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Type: Journal article
Title: Anaphylaxis following quadrivalent human papillomavirus vaccination
Author: Brotherton, J.
Gold, M.
Kemp, A.
McIntyre, P.
Burgess, M.
Campbell-Lloyd, S.
Citation: Canadian Medical Association Journal, 2008; 179(6):525-533
Publisher: Canadian Medical Association
Issue Date: 2008
ISSN: 0820-3946
Statement of
Julia M.L. Brotherton, Mike S. Gold, Andrew S. Kemp, Peter B. McIntyre, Margaret A. Burgess, Sue Campbell-Lloyd
Abstract: BACKGROUND: In 2007, Australia implemented the National human papillomavirus (HPV) Vaccination Program, which provides quadrivalent HPV vaccine free to all women aged 12–26 years. Following notification of 7 presumptive cases of anaphylaxis in the state of New South Wales, Australia, we verified cases and compared the incidence of anaphylaxis following HPV vaccination to other vaccines in comparable settings. METHODS: We contacted all patients with suspected anaphylaxis and obtained detailed histories from telephone interviews and a review of medical records. A multidisciplinary team determined whether each suspected case met the standardized Brighton definition. Some participants also received skin-prick allergy testing for common antigens and components of the HPV vaccine. RESULTS: Of 12 suspected cases, 8 were classified as anaphylaxis. Of these, 4 participants had negative skin-prick test results for intradermal Gardasil. From the 269 680 HPV vaccine doses administered in schools, 7 cases of anaphylaxis were identified, which represents an incidence rate of 2.6 per 100 000 doses (95% CI 1.0–5.3 per 100 000). In comparison, the rate of identified anaphylaxis was 0.1 per 100 000 doses (95% CI 0.003–0.7) for conjugated meningococcal C vaccination in a 2003 school-based program. INTERPRETATION: Based on the number of confirmed cases, the estimated rate of anaphylaxis following quadrivalent HPV vaccine was significantly higher than identified in comparable school-based delivery of other vaccines. However, overall rates were very low and managed appropriately with no serious sequelae.
Keywords: New South Wales Health HPV Adverse Events Panel; Humans; Anaphylaxis; Skin Tests; Immunization Schedule; Severity of Illness Index; Medical Records; Adolescent; Adult; Child; School Health Services; New South Wales; Female; Papillomavirus Vaccines; Interviews as Topic; Surveys and Questionnaires
Rights: © 2008 Canadian Medical Association or its licensors
RMID: 0020082609
DOI: 10.1503/cmaj.080916
Appears in Collections:Paediatrics publications

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