Human papillomavirus vaccination of adult women and risk of autoimmune and neurological diseases

Abstract

Unmasking of conditions at vaccination visits is a plausible explanation for the increased risk associated with qHPV in this study because coeliac disease is underdiagnosed in Scandinavian populations. In conclusion, our study of serious adverse event rates in qHPV-vaccinated and qHPV-unvaccinated adult women 18-44 years of age did not raise any safety issues of concern.

Systematic Review and Meta-analysis of Postlicensure Observational Studies on Human Papillomavirus Vaccination and Autoimmune and Other Rare Adverse Events

“…8 More than 60 different autoimmune and rare adverse events were studied. Some studies focused on any autoimmune diseases (n = 4), 28,31,32,35 others (n = 18) 8,9, [18][19][20][21][22][23][24][25][26][27]29,30,33,34,36,37 targeted specific outcomes. Type 1 diabetes mellitus was the most frequently studied (in 11 studies).…”

“…Type 1 diabetes mellitus was the most frequently studied (in 11 studies). 8,9,18,19,24,28,31-33,35,37 Autoimmune thyroiditis diseases 8,9,19,24,28,32,35,37 including Hashimoto and Grave diseases, hypothyroidism and other hyperthyroidism, and immune thrombocytopenia purpura 8,9,18,19,24,28,32,35 (ITP) were assessed in 8 studies: Crohn disease 21,24,28,32,35,37 in 6 studies, Bell palsy, 24,28,31,32,35 coeliac disease, 9,28,31,32,35 juvenile rheumatoid arthritis, 8,9,24,35 optic neuritis, 8,24,27,28,36 rheumatoid arthritis, 8,9,28,31,32 ulcerative colitis 24,28,31,…”

“…Four studies 9,19,21,29 among 7 including data on Guillain-Barre syndrome (GBS) provided risk estimates. Fourteen studies 8,18,20,23,24,[26][27][28][29][30][31][32]34,36 concerned 4vHPV vaccine exposure, while 4 studies 22,25,35,37 assessed 2vHPV vaccine exposure. Two studies 9,21 provided risk estimates separately for 4vHPV and 2vHPV vaccine exposures.…”

“…Five studies 8,9,20,27,37 developed complex algorithms combining diagnosis codes and additional clinical information such as medications, laboratory test results and referral to specialists to identify cases. Fifteen studies 19,[21][22][23][24][25][26][28][29][30][31][32][33][34][35][36] identifying cases by diagnosis codes only implemented a review of all medical charts or contacted health-care providers (6 studies). 21,24,26,27,33,36 Three studies, 8,20,37 in addition to elaborated algorithms, put in place a case ascertainment process with a panel of specialist physicians.…”

Characterization of the Differential Adverse Event Rates by Race/Ethnicity Groups for HPV Vaccine by Integrating Data From Different Sources

“…Such a potential association between HPV vaccination and autoimmune disorders were also investigated and reported in current literature, but the evidence for the association were not consistent. Cases of autoimmune disorder following HPV vaccination were reported(Colafrancesco et al, 2013 ; Tomljenovic et al, 2014 ; Palmieri et al, 2017 ), while some studies also found statistically insignificant association (Arnheim-Dahlström et al, 2013 ; Hviid et al, 2018 ). Such inconsistent findings can be potentially due to differential rates of AE among race and ethnicity groups, but to our knowledge, no current study has investigated differential AE following HPV vaccination among race and ethnicity groups, although differential rates of uptaking the vaccine among race and ethnicity groups has been reported (Bednarczyk et al, 2011 ), with a lower rate in black/African-American women compared to White.…”