Association Between Human Papillomavirus Vaccination and Serious Adverse Events in Females Aged 9 to 26 Years: A Systematic Review and Meta Analysis

OBJECTIVES: We aimed to evaluate evidence of the association between HPV vaccination and serious adverse events(SAEs) in females aged 9 to 26 years.

METHODS: PubMed, Medline, Web of Science, Scopus, Embase, Ovid and the Cochrane Library were searched from inception to Jan 10th 2022. STATA15.1 was applied to perform meta-analysis to explore the safety of the HPV vaccination.

RESULTS: 1624554 individuals with HPV vaccination and 1820574 individuals in the control group were included from the 21 eligible studies. The pooled risk ratios (RRs) of SAEs, vaccine-related SAEs, injection-site adverse events (AEs), systemic AEs and pregnancy related AEs were 0.87(95%CI:0.73-1.03), 1.14(95%CI:0.55-2.38), 1.12(95%CI:1.04-1.20), 0.97(95%CI:0.95-0.99) and 1.02(95%CI:0.90-1.15), respectively. In subgroup analysis, the pooled RRs were significantly different when study period was short 0.73(95%CI:0.67-0.80) and when placebo was applied in the control group 0.78(95%CI: 0.64-0.96.) Among systemic AEs, HPV vaccinated group occurred more pyrexia [1.21(95%CI:1.07-1.36)], gastrointestinal symptoms [1.04(95%CI:1.00-1.08)] and myalgia [1.52(95%CI:1.15-2.01)], but less dizziness [0.77(95%CI:0.71-0.82)] than the control group.

CONCLUSIONS: Overall, we found no evidence to support that HPV vaccination is associated with SAEs, vaccine-related SAEs, or pregnancy-related AEs.