A publicly-funded school-based human papilloma virus vaccination (HPVV) program was implemented in the province of Québec, in 2008 (total birth cohort ≈85 000). Grade 4 girls (9-10 y-o) were eligible for routine vaccination. A catch-up vaccination was also in place for grade 9 girls (14-15-y-o) from 2008 to 2013. In both grades, annual vaccination coverage was 76-81%. A French document (Alpérovitch, 2015) has recently reported an association between HPV vaccination and Guillain-Barré Syndrome (GBS). The objective of this analysis was to assess the hospitalisations rates for GBS in HPVV targeted cohorts compared to non-vaccinated cohorts of the similar age, in the province of Québec.
Hospital discharge records of children aged 7 to 17 with a main diagnosis of GBS were analyzed. Age- and sex-specific incidence rates according to HPVV program eligibility were computed for the period October 1999 to March 2014. Sex, age, year of diagnosis, and H1N1 pandemic period were tested in multivariate analyses and adjusted relative risk in targeted cohorts was estimated by Poisson regression.
One hundred SGB cases were retrieved and included in the analysis. The total hospitalisation rate for GBS in 7-17 year-olds was 0.73/100 000 person-years. Increasing age and H1N1 pandemic period were significantly associated with higher risk of hospitalisation for GBS. The adjusted relative risk of GBS in the HPVV targeted population (grade 4 and 9 girls) was estimated at 0.86 (95%CI: 0.29-2.26).
In Québec, no increase in hospitalisation rates for GBS was observed in HPVV targeted compared to non-targeted cohorts.
Alpérovitch A, Elbaz A, Faye A, et al. Vaccins anti-HPV et risque de maladies autoimmunes : étude pharmacoépidémiologique. Paris: Agence nationale de sécurité du médicament et des produits de santé, 2015, 91 p.