Bivalent HPV vaccine safety depending on subtypes of juvenile idiopathic arthritis (Annals of the Rheumatic Diseases)

We read with great interest the article by Heijstek et al1 regarding the safety of the bivalent human papillomavirus (HPV) vaccine in patients with juvenile idiopathic arthritis (JIA). Their prospective controlled observational cohort study of 68 patients revealed no differences in adverse events between female JIA patients and healthy girls. The authors concluded that the vaccine is well tolerated in JIA patients. Most reports regarding the safety of the HPV vaccine, including premarket cohort studies2–4 and postlicensing safety monitoring surveys,5 suggest no apparent causal relationship between the vaccine and serious adverse events (SAEs) in young girls. Now the focus has moved to vaccine safety in patients with illnesses such as immunological disorders.6 Heijstek et al1 did report longer durations of arthralgia, fatigue and headache after vaccination in JIA patients compared with healthy controls. In addition,...