No Association Between HPV Vaccination and Infertility in U.S. Females 18-33 Years Old [33B]

Abstract

INTRODUCTION: Human papillomavirus (HPV) infections are associated with adverse human reproductive health outcomes: miscarriages, preterm delivery, lower pregnancy rates, and poor semen quality. Fecundity may also be reduced by surgery for HPV-related cervical dysplasia. HPV immunizations could improve fertility by preventing HPV infections. Claims have been made suggesting HPV vaccines negatively affect reproductive capacity. This study examined the relationship between HPV immunization status and infertility using data from a nationally-representative sample. METHODS: Data were analyzed from the 2013-2016 National Health and Nutrition Examination Surveys, which included queries regarding respondents' intentions and unsuccessful attempts to become pregnant, as a proxy for infertility. To confine the sample to respondents who were young enough to be offered HPV vaccine and old enough to have infertility concerns, only females between 18 and 33 years old (N=1,092) were included. Logistic regression models, stratified by marital status, were performed to examine the association between the proxy measure of infertility and HPV vaccination. RESULTS: Univariate models indicate that HPV vaccination is inversely associated with infertility among women who have ever been married (OR 0.46, 95% CI 0.23-0.93), but not associated for women never married (OR 0.87, 95% CI 0.39-1.95). After adjustment for age, race/ethnicity, family income levels, and education, there is no association between HPV vaccination and infertility for ever-married females (OR 0.61, 95% CI 0.35-1.08) or never-married females (OR 0.84, 95% CI 0.34-2.08). CONCLUSION: There was no association between HPV immunization and inability to become pregnant when desired. This information is valuable given public concerns regarding vaccine safety and persistently low HPV immunization rates.