Human papillomavirus (HPV) vaccine and autonomic disorders: a position statement from the American Autonomic Society, 2020, Barboi et al

[Andy]

Introduction
Human papillomavirus (HPV) vaccination has been anecdotally connected to development of dysautonomia, chronic fatigue, complex regional pain syndrome and postural tachycardia syndrome.

Objectives
To critically evaluate a potential connection between HPV vaccination and above noted conditions.

Methods
We reviewed the literature containing the biology of the virus, pathophysiology of infection, epidemiology of associated cancers, indications of HPV vaccination, safety surveillance data and published reports linking HPV vaccination to autonomic disorders.

Results
At this time the American Autonomic Society finds that there are no data to support a causal relationship between HPV vaccination and CRPS, chronic fatigue, POTS or other forms of dysautonomia.

Conclusions
Certain conditions are prevalent in the same patient populations that are vaccinated with the HPV vaccine (peri-pubertal males and females). This association, however, is insufficient proof of causality.

Open access, https://www.autonomicneuroscience.com/article/S1566-0702(19)30116-X/fulltext

 

[rvallee]

I agree with this but the entirety of mental health "associations" with those health problems is exactly of the correlative type and taken as a matter of settled fact, used in practice and considered "gold standard" by most physicians. In fact this constitutes the entire body of evidence for MUS being labeled as psychosomatic, on which massive resources are being spent based entirely on those weak and very stretched correlations.

This is the exact same level of evidence here: correlation. Except one is of a much higher reliability, while the other relies strictly on biased questionnaires from biased researchers. From a biomedical perspective, it is not and does not imply causality. From a BPS perspective, it is confidently argued as being validated causality, strongly asserted and defended with zeal.

On all counts that the same standard should be applied, that correlation does not and cannot imply causality. But that is not happening. And that's a huge problem, a very clear double standard with loads of cherry-picking. One that isn't even seen as a problem, which is a huge problem all by itself.

 

[Snow Leopard]

Like other vaccine-disease associations (for example, Thrombocytopenic Purpura, Guillain Barre Syndrome with certain vaccines), the infectious disease itself usually triggers the disease at a much greater frequency than the vaccine.

Given relatively high vaccine efficacy and a relatively high rate of the population being exposed to the virus itself (15%+ infection rates), one would expect that if the virus and vaccine are risk factors for a particular disease, that the vaccine would actually lower the rate of the disease in the vaccinated population. Epidemiological studies can only study whether there is a change in risk for an overall population, not whether there is a change in risk for specific individuals.

Hence there are two possible hypotheses, the first is that neither HPV, nor the vaccine are associated with these diseases. The second is that the cases that have been avoided due to increased population immunity to the virus are instead being triggered by the vaccine, leading to minimal change in risk overall. The latter hypothesis in particular can be tested, if initial studies show no increased risk, or indeed reduced risk due to vaccination, but later studies start to show excess risk (while background infection rates are significantly lower). Hence there is no justification to stop monitoring epidemiological outcomes just yet.