HPV vaccine not associated with Multiple Sclerosis

1. This cohort study demonstrated no increased risk of multiple sclerosis (MS) among girls and women who received the quadrivalent human papillomavirus (HPV) vaccine in Denmark and Sweden.

2. This cohort study additionally demonstrated no increased risk of other, non-MS demyelinating diseases of the central nervous system among girls and women who received the quadrivalent human papillomavirus (HPV) vaccine in Denmark and Sweden.

Evidence Rating Level: 2 (Good)

Study Rundown: The quadrivalent human papillomavirus (HPV) vaccine was introduced in 2006 and has resulted in the widespread vaccination of girls and young women worldwide. However, one safety concern that has surfaced since 2006 is a potential association between HPV vaccination and demyelinating diseases of the central nervous system, such as multiple sclerosis (MS). This study analyzed vaccinated Swedish and Danish females between 10 and 44 years of age to explore an association between vaccination and MS and other demyelinating diseases (i.e. optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, and neuromyelitis optica). A total of 3,978,271 individuals were included in the MS analysis, and no association between vaccination and MS was observed. There was also no association between vaccination and other demyelinating disorders. Strengths of this study include the use of carefully managed vaccination record databases and the large number of individuals included in the study. Additionally, this study included all vaccination data from two European countries. One weakness of the study is the lack of family history or other demographic data to control for potential confounders. Additionally, outcomes were based on ICD-10 codes, which may not have correctly identified all cases of MS and other demyelinating diseases. Overall, however, this study demonstrates compelling evidence against an association between quadrivalent HPV vaccination and MS or other demyelinating diseases.

Click to read the study, published today in JAMA

Relevant Reading: Vaccines and the risk of multiple sclerosis and other central nervous system demyelinating diseases.

In-Depth [population-based cohort study]: This study explored the association between quadrivalent HPV vaccination and MS and other demyelinating diseases among 3,978,271 Danish and Swedish females between the ages of 10 and 44 years and followed for 21,332,622 total person-years. MS and other demyelinating diseases were identified based on ICD-10 billing codes during a risk period defined as 2 years following each HPV vaccination dose. During these risk periods there were 73 cases of MS and 90 cases of other demyelinating diseases noted. No association between vaccination and MS was observed (adjusted RR 0.90; 95% CI 0.70-1.15). There was also no association between vaccination and other demyelinating diseases (adjusted RR 1.00; 95%CI 0.80-1.26). Additional analyses by age, country, and time from vaccination also showed no association between vaccination and MS or other demyelinating diseases.

More from this author: Ambulances equipped for thrombolysis allow for more rapid stroke treatment, Stem cell transplant may be effective in sickle cell disease, Frozen fecal transplant effective for Clostridium difficile infection, Adding sargramostim to ipilimumab may improve survival in advanced melanoma, No change in health or education outcomes following implementation of duty-hour restrictions

Image: PD

©2014 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. No article should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2 Minute Medicine, Inc.