What are the potential allergic responses to Human Papillomavirus (HPV) vaccination?

Potential Allergic Responses to HPV Vaccination

The HPV vaccine is generally safe and well-tolerated, with immediate hypersensitivity to yeast or any vaccine component being the only absolute contraindication to vaccination. 1

Common Allergic Reactions

• Local injection site reactions are the most common adverse effects, which may include pain, swelling, and redness at the injection site 2, 3
• Syncope (fainting) can occur in adolescents after vaccination, so providers should consider having vaccine recipients sit or lie down for 15 minutes after administration 1

Contraindications and Precautions

• The vaccine should not be given to people with a history of immediate hypersensitivity to yeast or any vaccine component 1
• Immunization should be deferred for people with moderate or severe acute illness 1
• HPV vaccination is not recommended during pregnancy, though no safety concerns have been identified in pregnant women who received the vaccine inadvertently 1

Special Populations and Allergic Risk

Immunocompromised Individuals

• HPV vaccines are safe for immunocompromised individuals as they contain no viral DNA and are not infectious 4
• The vaccine is specifically recommended for immunocompromised populations, including:
  • HIV-positive patients through age 26, regardless of gender 1
  • Solid organ transplant recipients aged 9-26 years 1
  • Patients with primary immunodeficiencies 1
  • Patients receiving immunosuppressive or biological treatments 1

Patients with Autoimmune Conditions

• Studies in patients with juvenile idiopathic arthritis (JIA) showed the vaccine to be safe and well-tolerated 1
• No effect of methotrexate or anti-TNF treatment on vaccine response was observed and no safety concerns were found in JIA patients 1
• HPV vaccination is recommended for patients with systemic lupus erythematosus (SLE) and other autoimmune conditions receiving immunosuppressive therapy 1

Monitoring and Management of Allergic Responses

• As with any vaccine, appropriate medical treatment should be readily available in case of anaphylactic reactions 1
• For individuals who experience syncope, providers should have them sit or lie down for 15 minutes after administration 1
• If a patient experiences an allergic reaction to the first dose, subsequent doses should be postponed and the case should be evaluated by an allergist 1

Practical Recommendations

• HPV vaccine can be administered at the same visit as all other recommended vaccines 1
• For individuals with a history of allergic reactions to vaccines, consider pre-medication with antihistamines and monitoring for at least 30 minutes after vaccination 1
• HPV testing before vaccination is not recommended as there are no good measures of past exposure 4

While allergic reactions to HPV vaccines are rare, healthcare providers should be prepared to recognize and manage potential hypersensitivity reactions and should screen patients for contraindications before administering the vaccine.