No Link Between HPV Vaccine and Autoimmune Disorder Risk

Summary: Researchers report they have found no increased risk of autoimmune diseases in girls who received the HPV4 vaccine. The study adds to a growing body of evidence for the safety of the vaccine.

Source: CMAJ.

A new study in CMAJ (Canadian Medical Association Journal) found no increased risk of autoimmune disorders in girls who received quadrivalent human papillomavirus (HPV4) vaccination, adding to the body of evidence for the safety of the vaccine.

Human papillomavirus is the most common sexually transmitted disease worldwide, affecting 50%-75% of sexually active people. The HPV4 vaccine is effective at protecting against 90% of the strains that cause cervical and anal cancer. Despite studies showing safety of the vaccine, there have been concerns about a possible link to autoimmune disorders.

“Despite demonstrated effectiveness in real-world settings, concerns continue to persist regarding the safety of the HPV4 vaccine. In light of these concerns, we wanted to study the HPV4 vaccination since it was being offered free to all grade 8 girls in Ontario through school-based clinics,” says Dr. Jeffrey Kwong, a study author and a senior scientist at the Institute for Clinical Evaluative Sciences (ICES) and at Public Health Ontario.

vaccine being given
The HPV4 vaccine is effective at protecting against 90% of the strains that cause cervical and anal cancer. NeuroscienceNews.com image is in the public domain.

To determine whether the HPV4 vaccination triggered autoimmune conditions such lupus, rheumatoid arthritis, type 1 diabetes and multiple sclerosis, researchers looked at data on 290 939 girls aged 12 to 17 years in Ontario who were eligible for vaccination between 2007 and 2013. Of the total 180 819 girls who received the HPV4 (Gardasil and Merck) vaccination in school-based clinics, there were 681 diagnosed cases of autoimmune disorders between one week and two months after vaccination. This rate is consistent with the general rate of diagnosed cases in this age group.

“These findings add to the body of evidence on the safety of the HPV4 vaccine and should reassure parents and health care providers,” says Dr. Linda Lévesque, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.

About this neuroscience research article

Funding: The study was funded by the Ontario Ministry of Health and Long-Term Care, Drug Innovation Fund and the Canadian Institutes of Health Research (CIHR).

Source: Kim Barnhardt – CMAJ
Publisher: Organized by NeuroscienceNews.com.
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Open access research for “Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: the Ontario Grade 8 HPV Vaccine Cohort Study” by Erin Y. Liu, Leah M. Smith, Anne K. Ellis, Heather Whitaker, Barbara Law, Jeffrey C. Kwong, Paddy Farrington and Linda E. Lévesque in Canadian Medical Association Journal. Published May 28 2018.
doi:10.1503/cmaj.170871

Cite This NeuroscienceNews.com Article

[cbtabs][cbtab title=”MLA”]CMAJ “No Link Between HPV Vaccine and Autoimmune Disorder Risk.” NeuroscienceNews. NeuroscienceNews, 28 May 2018.
<https://neurosciencenews.com/hpv-vaccine-autoimmune-9156/>.[/cbtab][cbtab title=”APA”]CMAJ (2018, May 28). No Link Between HPV Vaccine and Autoimmune Disorder Risk. NeuroscienceNews. Retrieved May 28, 2018 from https://neurosciencenews.com/hpv-vaccine-autoimmune-9156/[/cbtab][cbtab title=”Chicago”]CMAJ “No Link Between HPV Vaccine and Autoimmune Disorder Risk.” https://neurosciencenews.com/hpv-vaccine-autoimmune-9156/ (accessed May 28, 2018).[/cbtab][/cbtabs]


Abstract

Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: the Ontario Grade 8 HPV Vaccine Cohort Study

BACKGROUND: Despite demonstrated effectiveness in real-world settings, concerns persist regarding the safety of the quadrivalent human papillomavirus (HPV4) vaccine. We sought to assess the risk of autoimmune disorders following HPV4 vaccination among grade 8 girls eligible for Ontario’s school-based HPV vaccination program.

METHODS: We undertook a population-based retrospective cohort study using Ontario’s administrative health and vaccination databases from 2007 to 2013. The self-controlled case series method was used to compare the rate of a composite end point of autoimmune disorders diagnosed during days 7–60 post-vaccination (“exposed” follow-up) to that at any other time (“unexposed”). The analysis was repeated to assess the effect of a history of immune-mediated diseases and time since vaccination. We also conducted an exploratory analysis of individual autoimmune disorders. Rate ratios and 95% confidence intervals (CIs) were estimated using conditional Poisson regression, adjusted for age, seasonality, concomitant vaccinations and infections.

RESULTS: The study cohort consisted of 290 939 girls aged 12–17 years who were eligible for vaccination between 2007 and 2013. There was no significant risk for developing an autoimmune disorder following HPV4 vaccination (n = 681; rate ratio 1.12, 95% CI 0.85–1.47), and the association was unchanged by a history of immune-mediated disorders and time since vaccination. Exploratory analyses of individual autoimmune disorders found no significant risks, including for Bell palsy (n = 65; rate ratio 1.73, 95% CI 0.77–3.89), optic neuritis (n = 67; rate ratio 1.57, 95% CI 0.74–3.33) and Graves disease (n = 47; rate ratio 1.55, 95% CI 0.92–2.63).

INTERPRETATION: We did not observe an increased risk of autoimmune disorders following HPV4 vaccination among teenaged girls. These findings should reassure parents and health care providers.

Human papillomavirus (HPV) is the most common sexually transmitted infection globally affecting 50%–75% of sexually active individuals. The quadrivalent HPV (HPV4) vaccine protects against 2 oncogenic strains of HPV and has been available since 2006. Despite demonstrated effectiveness in real-world settings including proven reduction in the risk of cervical dysplasia, concerns persist about the vaccine’s safety, particularly in light of case reports of autoimmune disorders following HPV vaccination.

A recent news story reporting cases of serious debilitating illnesses after HPV4 — although subsequently retracted — reactivated parental concerns about the safety of this vaccine. As such, we undertook a population-based, retrospective cohort study to assess the risk of autoimmune disorders following HPV4 vaccination among grade 8 girls eligible for Ontario’s HPV vaccination program.

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  1. I need to correct my comment above. I incorrectly read the forest graph. There was no increased risk for autoimmune hepatitis or hemolytic anaemia but these results were indicated by a longer line which means study group was very small, so unable to show an accurate result. But according to the graph(table 3) there seems to be an increased risk for 8 autoimmune disorders, including Bells Palsy, Optic neuritis, Graves disease and Hashimoto’s thyroiditis. If the result is above 1, this indicates a risk. I am a but confused as to why the horizontal lines cross the null effect line, we need to see the original study to get the exact numbers of cases in the control group and the vaccinated group. But to me this type of graph doesn’t seem to be very accurate or convincing and we really need more than just one study like this to compare. But as I said in my previous comment, collecting cases of new onset autoimmune disorders after vaccination for only a 60 day period, makes this study a very inaccurate study in my eyes. Autoimmune diseases can take a year or longer to appear! I am shocked that this study is accepted as proof of no increased risk in the HPV vaccinated group. It really is deceitful!

  2. Here is the study presented in another article with more information supplied. If you look at table 3 there was an increased incidence of haemolytic anaemia and autoimmune hepatitis in the vaccinated group. Why was this kept quiet? Also, I agree that following girls for only 60 days is not sufficient since autoimmune diseases may only present themselves after 1 to 3 years. So for these reasons, I also question this study. Rather shocking how quick everyone is to show this study to the public without studying it further. http://www.cmaj.ca/content/190/21/E648

  3. Любая прививка…это заражение организма! Понятно, что это возможность избежать проблем в будущем, но если использовать информацию об изменениях в пространстве, а это касается пространственной ДНК. Следует знать, структура пространства находится в постоянном изменении и поэтому прививки часто приносят вред, вместо пользы!
    С уважением!
    Валерий Елистратов

  4. Article ‘Adverse events following HPV vaccination, Alberta 2006–2014’ by Xianfang C. Liu et al published 26 February 2016 stated ‘Of the women who received HPV vaccine 958 were hospitalized and 19,351 had an ED visit within 42 days of immunization’. This was over 10% of those vaccinated.This is probably coherent with the reports on the WHO global database of adverse drug reactions (ADRs) at http://www.vigiaccess.org which lists over 309,000 ADRs iincluding 445 deaths (including 23 sudden death), 1,052 neoplasms (including 168 cervical cancers and 25 carcinoma in situ), 460 cases of POTS and 144 cases of CRPS, etc, etc.

    This article seems to be at odds with the existing evidence!

  5. Competing interests: Leah Smith is now employed by the Canadian Cancer Society, a charitable organization that promotes HPV vaccination and has received funds from Merck. However, this study was completed before Dr. Smith’s employment at the Canadian Cancer Society. Anne Ellis reports funding from ALK-Abelló, AstraZeneca, Bayer, Merck, Novartis, Pediapharm, Pfizer, Sanofi, Takeda and SunPharma. Linda Lévesque is now employed by Sanofi Pasteur, a global vaccine manufacturer; however, this study was completed before her employment at Sanofi Pasteur. No other competing interests were declared.

    They only looked at vaccine recipients not unvaccinated controls. Is 60 days post vaccination really long enough to see a connection between the vaccine and autoimmune diseases? Not saying there is a connection but this study is questionable.

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