title: Examining a possible association between human papilloma virus (HPV) vaccination and migraine: results of a cohort study in the Netherlands.
abstract: Since the introduction of the bivalent human papilloma virus (HPV) vaccine in the Netherlands, migraine has been reported as a notable event in the passive safety surveillance system. Research on the association between HPV vaccination and migraine is needed. Therefore, potential migraine cases in 2008-2010 were selected from a group of general practitioners and linked to the vaccination registry. Data were analysed in three ways: (i) incidences of migraine postvaccination (2009/2010) were compared to pre-vaccination incidences (2008); (ii) in a cohort, incidence rates of migraine in vaccinated and unvaccinated girls were compared and (iii) in a self-controlled case series analysis, the relative incidence of migraine in potentially high-risk periods was compared to non-high-risk periods. Incidence rates of migraine for 12- to 16-year-old girls and boys postvaccination were slightly higher than pre-vaccination incidence rates. Incidence rate ratios (IRRs) for vaccinated compared to unvaccinated girls were not statistically significantly higher. Furthermore, the RR for migraine in the high-risk period of 6 weeks following each dose versus non-high-risk period was 4.3 (95% confidence interval (CI) 0.69-26.6) for certain migraine.
  
  
  CONCLUSIONS
  Using different methods, no statistically significant association between HPV vaccination and incident migraine was found. However, the number of cases was low; to definitively exclude the risk, an increased sample size is needed.
authors.affiliation: Department National Immunisation Programme, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO box 1, 3720 BA, Bilthoven, The Netherlands, tessa.schurink@rivm.nl.
authors.forename: T M
authors.initials: TM
authors.lastname: Schurink-Van't Klooster
authors.forename: M A J
authors.initials: MA
authors.lastname: de Ridder
authors.forename: J M
authors.initials: JM
authors.lastname: Kemmeren
authors.forename: J
authors.initials: J
authors.lastname: van der Lei
authors.forename: F
authors.initials: F
authors.lastname: Dekker
authors.forename: M
authors.initials: M
authors.lastname: Sturkenboom
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000209:etiology*; D009426:Netherlands; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000009:adverse effects*; D014611:Vaccination / Q000009:adverse effects*
chemical_list: D053918:Papillomavirus Vaccines