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Authors Lützen TH, Bech BH, Mehlsen J, Høstrup Vestergaard C, Krogsgaard LW, Olsen J, Vestergaard M, Plana-Ripoll O, Rytter D
Received 21 February 2017
Accepted for publication 19 June 2017
Published 12 September 2017 Volume 2017:9 Pages 465—473
DOI https://doi.org/10.2147/CLEP.S135318
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 2
Editor who approved publication: Professor Irene Petersen
Aim: No association between human papilloma virus (HPV) vaccination and
numerous diseases has been found. Still, a large number of Danish women are
reporting suspected adverse events. Other factors may play a role, and the aim
of this study is to examine the association between psychiatric conditions,
general practitioner (GP) attendance and indicators of psychological symptoms
prior to HPV vaccination and the risk of referral to an HPV center following
vaccination.
Study design and setting: Register-based, matched case–control study.
Cases were identified from five Danish, regional HPV centers, and health data
for cases and controls were obtained from national registries.
Participants: Cases were defined as women referred to an HPV
center between January 1, 2015 and December 31, 2015 (n=1,496). Each case was
matched with five controls on age, region and time of first vaccine
registration. The total study population consisted of 8,976 women.
Results: Overall, women above 18 years who had been
referred to an HPV center were more likely to have used psychiatric medication
(odds ratio [OR]: 1.88 [95% CI 1.48–2.40]) or to have been hospitalized because
of a psychiatric disorder within 5 years prior to the first vaccine
registration (OR: 2.13 [95% CI 1.59–2.86]). Specifically, referred women were
more likely to have used antipsychotics, antidepressants, attention deficit
hyperactivity disorder (ADHD) medication or anxiolytics, and to have been
hospitalized for affective disorders or anxiety, but not to have been
hospitalized for schizoid, ADHD or eating disorders. In addition, they were
more likely to have had talk therapy or psychometric test performed prior to
vaccination (OR: 1.72 [95% CI 0.1.35–2.18] and OR: 1.67 [95% CI 1.30–2.13],
respectively). Referred women of all ages had higher use of GP before
vaccination. Population attributable fraction analyses indicated that
psychiatric medication, hospitalization due to a psychiatric disorder and use
of talk therapy, or psychometric test “explained” 13%, 10%, 12% and 11% of the
referrals, respectively. Results did not change substantially when adjusted for
potential confounders.
Conclusion: Women referred to HPV centers because of
suspected adverse events after vaccination more often had preexisting
psychiatric conditions, psychological symptoms or frequent GP attendance prior
to HPV vaccination.
Keywords: papillomavirus
vaccines, adverse drug events, psychoactive drugs, general practice