cerebral Thrombosis (undetermined as to venous or arterial) (CTU) Female / Male / Unknown 1300 / 1297 / 26 314 / 292 / 6 22 / 35 / 0 Female / Male 0.99 (0.95 - 1.04)
    • 4. International Journal of Innovative Research in Medical Science (IJIRMS) www.ijirms.in 624 106 / 132 / 0 25 / 21 / 0 Total 1767 / 1777 / 32 Cerebral Arterial Thrombosis (CAT) 47 / 50 / 2 Female / Male 0.94 (0.69 - 1.25) Cerebral Thrombosis Total (CTE) 2709 / 2376 / 52 Female / Male 1.14 (1.10 – 1.18) Table 4 depicts the female / male odds ratios in the comparison of CTE AEs by cerebral venous thrombosis (CVT), cerebral thrombosis undetermined as to venous or arterial (CTU), cerebral arterial thrombosis (CAT) and cerebral thrombosis total (CTE). As expected, CVT had the highest female / male ratio 1.63 (1.52 - 1.74), followed by CTE 1.14 (1.10 – 1.18), followed by CTU 0.99 (0.95 - 1.25), and lastly CAT which has a non-significant male preponderance 0.94 (0.69 - 1.25). Table 5: CTE AEs after COVID-19 vaccines are stratified by age and sex dates from 1/1/1990 through 12/31/2023. The female / male ratio in age group 18-59 years is 1.28 (676/527) with a 95% confidence interval of 1.19 - 1.38. Age Sex Female Male Unknown 18-29 years 134 43 3 30-39 years 136 83 1 40-49 years 202 146 0 50-59 years 204 255 1 Total 676 527 5 Table 5 compares data in the age range of greatest prevalence for CTE cases with vaccination dates from 1/1/1990 through 12/31/2023. The sex disparities in AEs after COVID-19 vaccination are stratified by age and sex. The female / male ratio in age group 18 - 59 years is 1.28 (676/527) with a 95% confidence interval of 1.19 - 1.38. Atrial fibrillation is the most common identifiable risk factor for cerebral arterial thromboembolism which is one of the leading causes of morbidity and mortality globally [17]. MedAlerts was analyzed for atrial fibrillation cases comparing COVID-19 vaccines from December 1, 2020 through April 26, 2024 (41 months) to all other vaccines between the dates of January 1, 1990 through April 26, 2024 (412 months). There are 9,821 reports of atrial fibrillation after COVID-19 vaccines in 41 months compared to 797 cases reported in 412 months for all other vaccines combined. The Proportional Risk Ratio (PRR) for atrial fibrillation associated with COVID-19 vaccines compared to all other vaccines in the database is 123 with a 95% confidence interval 88.3-172, p < 0.0001. Discussion Cerebral venous thrombosis (CVT) is a rare disorder characterized by thrombus formation within the cerebral veins or dural sinuses. The annual incidence ranges from 1.16 to 2.02 per 100,000 and is encountered more predominantly in female patients. Additionally, CVT affects a younger patient population than what is seen in arterial strokes, with a median age of 37 years with one study citing only 8% of patients were over the age of 65 [20]. Diagnosis of this condition is challenging for clinicians due to the wide and variable clinical presentation including headache, papilledema, visual loss, focal or generalized seizures, focal neurologic deficits, confusion, altered consciousness, and coma [21,22]. Typical risk factors for the development of CVT include inherited prothrombotic conditions, brain tumors, trauma, infections, hematological diseases, medications, surgery, pregnancy, and puerperium, amongst others [23] . Cerebral embolisms are one of the most common causes of morbidity and mortality globally. The global incidence rate of embolic (ischemic) strokes varies widely between countries and regions. Rates in the United States range from 74 per 100,000 to 329 per 100,000 people with males having the preponderance of cases [24]. Unlike cerebral thrombosis, a cerebral embolism occurs when a clot travels to the brain from elsewhere in the body, usually the heart. Symptoms vary greatly depending on the location of the embolus but often results in a painless acute neurological deficit. Risk factors include history of stroke, increasing age, hypertension, smoking, hypercholesterolemia, heart disease, diabetes, and high alcohol intake [25]. The most common identifiable risk factor for a cerebral arterial thromboembolism is atrial fibrillation [17]. Of interest, there were 3,554 cases of atrial fibrillation reported after COVID-19 vaccination in the Pfizer clinical trial post-marketing documents [26]. The Sars-CoV-2 vaccines were necessarily developed rapidly without the standard 10-15 years of development and testing to establish safety [27]. The vaccines were subsequently approved under Emergency Use Authorization (EUA) in response to the novel viral pathogen, Sars-CoV-2, that rapidly spread across the globe leaving chaos, fear, and death in its wake. Early in the COVID pandemic, it became evident that there was a thrombogenic effect of the Sars-CoV-2 virus and it is now believed that the spike protein is one of the major contributors to this thrombogenic effect [28,29]. As expected, the same thromboembolic effects have been noted postvaccination, likely a result of the spike protein component of the vaccine. During the first wave of infection with the original Wuhan strain of the virus, hospitalized patients experienced a variety of severe thromboembolic events and, over time, natural evolution may have resulted in less virulent strains. Subsequently, the hypercoagulability concerns from serious thromboembolic events seen in 2020 have diminished. However, fibrin-amyloid aggregates affecting the smaller vessels in the circulatory system known as “microclots” are being discussed globally as one of the main mechanisms driving Long COVID and vaccine injury [30]. Microclots circulate and deposit throughout the body having potential detrimental effects on every organ system, yet no standardized diagnostic test or treatment algorithm exists. Although the virus alone is not driving a substantial number of thromboembolic events, it is now widely understood that cumulative exposure to the spike protein, either from the virus or
    • 5. International Journal of Innovative Research in Medical Science (IJIRMS) www.ijirms.in 625 vaccine, greatly increases prothrombotic coagulopathy risks in patients [31]. This is a significant factor as most of the population has either been infected with the Sars-CoV-2 virus or taken the COVID vaccine(s), while many have had both. As documented by Statista, up to 80.3% of the US population has taken at least one COVID vaccine [32]. A NIH National Library of Medicine PubMed search on various thrombotic diagnoses confirms the alarming trend that we are seeing in the general population: there was a significant increase in the case reports and scientific papers on this topic between 2020 and 2021 with a notable variable being the rollout of the COVID vaccines during this time frame. A peer-reviewed publication in 2022 documented that there were 1,366 peer-reviewed medical journal articles published in just 16 months that document injuries and deaths after COVID-19 vaccines. This manuscript published and categorized these 1,366 articles with the most common categories being myocarditis/pericarditis in 336 articles, vaccine-induced thrombotic thrombocytopenia in 209 articles, and 160 articles regarding arterial and venous thromboembolism [33]. Hisano and colleagues published findings of their recent study in which antiphospholipid antibodies were found in the serum of the study participants post-vaccination. Persistence of these antibodies are associated with antiphospholipid syndrome, one of the potential mechanisms behind various thrombotic adverse events postvaccination, including recurrent miscarriages [34] . There are many strengths of this study. The open-source VAERS database used for this investigation is regulated, owned, and maintained by the CDC/FDA. These entities continue promoting COVID-19 vaccines in all patients, even the most vulnerable population, pregnant women, while making fraudulent claims of safety and efficacy. Despite the bias of the CDC/FDA and their attempts to hide, conceal, and “throttle” the deaths and injuries caused by the COVID-19 vaccines, there remains an unprecedented breach of the safety signal using their own criteria [35-37]. The limitations to this study are those inherent to the CDC/FDA’s VAERS database. The relative underreporting factor (URF) in VAERS is thought to be in the range of 30-100. This factor, which irrefutably and substantially reduces the danger signals, determines that the number of adverse events associated with the vaccines cannot confidently be known. The URF may be attributed to several reasons [38-40]. It has been reported that there is tremendous difficulty in VAERS processing because the CDC staff are overwhelmed with adverse effect reports [41]. Many clinicians do not possess the knowledge necessary to recognize, evaluate, report, or treat vaccine AEs. The VAERS database is well known for its difficulty in entering events, making it even more challenging for healthcare workers to submit each event with limited time in a hospital or clinic setting. This study demonstrates a significant breach in the safety signal threshold concerning COVID-19 vaccines’ association with an increased risk of cerebral venous thrombosis as compared to that of influenza vaccines as well as all other vaccines. Prior to the COVID-19 vaccine rollout, the prevalence of CVT was far less common than CAT with a reported ratio of 1:62.5 [42]. Females represent a far greater proportion of the cases of cerebral venous thrombosis which is likely associated with the greater risk of CTE in pregnancy, puerperium, contraceptive use, and hormonal replacement therapy. Conclusion This study demonstrates a significant breach in the safety signal threshold concerning the association of COVID-19 vaccines with an increased risk of cerebral venous thrombosis as compared to that of influenza vaccines as well as all other vaccines (excluding COVID19). The CTE AEs when analyzed using PRR by time (95% confidence interval) for the COVID-19 vaccine AEs vs influenza AEs is 1120 (95% confidence interval (723-1730), p < 0.0001) and for COVID-19 vaccines vs all others is 207 (95% confidence interval 144-296, p < 0.0001). Females represent a far greater proportion of the cases of cerebral venous thrombosis with a female / male odds ratio of 1.63 (95% confidence interval 1.52-1.74, p < 0.0001), likely associated with the greater risk of CTE in pregnancy, puerperium, contraceptive use, and hormonal replacement therapy. An immediate global moratorium on the use of COVID-19 vaccines is necessary to mitigate further risk with an absolute contraindication in women of reproductive age. Declarations Acknowledgements Not applicable Author Contributions CR: data curation, investigation, methodology, project administration, supervision, validation, writing - original draft, writing - review & editing. JT: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, writing - original draft, writing - review & editing KC: data curation, investigation, validation, writing - review & editing PM: formal analysis, investigation, methodology, supervision, validation, writing - review & editing Statements and declaration Not applicable Ethical considerations Not applicable Consent to participate Not applicable Consent for publication Not applicable Conflicting interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding statement Not applicable Data availability Raw data collected for and outlined in this paper may be obtained by searching the VAERS database at https://medalerts.org/vaersdb/index.php. References [1] Kushner A, West WP, Khan Suheb MZ, et al. Virchow Triad. [Updated 2022 Dec 10]. In: StatPearls [Internet]. 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