HPV vaccine and autoimmune diseases: systematic review and meta-analysis of the literature


Background: Human papillomavirus is one of the commonest sexually transmitted viruses worldwide. Though an effective vaccine is available in 65 countries, the worldwide vaccine coverage remains low. One of the reasons of this is the onset of adverse events as autoimmune disease.

Methods: We carried out a systematic review to identify all scientific publications dealing with the correlation between vaccine anti-papillomavirus and new onset of autoimmune diseases. To evaluate the safety of HPV vaccines, the dichotomous data on the number of subjects experiencing an autoimmune disorder in the study vaccine group and the placebo group were extracted from each study with subsequent determination of the risk ratios and their 95% confidence intervals. We combined data statistically using a random effects model. 

Results: We identified 3 studies reporting on bivalent HPV vaccines and 3 studies on quadrivalent vaccines. The total number of subjects included in the meta-analysis comprised 243,289 in the vaccine group and 248,820 in control groups. Four of the six trials had a Jadad score of 3 or 4 indicating an adequate trial quality. The most frequent autoimmune disease observed across the six studies were musculoskeletal,CNS conditions and endocrinological conditions . The results of the meta-analysis demonstrated no correlation between autoimmune disorders and HPV vaccines (pooled OR 1.038, 95% CI 0.689–1.562).

Conclusions: No correlation was identified for bivalent and quadrivalent HPV vaccines. It’s therefore essential to correctly inform the general population in order to try to increase both Italian and international vaccination coverage.