Frequency, Timing, Burden and Recurrence of Adverse Events Following Immunization After HPV Vaccine Based on a Cohort

Monika Raethke1, Jeroen Gorter1, Rachel Kalf1

  • 1Netherlands Pharmacovigilance Centre Lareb, Goudsbloemvallei 7, 5237 MH 's-Hertogenbosch, The Netherlands.

Vaccines
|August 28, 2025
PubMed

Insights

Adverse Events Following Immunization (AEFI) were more common after the first human papillomavirus (HPV) vaccine dose in children, particularly girls. Some side effects like injection site reactions may recur after the second dose.

Area of Science:

  • Pediatric immunology
  • Vaccine safety surveillance
  • Public health

Background:

  • The human papillomavirus (HPV) vaccine is part of the Dutch National Immunization Program (NIP).
  • Systematic assessment of Adverse Events Following Immunization (AEFI) is crucial for vaccine safety.
  • Understanding AEFI patterns and recurrence risk informs vaccination strategies.

Purpose of the Study:

  • To systematically assess AEFI in children following HPV vaccination.
  • To characterize the pattern and recurrence risk of AEFI after HPV revaccination.
  • To evaluate AEFI in the context of real-world data from a national immunization program.

Main Methods:

  • A prospective longitudinal cohort event monitoring study was conducted.
  • Patient-reported outcomes were collected from children receiving the HPV vaccine.
  • Data included 3063 children after the first dose and 2209 after the second dose.

Main Results:

  • Injection site reactions were the most common AEFI (46.5% after dose 1, 31.9% after dose 2).
  • AEFI were more frequent after the first HPV dose compared to the second (p=0.002).
  • Girls reported more AEFI than boys, and recurrence risk was noted for injection site reactions and headache.

Conclusions:

  • AEFI following HPV vaccination are generally more frequent after the first dose and in girls.
  • A potential increased risk of recurrence exists for certain AEFI, such as injection site reactions.
  • This study provides valuable real-world insights into the incidence and course of AEFI in children post-HPV vaccination.

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