Torella Marco, Marrapodi Maria Maddalena, Ronsini Carlo, Ruffolo Alessandro Ferdinando, Braga Andrea, Frigerio Matteo, Amabile Emanuele, Vastarella Maria Giovanna, Rossi Francesca, Riemma Gaetano
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80128 Naples, Italy.
Department of Obstetrics and Gynecology, IRCSS San Raffaele Scientific Institute, 20132 Milan, Italy.
Vaccines (Basel). 2023 Jan 9;11(1):140. doi: 10.3390/vaccines11010140.
(1) Background: Premature ovarian insufficiency (POI) has been linked to human papilloma virus (HPV) vaccination in small case-reports. The aim of this meta-analysis was to evaluate the risk of POI after HPV vaccination. (2) Methods: Electronic searches in MEDLINE Scopus, LILACS, ClinicalTrials.gov, EMBASE, PROSPERO, Cochrane CENTRAL and other registries were searched from inception to September 2022. Inclusion criteria were cohort studies of female children or adolescents vaccinated with quadrivalent (4vHPV), bivalent (2vHPV) or 9-valent (9vHPV) vaccine and compared to unvaccinated, other HPV vaccine, or vaccinated with other childhood vaccine girls. Primary outcome was risk of POI after vaccination. (3) Results: Four studies, including 1,253,758 patients, were included. Overall, there was no significant risk for POI between 4vHPV and controls (unvaccinated or other vaccines) (RR 0.47 (95% CI 0.14 to 1.59) I = 75%), or unvaccinated only controls (RR 0.75 (95% CI 0.22 to 2.49) I = 26%). One study reported a significant reduction of POI risk for 4vHPV relative to the other childhood vaccinations (RR 0.03 (95% CI 0.00 to 0.21)); meanwhile, one study showed no increased risk with 4vHPV relative to 2vHPV and 9vHPV (RR 0.93 (95% CI 0.33 to 2.64)). (4) Conclusions: 4vHPV vaccination does not seem to increase risk of POI relative to unvaccinated people or other childhood vaccines. No difference was seen with 4vHPV vaccine relative to 2vHPV and 9vHPV. Moreover, the risk of POI after HPV vaccination is relatable to worldwide incidence, giving reassurance about safety.
(1) 背景：在一些小规模病例报告中，卵巢早衰（POI）与人类乳头瘤病毒（HPV）疫苗接种有关。本荟萃分析的目的是评估HPV疫苗接种后发生POI的风险。(2) 方法：对MEDLINE、Scopus、LILACS、ClinicalTrials.gov、EMBASE、PROSPERO、Cochrane CENTRAL以及其他注册库进行电子检索，检索时间从建库至2022年9月。纳入标准为对接种四价（4vHPV）、二价（2vHPV）或九价（9vHPV）疫苗的女童或青少年进行队列研究，并与未接种疫苗、接种其他HPV疫苗或接种其他儿童疫苗的女孩进行比较。主要结局是接种疫苗后发生POI的风险。(3) 结果：纳入4项研究，共1,253,758例患者。总体而言，4vHPV与对照组（未接种疫苗或接种其他疫苗）之间发生POI的风险无显著差异（风险比[RR] 0.47（95%置信区间[CI] 0.14至1.59），I² = 75%），与仅未接种疫苗的对照组之间也无显著差异（RR 0.75（95% CI 0.22至2.49），I² = 26%）。一项研究报告称，相对于其他儿童疫苗接种，4vHPV的POI风险显著降低（RR 0.03（95% CI 0.00至0.21））；同时，一项研究表明，相对于2vHPV和9vHPV，4vHPV的风险没有增加（RR 0.93（95% CI 0.33至2.64））。(4) 结论：相对于未接种疫苗者或其他儿童疫苗，4vHPV疫苗接种似乎不会增加POI风险。4vHPV疫苗与2vHPV和9vHPV相比没有差异。此外，HPV疫苗接种后发生POI的风险与全球发病率相关，这为安全性提供了保证。
