Human papillomavirus (HPV) vaccine and autonomic disorders: a position statement from the American Autonomic Society

Abstract

Introduction: Human papillomavirus (HPV) vaccination has been anecdotally connected to development of dysautonomia, chronic fatigue, complex regional pain syndrome and postural tachycardia syndrome. Objectives: To critically evaluate a potential connection between HPV vaccination and above noted conditions. Methods: We reviewed the literature containing the biology of the virus, pathophysiology of infection, epidemiology of associated cancers, indications of HPV vaccination, safety surveillance data and published reports linking HPV vaccination to autonomic disorders. Results: At this time the American Autonomic Society finds that there are no data to support a causal relationship between HPV vaccination and CRPS, chronic fatigue, POTS or other forms of dysautonomia. Conclusions: Certain conditions are prevalent in the same patient populations that are vaccinated with the HPV vaccine (peri-pubertal males and females). This association, however, is insufficient proof of causality. 1. Impact of human papilloma virus on human health Human papillomaviruses (HPV) are non-enveloped viruses with a double-stranded circular DNA genome. The genome is enclosed in an icosahedral capsid, which is made up of two proteins: the major capsid protein (L1) and the minor capsid protein (L2). HPV is the most common sexually transmitted infection in the United States. An estimated 14 million persons are newly infected with HPV each year in the US with nearly half occurring in adolescents and young adults (In et al., 2015). Although HPV infection is common (40-80% lifetime

Complex Regional Pain Syndrome: A Comprehensive Review

“…Other musculoskeletal conditions, such as rheumatoid arthritis, may also increase the risk [20]. Although CRPS and other autonomic disorders have been anecdotally reported as adverse events after human papillomavirus (HPV) vaccination, review of published reports and a small population-based case series found no statistically significant correlation [21][22][23].…”

Inflammatory Biomarkers in Postural Orthostatic Tachycardia Syndrome with Elevated G-Protein-Coupled Receptor Autoantibodies

“…More recently, autoantibodies against G-protein-coupled receptor subtypes have been reported to be elevated in POTS [ 17 , 18 , 19 , 20 , 21 ]. There are also a number of reports of POTS developing subsequent to human papilloma virus immunization [ 22 , 23 , 24 ], implicating a potential role of inflammation and/or molecular mimicking as etiologies for the development of POTS. There is evidence that predisposing viral infections, celiac disease, and thyroiditis, all of which have a significant immune response, may be associated with POTS [ 6 , 10 , 25 ].…”

Isolated Tachycardia Presenting After Pfizer-BioNTech COVID-19 Vaccination

“…Park et al reported on a 5-month-old child who developed paroxysmal supraventricular tachycardia within four to six hours after each of the two, four, and six-month diphtheria, tetanus, and pertussis (DTaP) vaccinations [ 3 ]. While there have been many case reports with a multitude of similar symptoms suggesting an association between the human papillomavirus vaccination causing postural orthostatic tachycardia syndrome (POTS) and dysautonomia (with some suggesting an immune-mediated autonomic dysfunction [ 4 - 5 ]), the American Autonomic Society published a position paper refuting any such link [ 6 ]. Hviid et al found the temporal association possible but unlikely [ 7 ].…”