Association between quadrivalent human papillomavirus vaccination and selected syndromes with autonomic dysfunction: Hviid et al. 2020

[John Mac]

Full title:
Association between quadrivalent human papillomavirus vaccination and selected syndromes with autonomic dysfunction in Danish females: population based, self-controlled, case series analysis

Abstract
Objective To evaluate the association between quadrivalent human papillomavirus vaccination and syndromes with autonomic dysfunction, such as chronic fatigue syndrome, complex regional pain syndrome, and postural orthostatic tachycardia syndrome.

Design Population-based self-controlled case series.

Setting Information on human papillomavirus vaccinations and selected syndromes with autonomic dysfunction (chronic fatigue syndrome, complex regional pain syndrome, and postural orthostatic tachycardia syndrome) identified using ICD-10 (international classification of diseases, revision 10) diagnostic codes from Danish nationwide registers.

Participants 869 patients with autonomic dysfunction syndromes from a cohort of 1 375 737 Danish born female participants aged 10 to 44 years during 2007-16.

Main outcome measures Self-controlled case series rate ratios (95% confidence intervals) of the composite outcome of chronic fatigue syndrome, complex regional pain syndrome, and postural orthostatic tachycardia syndrome, adjusted for age and season, comparing female participants vaccinated and unvaccinated with the quadrivalent human papillomavirus vaccine. Chronic fatigue syndrome, complex regional pain syndrome, and postural orthostatic tachycardia syndrome were also considered separately in secondary analyses.

Results During 10 581 902 person years of follow-up, 869 female participants with syndromes of autonomic dysfunction (136 with chronic fatigue syndrome, 535 with complex regional pain syndrome, and 198 with postural orthostatic tachycardia syndrome) were identified. Quadrivalent human papillomavirus vaccination did not statistically significantly increase the rate of a composite outcome of all syndromes with autonomic dysfunction in a 365 day risk period following vaccination (rate ratio 0.99, 95% confidence interval 0.74 to 1.32) or the rate of any individual syndrome in the risk period (chronic fatigue syndrome (0.38, 0.13 to 1.09), complex regional pain syndrome (1.31, 0.91 to 1.90), or postural orthostatic tachycardia syndrome (0.86, 0.48 to 1.54)).

Conclusions When vaccination is introduced, adverse events could occur in close temporal relation to the vaccine purely by chance. These results do not support a causal association between quadrivalent human papillomavirus vaccination and chronic fatigue syndrome, complex regional pain syndrome, or postural orthostatic tachycardia syndrome, either individually or as a composite outcome. An increased risk of up to 32% cannot be formally excluded, but the statistical power of the study suggests that a larger increase in the rate of any syndrome associated with vaccination is unlikely.

My bolding

Human papillomavirus vaccines have been used in national immunisation programmes worldwide for more than a decade, with great success.1 In countries such as Denmark, Japan, and Ireland, however, national immunisation programmes have had serious setbacks owing to concerns about safety.23 These concerns have originated from anecdotal links between human papillomavirus vaccines and syndromes with autonomic dysfunction, such as chronic fatigue syndrome, postural orthostatic tachycardia syndrome, and complex regional pain syndrome.456 Rapid spread on social media and sensationalist media coverage have fuelled these concerns.

https://www.bmj.com/content/370/bmj.m2930.full.print

 

[Amw66]

i will have to read this later. There are a number of girls with primarily OI issues following HPV, but many with CFS too. It's always difficult to know if adverse events are statistically signiifcant or not.
The HPV vaccine, has I believe, been modified since first usage. ( i can't remember where I read this but it related to the Merck version)

 

[Dolphin]

Better link:
https://www.bmj.com/content/bmj/370/bmj.m2930.full

 

[rvallee]

I'm confused. They took a sample of patients with dysautonomia, then checked whether they developed more of those syndromes that tend to occur with one another? That seems odd, rather than taking a generic sample population and looking at the rates. If they already have (likely) post-infectious illness and look at... rates of (typically) post-infectious illness... 100% of that sample should... I don't get it.

I doubt there is an actual causal link but the method seems... confused. Since exposure to pathogens is common I would pretty much assume that this is the same type of thing happening with electromagnetic sensitivity, that simply lacking a clear diagnosis some people assign the cause to an arbitrary thing but they are most likely all post-infectious cases that were missed because medicine misses most of those cases and does no monitoring or follow-up that would illuminate the issue.

Really way past time tracking and monitoring of all human-infecting pathogens becomes normal, with standard tests almost overused simply so we don't miss out on useful data simply by being stingy.