[Safety of human papillomavirus 6, 11, 16 and 18 (recombinant): systematic review and meta-analysis]

Rev Paul Pediatr. 2015 Dec;33(4):474-82. doi: 10.1016/j.rpped.2015.02.006. Epub 2015 Aug 29.
[Article in Portuguese]

Abstract

Objective:: To identify and quantify the adverse effects associated with the recombinant human papillomavirus (types 6, 11, 16 and 18) vaccine in adolescents.

Data source:: Systematic review of randomized clinical trials from PubMed, SciELO and Lilacs databases. Articles investigating the safety of the vaccine in subjects under 18 years and comparing the recombinant human papillomavirus types 6, 11, 16 and 18 vaccine with a control group were included. Meta-analyses were performed for the outcomes of pain, erythema, swelling and fever, using clinical trials with maximum Jadad score.

Data synthesis:: Fourteen studies were included. The most common adverse effects related to the human papillomavirus vaccine were effects with no severity (pain, erythema, edema, and fever). Five studies were used for the meta-analyses: pain-risk difference (RD)=11% (p<0.001); edema-RD=8% (p<0.001); erythema-RD=5% (p<0.001); fever-RD=2% (p<0.003).

Conclusions:: The recombinant human papillomavirus types 6, 11, 16 and 18 vaccine was safe and well tolerated. The main adverse effects related to vaccination were pain, erythema, edema and fever. The low frequency of severe adverse effects encourages the administration of the vaccine in the population at risk.

Objetivo:: Identificar e quantificar os efeitos adversos associados à vacina papillomavirus humano 6, 11, 16 e 18 (recombinante) em adolescentes.

Fontes de dados:: Revisão sistemática de ensaios clínicos randomizados nas bases de dados do PubMed, SciELO e Lilacs. Foram incluídos artigos que abordavam a segurança da vacina em menores de 18 anos e que comparavam a vacina papillomavirus humano 6, 11, 16 e 18 (recombinante) com grupo controle. Foram feitas metanálises para os desfechos de dor, eritema, edema e febre com o uso de ensaios clínicos com escore de Jadad máximo.

Síntese dos dados:: Foram incluídos 14 estudos. Os efeitos adversos mais comuns relacionados à vacina foram intercorrências sem gravidade (dor, eritema, edema e febre). Cinco estudos foram usados para as metanálises, incluindo os desfechos: Dor - Diferença de Risco (DR)=11% (p<0,001); Edema-DR=8% (p<0,001); Eritema-DR=5% (p<0,001); Febre-DR=2% (p<0,003).

Conclusões:: A vacina papillomavirus humano 6, 11, 16 e 18 (recombinante) mostrou-se segura e bem tolerada. Os principais efeitos adversos relacionados à vacinação foram dor, eritema, edema e febre. A baixa frequência de efeitos adversos graves encoraja a aplicação da vacina na população de risco.

Keywords: Adolescent; Adolescente; Adverse effects; Efeitos adversos; Metanálise; Meta‐analysis; Papillomavirus vaccines; Safety; Segurança; Vacinas contra papillomavirus.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Edema / etiology
  • Erythema / etiology
  • Fever / etiology
  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / adverse effects*
  • Humans
  • Pain / etiology
  • Papillomavirus Infections / prevention & control

Substances

  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18