Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports

Human papillomavirus (HPV) vaccination is central to preventing cervical and other HPV-associated cancers. Although clinical trials have established favorable safety profiles, long-term, brand-specific real-world data remain limited. We evaluated adverse events (AEs) reported to the U.S. Vaccine Adv...

Full description

Saved in:
Bibliographic Details
Main Authors: Yonglong Su, Yirong Huang, Jinbao Wei, Xinjin Wang, Yanyan Zhou, Xiaohong Wu, Honghong Fu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Human Vaccines & Immunotherapeutics
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2025.2539590
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849247402426368000
author Yonglong Su
Yirong Huang
Jinbao Wei
Xinjin Wang
Yanyan Zhou
Xiaohong Wu
Honghong Fu
author_facet Yonglong Su
Yirong Huang
Jinbao Wei
Xinjin Wang
Yanyan Zhou
Xiaohong Wu
Honghong Fu
author_sort Yonglong Su
collection DOAJ
description Human papillomavirus (HPV) vaccination is central to preventing cervical and other HPV-associated cancers. Although clinical trials have established favorable safety profiles, long-term, brand-specific real-world data remain limited. We evaluated adverse events (AEs) reported to the U.S. Vaccine Adverse Event Reporting System (VAERS) for Cervarix® (bivalent), Gardasil® (quadrivalent), and Gardasil-9® (9-valent) between January 2006 and December 2024. Domestic VAERS reports listing ≥1 HPV vaccine were extracted, deduplicated, and classified by brand. Disproportionality analyses were performed using reporting odds ratios (RORs) and 95% confidence intervals (CIs), adjusting for multiplicity with a 5% Benjamini – Hochberg false discovery rate (FDR). Time-to-onset was assessed with Kaplan–Meier analysis. This analysis of 76,575 HPV vaccine adverse event reports shows improving safety profiles across vaccine generations. Serious adverse events decreased significantly from Cervarix® (33.4%) to Gardasil® (16.2%) to Gardasil-9® (7.8%). The most common signals were presyncope for Cervarix® (ROR 11.5) and administration errors for Gardasil® and Gardasil-9®, including inappropriate scheduling (ROR 19.5) and incorrect storage (ROR 12.1). Most adverse events (82.9%) occurred within 7 d post-vaccination, with 62.5% occurring on the same day. Gardasil-9® exhibited the narrowest IQR for time to onset (0–1 d), compared to other HPV vaccines. HPV vaccines demonstrate a consistent, favorable safety profile in U.S. real-world practice. Most reported AEs were acute vasovagal reactions, and strongest signals reflected preventable errors. Strengthening provider education in cold-chain management and schedule adherence may further enhance vaccine safety. Continued active surveillance is recommended.
format Article
id doaj-art-1615ca5482e64d07b7870c3d07e11dd9
institution Kabale University
issn 2164-5515
2164-554X
language English
publishDate 2025-12-01
publisher Taylor & Francis Group
record_format Article
series Human Vaccines & Immunotherapeutics
spelling doaj-art-1615ca5482e64d07b7870c3d07e11dd92025-08-20T03:58:14ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2025-12-0121110.1080/21645515.2025.2539590Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reportsYonglong Su0Yirong Huang1Jinbao Wei2Xinjin Wang3Yanyan Zhou4Xiaohong Wu5Honghong Fu6Xiamen Haicang Hospital, Xiamen, Fujian Province, ChinaFujian Medical University Union Hospital, Fuzhou, Fujian Province, ChinaXiamen Haicang Hospital, Xiamen, Fujian Province, ChinaFujian Institute for Food and Drug Quality Control, Fuzhou, Fujian Province, ChinaXiamen Haicang Hospital, Xiamen, Fujian Province, ChinaXiamen Haicang Hospital, Xiamen, Fujian Province, ChinaFujian Institute for Food and Drug Quality Control, Fuzhou, Fujian Province, ChinaHuman papillomavirus (HPV) vaccination is central to preventing cervical and other HPV-associated cancers. Although clinical trials have established favorable safety profiles, long-term, brand-specific real-world data remain limited. We evaluated adverse events (AEs) reported to the U.S. Vaccine Adverse Event Reporting System (VAERS) for Cervarix® (bivalent), Gardasil® (quadrivalent), and Gardasil-9® (9-valent) between January 2006 and December 2024. Domestic VAERS reports listing ≥1 HPV vaccine were extracted, deduplicated, and classified by brand. Disproportionality analyses were performed using reporting odds ratios (RORs) and 95% confidence intervals (CIs), adjusting for multiplicity with a 5% Benjamini – Hochberg false discovery rate (FDR). Time-to-onset was assessed with Kaplan–Meier analysis. This analysis of 76,575 HPV vaccine adverse event reports shows improving safety profiles across vaccine generations. Serious adverse events decreased significantly from Cervarix® (33.4%) to Gardasil® (16.2%) to Gardasil-9® (7.8%). The most common signals were presyncope for Cervarix® (ROR 11.5) and administration errors for Gardasil® and Gardasil-9®, including inappropriate scheduling (ROR 19.5) and incorrect storage (ROR 12.1). Most adverse events (82.9%) occurred within 7 d post-vaccination, with 62.5% occurring on the same day. Gardasil-9® exhibited the narrowest IQR for time to onset (0–1 d), compared to other HPV vaccines. HPV vaccines demonstrate a consistent, favorable safety profile in U.S. real-world practice. Most reported AEs were acute vasovagal reactions, and strongest signals reflected preventable errors. Strengthening provider education in cold-chain management and schedule adherence may further enhance vaccine safety. Continued active surveillance is recommended.https://www.tandfonline.com/doi/10.1080/21645515.2025.2539590Human papillomavirus vaccinesvaccine safetypharmacovigilanceVAERSreal-world evidence
spellingShingle Yonglong Su
Yirong Huang
Jinbao Wei
Xinjin Wang
Yanyan Zhou
Xiaohong Wu
Honghong Fu
Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
Human Vaccines & Immunotherapeutics
Human papillomavirus vaccines
vaccine safety
pharmacovigilance
VAERS
real-world evidence
title Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
title_full Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
title_fullStr Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
title_full_unstemmed Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
title_short Real-world safety of HPV vaccines over 18 y: A comprehensive analysis of U.S. VAERS reports
title_sort real world safety of hpv vaccines over 18 y a comprehensive analysis of u s vaers reports
topic Human papillomavirus vaccines
vaccine safety
pharmacovigilance
VAERS
real-world evidence
url https://www.tandfonline.com/doi/10.1080/21645515.2025.2539590
work_keys_str_mv AT yonglongsu realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT yironghuang realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT jinbaowei realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT xinjinwang realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT yanyanzhou realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT xiaohongwu realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports
AT honghongfu realworldsafetyofhpvvaccinesover18yacomprehensiveanalysisofusvaersreports