title: Suspected side effects to the quadrivalent human papilloma vaccine.
abstract: BACKGROUND
  The quadrivalent vaccine that protects against human papilloma virus types 6, 11, 16 and 18 (Q-HPV vaccine, Gardasil) was included into the Danish childhood vaccination programme in 2009. During the past years, a collection of symptoms primarily consistent with sympathetic nervous system dysfunction have been described as suspected side effects to the Q-HPV vaccine.
  
  
  METHODS
  We present a description of suspected side effects to the Q-HPV vaccine in 53 patients referred to our Syncope Unit for tilt table test and evaluation of autonomic nervous system function.
  
  
  RESULTS
  All patients had symptoms consistent with pronounced autonomic dysfunction including different degrees of orthostatic intolerance, severe non-migraine-like headache, excessive fatigue, cognitive dysfunction, gastrointestinal discomfort and widespread pain of a neuropathic character.
  
  
  CONCLUSIONS
  We found consistency in the reported symptoms as well as between our findings and those described by others. Our findings neither confirm nor dismiss a causal link to the Q-HPV vaccine, but they suggest that further research is urgently warranted to clarify the pathophysiology behind the symptoms experienced in these patients and to evaluate the possibility and the nature of any causal link and hopefully establish targeted treatment options.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors: Koordinerende Forskningsenhed/Synkopecenteret, Vej 3, Indgang 4, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark. louise.schouborg.brinth@regionh.dk.
authors: Louise
authors: L
authors: Brinth
authors: Ann Cathrine
authors: AC
authors: Theibel
authors: Kirsten
authors: K
authors: Pors
authors: Jesper
authors: J
authors: Mehlsen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D015331:Cohort Studies; D003718:Denmark; D005500:Follow-Up Studies; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D030361:Papillomavirus Infections / Q000517:prevention & control*; D061214:Patient Safety; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D013575:Syncope / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014611:Vaccination / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18