The Association of HPV Vaccination and Risk of Immune-Mediated Diseases

Whether prior human papillomavirus vaccination (HPVV) can influence later development of immune-mediated diseases remain controversial. We aim to examine HPVV 's association with various immune-mediated diseases among females aged 9-45 years, considering age, vaccine types, and racial disparities.

Based on data from the US Collaborative Network in TriNetX spanning from January 1, 2018, to December 20, 2022, we enrolled 208,638 females aged 9-45 years who had received HPVV and matched them with 208,638 individuals who had never received HPVV, using propensity scores. The primary outcome was the incidence of immune-mediated diseases. We conducted Cox proportional hazard regression analyses to estimate hazard ratios (HR) and 95% confidence intervals (CI). Subgroup analyses were conducted, stratified by age, race, smoking, obesity, asthma, and different types of HPV vaccines. Additionally, we executed sensitivity analyses to evaluate the robustness of our findings.

HPVV was associated with reduced risks of rheumatoid arthritis (HR: 0.487, 95% CI: 0.311 to 0.762), systemic lupus erythematosus (HR: 0.287, 95% CI: 0.179 to 0.460), dermatomyositis (HR: 0.299, 95% CI: 0.098 to 0.908), inflammatory bowel disease (HR: 0.876, 95% CI: 0.811 to 0.946), celiac disease (HR: 0.400, 95% CI: 0.304 to 0.526), and type 1 diabetes mellitus (HR: 0.242, 95% CI: 0.184 to 0.318). Subgroup analyses indicated a significant reduction in the incidence of immune-mediated diseases among females aged 9-26 years and those who had received the 9-valent HPV vaccines, compared to unvaccinated populations.

This study indicates HPVV is associated with reduced risks of various immune-mediated diseases.