Panuveitis following administration of quadrivalent human papillomavirus vaccine

Vaccines and the Eye: Current Understanding of the Molecular and Immunological Effects of Vaccination on the Eye

“…Additionally, it has been confirmed that molecular mimicry and antigenic similarity between Mycobacterium tuberculosis proteins and retinal antigens are potentially responsible for the uveitis caused by Bacillus Calmette-Guérin (BCG) vaccination [90]. Chen et al described the case of a 27-year-old woman who developed acute panuveitis rapidly (4 days) after receiving the third dose of the quadrivalent HPV vaccine; analysis of skin samples of the patient showed intimal hyperplasia and vessel wall hyalinization accompanied by the infiltration of a large number of monocytes, macrophages, and lymphocytes, consistent with the vasculitis diagnosis, and suggesting that HPV vaccination might be related to immune-reactive vasculitis [45]. In addition, the cases of choroiditis described by Khalifa et al lacked viral prodromal symptoms, thus favoring molecular mimicry rather than nonspecific immune responses when considering the underlying mechanisms [46] (Figure 3 and Table 1).…”

Ocular Inflammation Post-Vaccination

“…After conducting a comprehensive review, a total of 51 reported cases (involving 61 patients), spanning from 1978 to 2023, have been associated with uveitis following various vaccinations (Table 1), including 4 case reports (5 patients) related to hepatitis B virus (HBV) vaccination [28][29][30][31]; 7 case reports (8 patients) related to human papillomavirus (HPV) vaccination [21][22][23][32][33][34][35]; 16 cases (18 patients) regarding uveitis after influenza vaccination [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]; 3 cases (4 patients) related to measles-mumps-rubella (MMR) vaccination [52][53][54]; 12 cases (16 patients) related to varicella zoster virus (VZV) vaccination [24][25][26][27][55][56][57][58][59][60][61][62]; 4 cases (5 patients) for yellow fever [63][64]…”

“…The average age of the affected individuals was 38.5 years (range, 1-86 years), with a female predominance (female:male = 35:26). Based on the site of infection, this study included 11 cases of anterior uveitis [27,35,37,45,52,54,56,58,63], 1 case of intermediate uveitis [63], 8 cases of posterior uveitis [21,22,27,28,32,42], 3 cases of uveitis involving both anterior and intermediate segments [27,55,64], 1 case of anterior and posterior uveitis [38], and 7 cases of pan-uveitis [23,34,40,43,48,53]. Distinct types of uveitis, such as acute posterior multifocal placoid pigment epitheliopathy (APMPPE) [36,41,46,47,57], Vogt-Koyanagi-Harada syndrome (VKH) [31,39,49,51,65,66], multiple evanescent white dot syndrome (MEWDS) [30,33,50,[67][68][69][70], acute retinal necrosis (ARN) [24]…”

“…Our study specifically focused on uveitis and compiled the reported cases of HPV-related uveitis to date (Table 1). Seven cases involving eight female patients (average age = 21.75 years) [21][22][23][32][33][34][35] developed uveitis at various locations following HPV vaccination (two anterior [35], one posterior [32], two pan-uveitis [23,34], one MEWDS [33], and two Harada-like uveitis [21,22]). Symptoms manifested within weeks, ranging from 4 days to 10 weeks after vaccination, with the majority (four out of eight) occurring after the third vaccine dose [21,22,34,35].…”

“…Seven cases involving eight female patients (average age = 21.75 years) [21][22][23][32][33][34][35] developed uveitis at various locations following HPV vaccination (two anterior [35], one posterior [32], two pan-uveitis [23,34], one MEWDS [33], and two Harada-like uveitis [21,22]). Symptoms manifested within weeks, ranging from 4 days to 10 weeks after vaccination, with the majority (four out of eight) occurring after the third vaccine dose [21,22,34,35]. Except for one unreported case [35], approximately 42.9% (three out of seven) of patients exhibited systemic symptoms such as fever, hearing loss, sore throat, headache, and joint pain [33][34][35].…”