196886 How much will it hurt? HPV vaccine side effects and influence on completion of the three-dose vaccine regimen

Monday, November 9, 2009: 11:10 AM

Paul L. Reiter, PhD , Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Noel T. Brewer, PhD , Health Behavior and Health Education, UNC-Chapel Hill, School of Public Health, Chapel Hill, NC
Sami L. Gottlieb, MD, MSPH , Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Annie-Laurie McRee, MPH , Maternal and Child Health, University of North Carolina, Chapel Hill, NC
Jennifer S. Smith, PhD , Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Background: Media coverage of human papillomavirus (HPV) vaccine has focused on side effects including pain at injection site and fainting. Such perceived adverse events may present barriers to initiation and completion of HPV vaccination.

Objective/Purpose: We aimed to determine whether HPV vaccine-related pain and fainting differed from other adolescent vaccines, and whether it affected completion of the three-dose HPV vaccine regimen.

Methods: We interviewed parents of adolescent girls aged 10-18, living in areas of North Carolina with elevated cervical cancer mortality rates, whose daughters had received at least one dose of HPV vaccine. Data were analyzed using McNemar's chi-square test and logistic regression.

Results: Most parents (58%, 133/229) stated their daughters experienced pain from HPV vaccination at the time of injection. However, more parents reported their daughters experienced pain at the time of injection from meningitis (74%, 77/104, p<0.05) and tetanus booster (83%, 154/186, p<0.05) vaccines than from HPV vaccine. Average reported pain at the time of injection was greater with these other vaccines than with HPV vaccine (p<0.05). Pain at the time of injection from HPV vaccination was not associated with failure to complete the vaccine regimen (p=0.55). No parents reported their daughters fainted following HPV vaccination, but eight (4%) reported dizziness.

Discussion/Conclusions: Pain associated with HPV vaccination appears to be less frequent than with two other adolescent vaccines and does not appear to affect vaccine regimen completion. These findings are important to strategies designed to increase HPV vaccination coverage.

This research was supported by the CDC and ACS.

Learning Objectives:
1. Describe the reported prevalence of postvaccination pain and fainting associated with HPV vaccination; 2. Describe how the pain level associated with HPV vaccination compares to two other adolescent vaccines; and 3. Assess whether pain from HPV vaccination discourages completion of the three-dose vaccine regimen.

Keywords: Women's Health, Cancer Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a member of the research team conducting this study and assisted with study design, data analysis, interpretation of the results, and drafting this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.