A link between human papilloma virus vaccination and primary ovarian insufficiency

Gruber, Noah; Shoenfeld, Yehuda

doi:10.1097/gco.0000000000000183

Cited by 23 publications

(16 citation statements)

References 40 publications

(41 reference statements)

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“…Similarly, other investigators observed a case series of three women that had onset or exacerbation of lupus following HPV immunization [12]. Other researchers have suggested that an increasing number of cases of ovarian damage has been observed following HPV4 vaccine administration [13]. …”

Section: Discussionmentioning

confidence: 83%

See 1 more Smart Citation

Quadrivalent human papillomavirus vaccine and autoimmune adverse events: a case–control assessment of the vaccine adverse event reporting system (VAERS) database

Geier¹,

Geier²

2016

Immunol Res

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Gardasil is a quadrivalent human papillomavirus (HPV4) vaccine that was approved for use by the US Food and Drug Administration in June 2006. HPV4 vaccine is routinely recommended for administration to women in the USA who are 11–12 years old by the Advisory Committee on Immunization Practices. Previous studies suggest HPV4 vaccine administration was associated with autoimmune diseases. As a consequence, an epidemiological assessment of the vaccine adverse event reporting system database was undertaken for adverse event reports associated with vaccines administered from 2006 to 2014 to 6–39 year-old recipients with a listed US residence and a specified female gender. Cases with the serious autoimmune adverse event (SAAE) outcomes of gastroenteritis (odds ratio (OR) 4.627, 95 % confidence interval (CI) 1.892–12.389), rheumatoid arthritis (OR 5.629, 95 % CI 2.809–12.039), thrombocytopenia (OR 2.178, 95 % CI 1.222–3.885), systemic lupus erythematosus (OR 7.626, 95 % CI 3.385–19.366), vasculitis (OR 3.420, 95 % CI 1.211–10.408), alopecia (OR 8.894, 95 % CI 6.255–12.914), CNS demyelinating conditions (OR 1.585, 95 % CI 1.129–2.213), ovarian damage (OR 14.961, 95 % CI 6.728–39.199), or irritable bowel syndrome (OR 10.021, 95 % CI 3.725–33.749) were significantly more likely than controls to have received HPV4 vaccine (median onset of initial symptoms ranged from 3 to 37 days post-HPV4 vaccination). Cases with the outcome of Guillain–Barre syndrome (OR 0.839, 95 % CI 0.601–1.145) were no more likely than controls to have received HPV4 vaccine. In addition, cases with the known HPV4-related outcome of syncope were significantly more likely than controls to have received HPV4 vaccine (OR 5.342, 95 % CI 4.942–5.777). Cases with the general health outcomes of infection (OR 0.765, 95 % CI 0.428–1.312), conjunctivitis (OR 1.010, 95 % CI 0.480–2.016), diarrhea (OR 0.927, 95 % CI 0.809–1.059), or pneumonia (OR 0.785, 95 % CI 0.481–1.246) were no more likely than controls to have received HPV4 vaccine. Confirmatory epidemiological studies in other databases should be undertaken and long-term clinical consequences of HPV-linked SAAEs should be examined.

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Section: Discussionmentioning

confidence: 83%

“…Other investigators described animal models that showed aluminum exposure to inhibit expression of female reproductive hormones and to induce histologic changes in the ovaries [13]. …”

Section: Discussionmentioning

confidence: 99%

Quadrivalent human papillomavirus vaccine and autoimmune adverse events: a case–control assessment of the vaccine adverse event reporting system (VAERS) database

Geier¹,

Geier²

2016

Immunol Res

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“…The possible trigger for this has been reported to be aluminium‐containing adjuvant in the vaccine preparation, which increases the immune reaction, termed as autoimmune/inflammatory syndrome induced by adjuvants (ASIA) . Furthermore, the idea of autoimmunity in this case was supported by the presence of anti‐ovarian and anti‐thyroid peroxidise Abs …”

Section: Molecular Mimicry: the Conceptmentioning

confidence: 88%

Molecular mimicry: An explanation for autoimmune diseases and infertility

Thaper

Prabha

2018

Scand J Immunol

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Microorganisms execute an enthralling range of adjustments in order to survive in the host. Among the various strategies employed by microorganisms to surmount the host immune response, the phenomenon of molecular mimicry empowers the microorganisms to manoeuvre host physiology and cellular functions for their own advantage by mimicking the host proteins and initiating autoimmunity. This phenomena, by and large, has been studied in context of autoimmune diseases, however, its implications have also been reported in infertility. Hence, in this article, we provide a review of the various instances of molecular mimicry initiated by bacteria, parasites and viruses in the world of autoimmune diseases and infertility. This article is protected by copyright. All rights reserved.

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“…The health registry-based surveillance was more sensitive than the conventional SAE surveillance. This kind of health registry-based quantitative analysis is an important adjunct to the safety data on the HPV-16/18 vaccine and will in the future continue to be most appealing to health authorities in the context of newly licensed vaccines for suspected or alleged vaccine-associated adverse effects (e.g., autism, narcolepsy) or in the case of HPV vaccination, primary ovarian failure syndrome 29 or miscarriage 23,30-32 …”

Section: Discussionmentioning

confidence: 99%

Safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in adolescents aged 12–15 years: Interim analysis of a large community-randomized controlled trial

Lehtinen

Eriksson

Apter

et al. 2016

Human Vaccines & Immunotherapeutics

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This community-randomized controlled trial was initiated to assess the overall and herd effects of 2 different human papillomavirus (HPV) immunization strategies in over 80,000 girls and boys aged 12–15 y in 33 communities in Finland (ClinicalTrials.gov NCT00534638). Overall, 14,838 adolescents received HPV-16/18 vaccine (2,440 boys and 12,398 girls) and 17,338 received hepatitis-B virus (HBV) vaccine (9,221 boys and 8,117 girls). In an interim analysis, vaccine safety was assessed by active monitoring and surveillance via health registry linkage. Active monitoring showed that the HPV-16/18 vaccine has acceptable safety and reactogenicity in boys. In all study participants, the observed incidences (per 100,000 person-years) of serious adverse events (SAEs) possibly related to vaccination were 54.3 (95% Confidence Interval [CI]: 34.0–82.1) in the HPV-16/18 group and 64.0 (95% CI: 43.2–91.3) in the HBV group. During the follow-up period for this interim analysis, the most common new-onset autoimmune diseases (NOADs; with incidence rate ≥15 per 100,000) in any group based on hospital discharge registry (HILMO) download were ulcerative colitis, juvenile arthritis, celiac disease, insulin-dependent diabetes mellitus (IDDM) and Crohn's disease. No increased NOAD incidences were observed in HPV-16/18 vaccine recipients compared to HBV vaccine recipients. In both the SAE possibly related- and HILMO-analyses, a lower incidence of IDDM was observed in HPV-16/18 vaccinees compared to HBV vaccinees (relative risks, 0.26 [95% CI: 0.03–1.24] and 0.16 [95% CI: 0.03–0.55], respectively).

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A link between human papilloma virus vaccination and primary ovarian insufficiency

Abstract: The mechanisms responsible for POI are not yet fully understood. Although case reports cannot establish causation, awareness of a possible link between HPV4 and POI will help to identify and manage future cases that may arise.

Cited by 23 publications

References 40 publications

Quadrivalent human papillomavirus vaccine and autoimmune adverse events: a case–control assessment of the vaccine adverse event reporting system (VAERS) database

Quadrivalent human papillomavirus vaccine and autoimmune adverse events: a case–control assessment of the vaccine adverse event reporting system (VAERS) database

Molecular mimicry: An explanation for autoimmune diseases and infertility

Safety of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in adolescents aged 12–15 years: Interim analysis of a large community-randomized controlled trial

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