title: Quadrivalent HPV vaccination reactions--more hype than harm.
abstract: BACKGROUND
  The quadrivalent human papillomavirus (HPV) vaccine Gardasil was licensed for use in June 2006. Since its approval more than 26 million doses of the vaccine have been distributed worldwide. There is ongoing debate as to the safety of the vaccine, with suggestions of a link between the vaccine and syncopal events, and the aetiology of more chronic conditions such as Guillain-Barre syndrome.
  
  
  OBJECTIVE
  A case of subcutaneous emphysema secondary to quadrivalent HPV vaccination is described, and reported adverse events to quadrivalent HPV vaccination in both Australia and the United States are examined.
  
  
  CONCLUSIONS
  On the basis of published peer reviewed literature, and from data analysis conducted by reputable agencies, the conclusion is drawn that adverse events are mild and self limiting and quadrivalent HPV vaccine is safe when administered according to the manufacturer's recommendations.
authors.affiliation: Emergency Medicine and General Practice, Royal Adelaide Hospital, South Australia. rabs01@hotmail.com
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Douglas
mesh_terms: D000328:Adult; D001315:Australia; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000009:adverse effects*; D013352:Subcutaneous Emphysema / Q000139:chemically induced* / Q000175:diagnosis; D014412:Tumor Virus Infections / Q000517:prevention & control
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines