COMMENTARY

Paul Offit Responds to News About HPV Vaccine 'Syndrome'

Paul A. Offit, MD

Disclosures

August 26, 2016

To the Editor:

I am writing from the Vaccine Education Center at the Children's Hospital of Philadelphia, in response to a Medscape Medical News article published on August 11, 2016, titled "Chronic Symptoms After HPV Vaccine: Part of Wider Syndrome?" This news article covered a study by an Italian group that was recently published in Immunologic Research.[1] This notion that the HPV vaccine can cause symptoms of chronic fatigue or fibromyalgia has been out there for years. And frankly, it's the reason that the Ministry of Health in Japan has decided not to recommend the HPV vaccine, which is sad because this issue has been looked at again and again.

First of all, the HPV vaccine was studied for safety in 30,000 people for 7 years before licensure.[2] It has been formally studied both in phase 4 postlicensure studies and by the Vaccine Safety Datalink in more than a million people, and has been found not to cause chronic fatigue or fibromyalgia. When those symptoms do occur, they occur at the same rate in both vaccinated and unvaccinated groups.[3]

We learned from these studies that the HPV vaccine doesn't prevent fibromyalgia or chronic fatigue in adolescents. That Medscape chose to highlight this article,[1] as if it were in any way an advance, is disappointing. Frankly, this falls under the same category as the syndrome described by Andrew Wakefield—that the MMR vaccine caused intestinal symptoms and autism, which also was thoroughly debunked.[4]

The problem is that this raises the same ill-founded belief that was raised by Katie Couric on her show Katie that the HPV vaccine may cause chronic symptoms. As a consequence, at least a segment of society has become falsely concerned about the safety of this vaccine. We know that the HPV vaccine doesn't cause these problems, but people are making the choice not to have their children receive the vaccine; only 40% of girls and about 21% of boys are getting this vaccine.[5]

Every year in this country, the HPV-9 [vaccine] would prevent about 29,000 cases of cancer—two thirds in girls, about one third in boys—and it would prevent about 4800 deaths.[6] So when only 40% of girls and 21% of boys are getting this vaccine, we can assume that about 2000 children every year in this country are going to become adults who die, needlessly, from this infection.

I think we have scared people unnecessarily, in part because we have been a little concerned about bringing up the issue of sex in front of these children (and that can be uncomfortable), instead of just talking about what we should talk about: that this is a cancer-preventing vaccine that's being underutilized. So, I'm a little disappointed that Medscape chose, in any sense, to highlight an article claiming that the HPV vaccine caused chronic disease when such a claim is without basis. Thank you.

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