HPV vaccine

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HPV vaccines are a group of vaccines have been developed to protect again human papillomavirus infection, which may lead to certain types of cancers. HPV refers to a very large group of viruses, and some of these, including HPV 16 and HPV 18, cause cervical cancer, anal cancer, genital warts, and other serious illness.[1]

Available vaccines protect against either two, four, or nine types of HPV.[2][3] All vaccines protect against at least HPV type 16 and 18 that cause the greatest risk of cervical cancer.[3]

Types[edit | edit source]

A number of different vaccines are in use, with bivalent vaccines protecting against two types of HPV, and quadrivalent vaccines protecting against four types of HPV:

  • Bivalent: Ceravix which protects against HPV 16 and HPV 18 only, and contains aluminum hydroxide and monophosphoryl lipid[2]
  • Quadrivalent: Gardasil which protects against HPV 6 and 11, plus HPV 16 and 18, and contains amorphous aluminum hydroxyphosphate sulfate. This is the vaccine currently used in the UK.[4][5]
  • Nonavalent: Gardasil-9, which protects against 9 types of HPV: HPV 6 and 11, HPV 16 and 18, plus HPV 31, HPV 33, HPV 45, HPV 52, and HPV 58, and contains a larger amount of aluminum hydroxyphosphate sulfate and more than twice as many virus-like particles than the quadrivalent vaccine.[6][7] Gardasil-9 was approved for use in the United States in 2014.[7]

Controversy[edit | edit source]

  • Should Your Child Get the HPV Vaccine?[8]
  • 2012, The HPV Vaccine Controversy[9]
  • 2014, Pros, cons, and ethics of HPV vaccine in teens—Why such controversy?[10]
  • Gøtzsche et al. (2021) criticized the European Medicines Agency report on HPV vaccine safety for being overly confident and relying too heavily on data on serious adverse events reported by the manufacturers during clinical trials, and also made criticisms of the Cochrane review process. They referred to previous investigations into rates of raised particular concerns about rates of POTS, ME/CFS and Chronic Regional Pain Syndrome (CRPS) after HPV vaccination, and to rates of post-vaccination in POTS compared to POTS rates after other vaccines. However, Gøtzsche et al avoided stating that the HPV vaccines were not safe and they present any analysis of data, or draw their own conclusions about the HPV vaccines.[11]

ME/CFS[edit | edit source]

The recent use of different HPV vaccines has led to a number of studies looking at HPV vaccine safety, including whether any of the HPV vaccines may increase the risk of developing ME/CFS.[1]

Feiring et al. (2007) conducted a national study in Norway covering six birth cohorts, and found that ME/CFS was not associated with HPV vaccination in girls, but medical history was associated with a higher number of girls developing ME/CFS within two years of HPV vaccine, and lower uptake of HPV vaccination.[6] They commented that ages 10-19 and 30-39 had the highest incidence of ME/CFS.

Notable studies and scientific publications[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 "Information About the Human Papillomavirus (HPV)". WebMD. Retrieved May 10, 2020.
  2. 2.0 2.1 National Cancer Institute (October 8, 2019). "Human Papillomavirus (HPV) Vaccines". cancer.gov. Retrieved May 10, 2020.
  3. 3.0 3.1 Kash, Natalie; Lee, Michael A.; Kollipara, Ramya; Downing, Christopher; Guidry, Jacqueline; Tyring, Stephen K. (April 3, 2015). "Safety and Efficacy Data on Vaccines and Immunization to Human Papillomavirus". Journal of Clinical Medicine. 4 (4): 614–633. doi:10.3390/jcm4040614. ISSN 2077-0383. PMC 4470159. PMID 26239350.
  4. National Health Service (July 31, 2019). "HPV vaccine overview". nhs.uk. Retrieved May 10, 2020.
  5. Electronic Medicines Compendium (May 7, 2019). "Gardasil suspension for injection - Summary of Product Characteristics (SmPC) - (emc)". emc-prod-wa.azurewebsites.net. Retrieved May 10, 2020.
  6. 6.0 6.1 6.2 Blitshteyn, Svetlana; Brinth, Louise; Hendrickson, Jeanne E.; Martinez-Lavin, Manuel (December 2018). "Autonomic dysfunction and HPV immunization: an overview". Immunologic Research. 66 (6): 744–754. doi:10.1007/s12026-018-9036-1. ISSN 1559-0755. PMID 30478703.
  7. 7.0 7.1 Centers for Disease Control. "Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices". Centers for Disease Control and Prevention. Retrieved May 10, 2020.
  8. Edgar, Julie. "Should Your Child Get the HPV Vaccine?". WebMD. Retrieved November 29, 2018.
  9. Intlekofer, Karlie A.; Cunningham, Michael J.; Caplan, Arthur L. (January 1, 2012). "The HPV Vaccine Controversy". AMA Journal of Ethics. 14 (1). ISSN 2376-6980.
  10. White, Mark Donald (2014). "Pros, cons, and ethics of HPV vaccine in teens—Why such controversy?". Translational Andrology and Urology. 3 (4): 429–434. doi:10.3978/j.issn.2223-4683.2014.11.02. ISSN 2223-4691. PMC 4708146. PMID 26816799.
  11. 11.0 11.1 http://dx.doi.org/10.1136/bmjebm-2020-111470
  12. Feiring, Berit; Laake, Ida; Bakken, Inger Johanne; Greve-Isdahl, Margrethe; Wyller, Vegard Bruun; Håberg, Siri E.; Magnus, Per; Trogstad, Lill (July 24, 2017). "HPV vaccination and risk of chronic fatigue syndrome/myalgic encephalomyelitis: A nationwide register-based study from Norway". Vaccine. 35 (33): 4203–4212. doi:10.1016/j.vaccine.2017.06.031. ISSN 0264-410X.
  13. Donegan, Katherine; Beau-Lejdstrom, Raphaelle; King, Bridget; Seabroke, Suzie; Thomson, Andrew; Bryan, Philip (October 9, 2013). "Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK". Vaccine. 31 (43): 4961–4967. doi:10.1016/j.vaccine.2013.08.024. ISSN 0264-410X.
  14. Tomljenovic, Lucija; Colafrancesco, Serena; Perricone, Carlo; Shoenfeld, Yehuda (January 1, 2014). "Postural Orthostatic Tachycardia With Chronic Fatigue After HPV Vaccination as Part of the "Autoimmune/Auto-inflammatory Syndrome Induced by Adjuvants": Case Report and Literature Review". Journal of Investigative Medicine High Impact Case Reports. 2 (1): 2324709614527812. doi:10.1177/2324709614527812. ISSN 2324-7096. PMC 4528866. PMID 26425598.
  15. Brinth, Louise; Pors, Kirsten; Hoppe, Anna AG; Badreldin, Iman; Mehlsen, Jesper (June 15, 2015). "Is Chronic Fatigue Syndrome/Myalgic Encephalomyelitis a Relevant Diagnosis in Patients with Suspected Side Effects to Human Papilloma Virus Vaccine?" (PDF). International Journal of Vaccines & Vaccination. 1 (1): 00003. doi:10.15406/ijvv.2015.01.00003. ISSN 2470-9980.
  16. 16.0 16.1 Blitshetyn, Svetlana; Brinth, Louise; Hendrickson, Jeanne E.; Martinez-Lavin, Manuel (November 27, 2018). "Autonomic dysfunction and HPV immunization: an overview". Immunologic Research. doi:10.1007/s12026-018-9036-1. ISSN 1559-0755. PMID 30478703.