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人乳头瘤病毒疫苗的安全性概况:对 2007 年至 2017 年美国疫苗不良事件报告系统的分析。

Safety profile of human papilloma virus vaccines: an analysis of the US Vaccine Adverse Event Reporting System from 2007 to 2017.

机构信息

Unit of Pharmacology, Department of Medical and Surgical Sciences, University of Bologna, via Irnerio 48, 40126, Bologna, Italy.

出版信息

Br J Clin Pharmacol. 2019 Mar;85(3):634-643. doi: 10.1111/bcp.13841. Epub 2019 Jan 21.

Abstract

AIMS

Human papilloma virus (HPV) is the cause of different types of carcinoma. Despite the remarkable effectiveness of the HPV vaccines, there have been many complaints about their risk-benefit profile due to adverse events following immunization (AEFI). The purpose of this study is to analyse the safety profile of the HPV vaccine basing on real-life data derived from reports of suspected AEFIs collected in the US Vaccine Adverse Events Reporting System (VAERS) and assess if the searches on Google overlap with spontaneous reporting.

METHODS

We collected all the reports in VAERS between January 2007 to December 2017 related to the HPV vaccines. A disproportionality analysis using reporting odds ratio (ROR) with 95% confidence interval was performed.

RESULTS

Over the 10-year period, 55 356 reports of AEFI related to HPV vaccines were retrieved in VAERS, corresponding to 224 863 vaccine-event pairs. The highest number of reports was related to Gardasil (n = 42 244). The two events more frequently reported and statistically significant for HPV vaccines were dizziness (n = 6259; ROR = 2.60; 95% confidence interval 2.53-2.66) and syncope (n = 6004; ROR = 6.28; 95% confidence interval 6.12-6.44). The trends of spontaneous reporting and Google searches overlap.

CONCLUSION

The AEFI analysis showed that the events most frequently reported were non-serious and listed in the corresponding summary of product characteristics. Potential safety signals arose regarding less frequent AEFIs that would deserve further investigation. It is extremely important to disseminate correct and evidence-based scientific information.

摘要

目的

人乳头瘤病毒(HPV)是多种癌症的病因。尽管 HPV 疫苗具有显著的有效性,但由于接种后不良反应事件(AEFI),其风险效益比存在许多争议。本研究旨在根据从美国疫苗不良事件报告系统(VAERS)中收集的疑似 AEFI 报告中得出的真实数据,分析 HPV 疫苗的安全性概况,并评估 Google 搜索与自发报告是否存在重叠。

方法

我们收集了 VAERS 中 2007 年 1 月至 2017 年 12 月期间与 HPV 疫苗相关的所有报告。使用报告比值比(ROR)和 95%置信区间进行了比例失调分析。

结果

在 10 年期间,VAERS 中检索到与 HPV 疫苗相关的 55356 份 AEFI 报告,相当于 224863 个疫苗事件对。报告数量最多的是 Gardasil(n=42244)。HPV 疫苗报告频率最高且具有统计学意义的两个事件是头晕(n=6259;ROR=2.60;95%置信区间 2.53-2.66)和晕厥(n=6004;ROR=6.28;95%置信区间 6.12-6.44)。自发报告和 Google 搜索的趋势存在重叠。

结论

AEFI 分析表明,最常报告的事件是非严重事件,并列入相应的产品特性摘要。对于不太常见的 AEFI,出现了潜在的安全信号,需要进一步调查。传播正确和基于证据的科学信息极其重要。

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