Does the HPV vaccine have more frequent adverse reactions than other immunisations?

Question

This recent article in the Independent claims that the HPV vaccine now part of standard round of vaccinations given to children in the UK is causing a range of side effects.

Quoting Dr Manuel Martinez-Lavin, the article summarises the situation like this:

Adverse reactions appear to be more frequent after HPV vaccination when compared to other type of immunisations.

But the article is heavily dependent on the story of a single teenager's experience (and anecdotes are a poor way of clarifying the relationship between cause and effect). The piece has been criticised by statsguy.co.uk as:

a ridiculous piece of antivaccine scaremongering

Is the HPV vaccine a fairly normal vaccine or does it have a higher rate of side effects than typical?

Answer 1

The World Health Organisation reports the observed rate of vaccine reactions from each of sixteen different classes of vaccinations. It divides each type of reaction into mild adverse events or severe adverse events.

For HPV in particular, it offers statistics for quadrivalent (i.e. protecting from four variations of HPV) and bivalent version of the vaccine. I quote from the quadrivalent version that seems to have more reactions.

There are a number of possible reactions. Mild reactions are common, including pain at the injection site (83% of patients) and headaches (26%). Serious reactions are much rarer, with anaphylaxis occurring 0.00017% of the time.

Compare that to BCG, and we find more occurrences of mild reactions with papules (lumps), mild ulcerations and/or scars occurring in "almost all vaccinations". There are also more occurrences of severe reactions, with local abscesses, infections and similar occurring in 0.01-0.1% of the time, osteitis (bone inflammation) occurring up to 0.03% of the time and Immune Reconstitution Syndrome occurring 0.00016% of the time (amongst other severe adverse events).

10% of the Rubella portion of MMR vaccines leads to serious reactions - acute arthritis. Fortunately, it is generally short-lived:

Symptoms typically begin 1-3 weeks after vaccination and last one day to three weeks.

In conclusion, BCG has more occurrences of both mild and severe reactions than HPV vaccines, while MMR vaccines have much more occurrences of severe reactions than HPV vaccines.

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Note: This should not be read as an argument not to get vaccinated, as the risk of the diseases is considered higher. However, it is an argument against people who overstep the science when they claim that vaccines are "100% safe".

Answer 2

In addition to @Oddthinking's answer; I have to quote The WHO Global Advisory Committee on Vaccine Safety (GACVS) which regularly reviews the emerging international evidence on the safety of HPV vaccination issued a statement in March 2014 concluding there is no proven link between the HPV vaccination and adverse effects. Quoting the report:

Serious adverse events that have been reported as potential signals have been investigated in more detail and were not confirmed, including Guillain-Barré syndrome, seizures, stroke, venous thromboembolism, anaphylaxis and other allergic reactions.

And said:

Examples of such studies include a register-based cohort study in Sweden and Finland that included almost 1 million girls aged 10–17 years, among whom almost 300 000 were vaccinated against HPV.12 The study investigated whether vaccination was associated with an increased risk of autoimmune, neurological or thromboembolic events. The study results did not show evidence of any association between exposure to HPV vaccine and autoimmune, neurological, and venous thromboembolic adverse events.

What is more important is the results of another study:

An observational study involving almost 200 000 girls and young women who had received at least 1 dose of HPV vaccine found no increased incidence of 16 investigated autoimmune diseases in the vaccinated compared to the non-vaccinated group.

Source: Chao C et al. Surveillance of autoimmune conditions following routine use of quadrivalent human papillomavirus vaccine. J Intern Med. 2012 Feb;271(2):193-203.

The conclusion:

Multiple studies have demonstrated no increase in risk of autoimmune diseases, including MS, among girls who have received HPV vaccine compared to those who have not. The Committee remains reassured by the safety profile of the vaccine, but noted the importance of continued surveillance and epidemiological investigation with an emphasis on the collection of high quality data; such data are essential for interpretation of any adverse events which may occur following vaccination. Allegations of harm due to vaccination based on incomplete information may lead to unnecessary harm when effective vaccines are not used.