Papillomavirus vaccination and Guillain-Barre Syndrome among girls: A cohort study in Spain
| Autor: | Ana Llorente-García, Dolores Montero-Corominas, Elisa Martín-Merino, Belén Castillo-Cano, Mar Martín-Pérez |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Adolescent 030231 tropical medicine Guillain-Barre Syndrome Cohort Studies 03 medical and health sciences 0302 clinical medicine medicine Humans Papillomavirus Vaccines 030212 general & internal medicine General Veterinary General Immunology and Microbiology Guillain-Barre syndrome business.industry Incidence Papillomavirus Infections Vaccination Hazard ratio Confounding Public Health Environmental and Occupational Health Pharmacoepidemiology medicine.disease Infectious Diseases Influenza Vaccines Spain Relative risk Cohort Molecular Medicine Female business Cohort study |
| Zdroj: | Vaccine. 39:4306-4313 |
| ISSN: | 0264-410X |
| Popis: | Background Studies of the association of Guillain-Barre Syndrome (GBS) with papillomavirus vaccination (HPVv; scheduled from 2007) have provided contradicting results, probably due to the low frequency of this disease. We aimed at estimating that risk relative to non-vaccination among girls, by using the Spanish Primary Care Database for Pharmacoepidemiological Research (BIFAP). Methods A cohort study of girls aged 9–18 years during 2007–2016 free of GBS or HPVv was selected and followed up to GBS diagnosis. Follow-up time was divided by time-varying HPVv exposure and confounders. Crude Incidence rates (IR per 1,000,000 person-years (py)) and adjusted Hazard Ratios (HR) of GBS were estimated anytime after vaccination compared to non-exposed periods. HRs were also estimated for the first 90 days after HPVv (risk-window) and thereafter. Results Out of 388,849 girls, of which 154,255 were vaccinated, 6 'confirmed' GBS cases occurred during non-exposure periods (IR of 5.83 per million person-years; 95% CI: 2.62–12.97) and 3 ‘confirmed’ cases anytime after vaccination (IR of 7.87; 95% CI: 2.54–24.39). The resulting adjusted HR anytime after vaccination was 1.24 (95% CI: 0.19–8.00). All three cases occurred after the risk window of 90 days with an HR of 1.77 (95% CI: 0.25–12.54) for post-exposure periods as compared with non-exposure. Since zero cases occurred during the risk window, no HR could be estimated for exposed periods. Conclusions Incidences of GBS were in line with the range previously reported for young people, supporting the potential of BIFAP for performing studies on GBS. However, a lack of power may be present for quantifying the relative risk of such a rare disease after the vaccination among the study cohort, where we can only exclude an increased risk of 8-times relative to no vaccination. |
| Databáze: | OpenAIRE |
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