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The Pediatric Infectious Disease Journal
Article . 2007 . Peer-reviewed
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Human Papilloma Virus Immunization in Adolescent and Young Adults

A Cohort Study to Illustrate What Events Might be Mistaken for Adverse Reactions
Authors: Siegrist, Claire-Anne; Lewis, Edwin M; Eskola, Juhani; Evans, Stephen J W; Black, Steven B;

Human Papilloma Virus Immunization in Adolescent and Young Adults

Abstract

The large-scale implementation of human papilloma virus (HPV) immunization will be followed by cases of autoimmune diseases occurring in temporal association with immunizations. To anticipate events that might be mistakenly assumed to be caused by immunization, their prevalence was monitored before vaccine introduction.Cohort study carried out within a database of female adolescents (n = 214,896) and young adults (n = 221,472) followed in the pre-HPV vaccine era (2005), computing rates of emergency consultations, hospitalizations and outpatient consultations, and estimation of risks of coincident associations.Immune-mediated conditions were a frequent cause (10.3%) of emergency room consultation by adolescent girls. Nonallergic immune-mediated conditions affected 86 per 100,000, diabetes ranking first. In 2005, 53 per 100,000 adolescents and 389 per 100,000 women were hospitalized for diseases of presumed autoimmune origin, thyroiditis being the most frequent diagnosis. If HPV immunization had been used with 80% coverage, 3 per 100,000 adolescents would have required emergency care for asthma/allergy within 24 hours and 2 per 100,000 for diabetes within 1 week of an injection. The risks of hospitalization in temporal association with immunization are 4 times higher for thyroiditis than for multiple sclerosis or Guillain-Barré's syndrome, and more than 20 times higher in young women than in adolescents.The distinction between HPV vaccine-caused adverse reactions and events only observed by chance in temporal association is difficult. The prior use of population-based data allows for identification of issues of potential concern, for monitoring the impact of large-scale interventions and for addressing rapidly vaccine-safety issues that may compromise vaccine programs.

Country
Switzerland
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Keywords

Health Maintenance Organizations/statistics & numerical data, Adult, Emergency Medical Services, Adolescent, Autoimmunity, 616.07, California, Autoimmune Diseases, 618, Cohort Studies, Papillomavirus Infections/prevention & control, Outpatients, Adverse Drug Reaction Reporting Systems, Humans, Papillomavirus Vaccines, Child, Autoimmune Diseases/diagnosis/epidemiology/etiology, Papillomaviridae, Hospitalization/statistics & numerical data, Emergency Medical Services/statistics & numerical data, Papillomavirus Infections, Health Maintenance Organizations, Outpatients/statistics & numerical data, Papillomaviridae/immunology, Hospitalization, Female, Immunization, Public Health, Papillomavirus Vaccines/adverse effects, ddc: ddc:616.07, ddc: ddc:618

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
106
Top 10%
Top 1%
Top 1%
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