Does Adolescent Vaccination Increase Primary Ovarian Insufficiency Risk?

Adolescent vaccination was not associated with an elevated risk of primary ovarian insufficiency, according to a population-based retrospective cohort study published in Pediatrics.

For this study, researchers investigated the incidence of primary ovarian insufficiency (POI) incidence and estimated risk for POI after vaccination with human papillomavirus (HPV), Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed), influenza (inactivated) and meningococcal conjugate (MenACWY) using Kaiser Permanente Northwest electronic health records from 2006 to 2014. Specifically, they reviewed medical records of female patients (11-34 years) with an outpatient diagnosis suggestive of idiopathic POI.

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“Reports of premature menopause after HPV vaccination have received a lot of media attention, including on social media,” said Allison Naleway, PhD, lead author and investigator with the Kaiser Permanente Center for Health Research in Portland, Oregon. “However, these reports were based on a small number of isolated cases and must be interpreted with caution.

Of the total cohort (N=199,078), 120 patients were diagnosed with POI, with 46 of these being idiopathic POI cases. The incidence of POI was found to be low in the youngest patients (11-14 years) and increased with age. The adjusted hazard ratio, calculated to estimate risk of POI, was 0.30 (95% CI: 0.07–1.36) after HPV vaccination, 0.88 (95% CI: 0.37–2.10) after Tdap vaccination, 1.42 (95% CI: 0.59–3.41) after inactivated influenza vaccination, and 0.94 (95% CI: 0.27–3.23) after MenACWY vaccination.

“In a population of 58,871 young women who received the HPV vaccine during the study period, we found only one case of an individual who possibly had symptoms of primary ovarian insufficiency after vaccination,” said Naleway. “If POI is triggered by the HPV vaccine or another recommended adolescent vaccine, we would have expected to see higher incidence in the younger women who were most likely to be vaccinated. But we found no elevated risk for these individuals.”

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