Quadrivalent HPV Vaccine Appears Safe for Females With JIA

For the first patients with juvenile idiopathic arthritis (JIA) enrolled in a study of the quadrivalent human papillomavirus (HPV) vaccine Gardasil, the injection appears both safe and effective after one year of exposure, according to a report from pediatric rheumatologists at five medical centers in the US.

Although sometimes portrayed in the lay literature as risky, HPV vaccination ie especially important for patients with JIA, observed Nora Singer MD, because HPV infection may not resolve spontaneously in these patients as it does in healthy young women.

The study, which excludes both patients with actively flaring disease and those with known histories of HPV exposure, is measuring geometric mean titers of the virus at the time of Gardasil vaccination and 7, 12, and where possible 24 months later. Singer, who is a professor at Case Western Reserve University School of Medicine in Cleveland, reported 7-month results in an interim analysis at the European Union League Against Rheumatism (EULAR) 2014 meeting now under way in Paris.

Of the 28 JIA patients with 7- or 12-month readings to date, all but one have reached titers comparable to those in healthy controls, Singer said, and there have been no serious adverse events. The most common unpleasant post-vaccine symptoms have been upper respiratory or sinus infections (8), vomiting and/or diarrhea (5), and light-headedness or arthralgia and stiffness (4 each).

The subjects showed a trend towards slightly lower median titers of antivirus antibodies than healthy individuals, but "still within the confidence limits for healthy and expected to be protective against natural infection," the researchers conclude.