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BriefReport

ClinicalRheumatology
pp13
Firstonline:10September2015

HPVvaccinationsyndrome.A
questionnairebasedstudy
ManuelMartnezLavn
,LauraAlineMartnezMartnez
,PaolaReyesLoyola

Abstract
Isolatedcasesandsmallserieshavedescribedthedevelopmentofcomplexregional
painsyndrome,posturalorthostatictachycardia,andfibromyalgiaafterhuman
papillomavirus(HPV)vaccination.Theseillnessesaredifficulttodiagnoseandhave
overlappingclinicalfeatures.Smallfiberneuropathyanddysautonomiamayplaya
majorroleinthepathogenesisoftheseentities.Weusedthefollowingvalidated
questionnairestoappraisethechronicillnessthatmightappearafterHPV
vaccination:The2010AmericanCollegeofRheumatologyFibromyalgiaDiagnostic
Criteria,COMPASS31dysautonomiaquestionnaire,andSLANSSneuropathicpain
form.Thesequestionnairesandapresentillnesssurveywereemailedtopersons
whohadtheonsetofachronicailmentsoonafterHPVvaccination.Fortyfivefilled
questionnairesfromindividualslivingin13differentcountrieswerecollectedina
monthsperiod.Mean(SD)ageatvaccinationtimewas145years.Twentynine
percentofthecaseshadimmediate(within24h)postvaccinationillnessonset.The
mostcommonpresentingcomplaintsweremusculoskeletalpain(66%),fatigue
(57%),headache(57%),dizziness/vertigo(43%),andparesthesias/allodynia
(36%).Fiftythreepercentofaffectedindividualsfulfillthefibromyalgiacriteria.
COMPASS31scorewas4321,implyingadvancedautonomicdysfunction.Eighty
threepercentofthepatientswhohadongoingpaindisplayedSLANSSvalues>12,
suggestinganeuropathiccomponentintheirpainexperience.Afterameanperiodof

4.22.5yearspostvaccination,93%ofpatientscontinuetohaveincapacitating
symptomsandremainunabletoattendschoolorwork.Inconclusion,adisabling
syndromeofchronicneuropathicpain,fatigue,andautonomicdysfunctionmay
appearafterHPVvaccination.

Keywords
ComplexregionalpainsyndromeDysautonomiaFibromyalgiaGulfWarIllnessHPV
vaccineMyalgicencephalomyelitisSmallfiberneuropathy

Conceptsfoundinthisarticle
GulfWarIllness
NeuropathicPain

ASIASyndrome

Whatisthis?

SmallFiberNeuropathy

ChronicNeuropathicPain

MacrophagicMyofasciitis

VaccinationSideEffect

ComplexRegionalPainSyndrome
PosturalOrthostaticTachycardiaSyndrome
AutonomicSymptom

SymptomOnset

AutonomicDysfunction
HumanPapillomavirus

OrthostaticIntolerance

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AboutthisArticle
Title
HPVvaccinationsyndrome.Aquestionnairebasedstudy
Journal
ClinicalRheumatology

DOI
10.1007/s1006701530703
PrintISSN
07703198
OnlineISSN
14349949
Publisher
SpringerLondon
AdditionalLinks
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Topics
Rheumatology
Keywords
Complexregionalpainsyndrome
Dysautonomia
Fibromyalgia
GulfWarIllness
HPVvaccine
Myalgicencephalomyelitis
Smallfiberneuropathy
IndustrySectors
Pharma
ChemicalManufacturing

Health&Hospitals
Biotechnology
Finance,Business&Banking
Electronics
IT&Software
Telecommunications
ConsumerPackagedGoods
Authors
ManuelMartnezLavn(1)
LauraAlineMartnezMartnez(1)
PaolaReyesLoyola(1)
AuthorAffiliations
1.DepartamentodeReumatologa,InstitutoNacionaldeCardiologaIgnacio
Chvez,JuanBadiano1,14080,MexicoCity,Mexico

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