Abstract Details

There are isolated reports of GBS after HPV vaccination.

To investigate the association of Guillain-Barre syndrome (GBS) after administration of HPV vaccination.

We used data from the Vaccine Adverse Event Reporting System (VAERS) from 2006 to 2021. GBS data was ascertained using Brighton criteria. Self-controlled case series analysis and case-centered analysis were used. Six weeks after vaccination was defined as the risk period of possible cause effect between vaccination and GBS.

From 2006 to 2021, 132 cases (mean age 16.8 ± 7.4) of GBS after HPV vaccination fulfilling Brighton criteria and 15 cases not fulfilling Brighton criteria were reported. Among the patients fulfilling Brighton criteria, 60.6% developed GBS within 6 weeks, 24.2% after 6 weeks, and 15.2% within an unknown timeframe. The distribution of GBS within the first 6 weeks was unbalanced: 70% of GBS cases were reported within the first two weeks. Hospitalization and disability were reported in 72% and 16% cases respectively. GBS occurred in 108 cases where HPV was administered alone, 82% of cases, and in 24 cases where HPV was administered in conjunction with other vaccines, 18%  of cases. 

The reporting rate of GBS after HPV vaccination was not significantly different from the reporting rate of GBS after Menactra vaccination (0.87% vs 0.8% per million p = 0.49) and the incidence range of GBS in the general population.

Using self-controlled analysis and case centered analysis, there is a significant difference in the reporting rate of GBS after HPV vaccination between the risk period and control period (71.4% vs 1.8-7.1% p<0.0001).