Portland, OR—Pharmacists can use information from a new study to help combat misinformation and exaggerated reports of premature menopause in adolescents receiving the human papillomavirus vaccine.

A study in Pediatrics emphasizes that adolescents who receive recommended vaccinations, including for HPV, have no increased risk of primary ovarian insufficiency (POI).

“Reports of premature menopause after HPV vaccination have received a lot of media attention, including on social media,” said lead investigator Allison Naleway, PhD, with the Kaiser Permanente Center for Health Research. “However, these reports were based on a small number of isolated cases and must be interpreted with caution. To bring clarity to this issue, we conducted a study of nearly 200,000 young women and found no elevated risk of POI after HPV or other recommended vaccinations.”

Background information in the article decried low rates of HPV vaccination compared with other recommended immunizations, such as tetanus-diphtheria-acellular pertussis (Tdap) and meningococcal conjugate. In fact, 2016 statistics showed that only 65% of girls aged 13 to 17 years received at least one HPV vaccination and only 49.5% were up to date with the series, compared with about 88% of adolescents receiving the Tdap vaccine.

One issue, the study notes, has been safety concerns by parents, including effects on their children’s future fertility.

The researchers searched Kaiser Permanente Northwest electronic health records for 2006 and 2014 to identify outpatient diagnoses related to POI in female patients aged 11 to 34 years. Ultimately, 120 cases were identified from a cohort of nearly 200,000.

With 46 idiopathic cases, POI incidence was determined to be low in 11- to 14-year-olds (0.87 per 1,000,000 person-months) and increased with age. The researchers noted that one confirmed-case patient received the HPV vaccine nearly 2 years before the first clinical evaluation for delayed menarche. The study team calculated the adjusted hazard ratio as 0.30 (95% CI: 0.07-1.36) after HPV vaccination; 0.88 (95% CI: 0.37-2.10) after Tdap; 1.42 (95% CI: 0.59-3.41) after II: and 0.94 (95% CI: 0.27-3.23) after MenACWY vaccination.

“We did not find a statistically significant elevated risk of POI after HPV, Tdap, II, or MenACWY vaccination in this population-based retrospective cohort study,” the study authors write. “These findings should lessen concern about POI risk after adolescent vaccination.”

“In a population of 58,871 young women who received the HPV vaccine during the study period, we found only one case of an individual who possibly had symptoms of primary ovarian sufficiency after vaccination,” Naleway explained in a Kaiser Permanente press release. “If POI is triggered by the HPV vaccine or another recommended adolescent vaccine, we would have expected to see higher incidence in the younger women who were most likely to be vaccinated. But we found no elevated risk for these individuals.”

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