Acute Disseminated Encephalomyelitis Following Immunization with Human Papillomavirus Vaccines.

Abstract

The immunization of adolescent girls with the human papilloma virus (HPV) vaccines, a bivalent CervarixⓇ and a quadrivalent GardasilⓇ, has been widely introduced to prevent uterine and cervical cancer (1). Since the regulatory approval of the first quadrivalent HPV vaccine in 2006 and later the bivalent HPV vaccine, as of 2011, about 120 million doses have been distributed worldwide (1). Since 2010, both vaccines have been introduced for administration to adolescent girls in Japan. However, with the rise in the number of subjects receiving this vaccine, some adverse effects have also started to be reported in Japan. These adverse effects comprise varied clinical manifestations, such as orthostatic intolerance; postural tachycardia syndrome; pain or coldness of ambiguous origin in the limbs, as with complex regional pain syndrome; involuntary movements; abnormal behavior resembling psychosis; headaches; general fatigue; Guillain-Barre syndrome; acute cerebellar ataxia; and acute disseminated encephalomyelitis (ADEM) (2-6).