The Quadrivalent Human Papillomavirus Vaccine: Erythema Multiforme and Cutaneous Side Effects after Administration

Abstract

The quadrivalent human papillomavirus (qHPV) vaccine, the first vaccine for use in the prevention of cervical cancer and condyloma acuminatum, was approved in June 2006. In 2008, the mass media reported suspected links between the qHPV vaccine and serious adverse events; however, several studies have found that the vaccine is safe and the main adverse events are mild local reactions. Erythema multiforme (EM) is an acute self-limited cutaneous or mucocutaneous syndrome characterized by the abrupt onset of symmetric target lesions. The clinical manifestations and histological features of EM, Stevens-Johnson syndrome and toxic epidermal necrolysis show considerable overlap, and they are classically considered to represent a spectrum of skin disorders. We present a case of EM following qHPV vaccination to review the cutaneous side effects of this vaccine and the possibility of more serious side effects with the administration of booster doses.

How Silencing of Dissent in Science Impacts Woman. The Gardasil® Story

“…so the question is not whether Gardasil ® has the potential to cause serious AEs but the frequency with which this occurs, information that is not always revealed to parents. As of 2015 serious adverse events (AE's) following Gardasil ® vaccination that have been reported in the medical literature include: premature ovarian failure [78], Guillian Barre syndrome and lupus and a host of other autoimmune related diseases [79], erythema multiform and other dermatological disorders [80], nervous system disorders such as POTS and many others [34], including death [81]. Most of these events are dismissed by pharmaceutical company experts as coincidental, occurring no more often then they might have with a placebo.…”

Telogen Effluvium following Bivalent Human Papillomavirus Vaccine Administration: A Report of Two Cases

“…Other more relevant adverse event involving the skin, such as erythema multiforme, lipoatrophy, scleroderma and dermatomyositis have also been described [2,3]. However, to the best of our knowledge, telogen effluvium has never been previously associated with anti-HPV vaccine administration.…”

“…The most common adverse events which can be observed following the administration of anti-HPV vaccines consist of local reactions at the inoculation site [2]. Severe adverse effects are rare, and these may include nervous system disorders (Bell’s palsy, Guillain-Barré syndrome, seizures) and cardiovascular events (thrombosis).…”

Cutaneous pseudolymphoma following quadrivalent human papillomavirus vaccination – a rare adverse event

“…Gardasil ® contains HPV types 6, 11, 16 and 18 with amorphous aluminum hydroxyphosphate sulfate as an adjuvant [ 9 ] . Short-term local reactions at the injection site are common after Gardasil vaccination and are mainly related to the aluminum vaccine content [ 1,9 ] .…”

“…Gardasil ® contains HPV types 6, 11, 16 and 18 with amorphous aluminum hydroxyphosphate sulfate as an adjuvant [ 9 ] . Short-term local reactions at the injection site are common after Gardasil vaccination and are mainly related to the aluminum vaccine content [ 1,9 ] . Other adverse cutaneous events include rare local reactions (aluminum-induced lipoatrophy; aluminum granuloma; cellulitis; iatrogenic subcutaneous emphysema) as well as erythema multiforme, urticaria and dermographism [ 9,10 ] .…”