Peri-Conception Human Papillomavirus Vaccination Exposure and Risk of Birth Defects: A Population-Based Retrospective...

Area of Science:

• Reproductive Health
• Vaccinology
• Epidemiology

Background:

• Limited evidence exists on the safety of human papillomavirus (HPV) vaccination during pregnancy.
• Assessing birth defect (BD) risks associated with peri-conception HPV vaccination is crucial for public health.
• This study addresses the safety concerns of HPV vaccination in women of childbearing age.

Purpose of the Study:

• To evaluate the association between peri-conception HPV vaccination and the risk of birth defects (BDs).
• To assess risks for total BDs and 10 organ system-specific BDs.
• To analyze data from a large population-based cohort in China.

Main Methods:

• A retrospective cohort study of 177,574 pregnancies in Xiamen, China (March 2018-March 2021).
• Propensity score matching (PSM) and Poisson regression were used to estimate adjusted relative risks (aRRs).
• Subgroup analyses for different vaccine valences and eight sensitivity analyses were conducted.

Main Results:

• Peri-conception HPV vaccination was not associated with an increased risk of total BDs (aRR 0.66; 95% CI 0.26-1.70) after PSM.
• No significant associations were found for organ system-specific BDs.
• Subgroup analyses for 4vHPV and 9vHPV vaccines also showed no increased BD risk.

Conclusions:

• Exposure to HPV vaccine during the peri-conception period does not appear to elevate the risk of birth defects.
• While findings are robust, further large-scale studies are needed to confirm precision for organ system-specific BDs.
• This study provides evidence supporting the safety of peri-conception HPV vaccination.