Maternal and infant outcomes following exposure to quadrivalent human papillomavirus vaccine during pregnancy |
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| Affiliation: | 1. Department of Psychiatry, University of California, San Diego, La Jolla, California;2. Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts;3. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland;4. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California;5. Institute for Social Research, University of Michigan, Ann Arbor, Michigan;6. Department of Psychology, Harvard University, Cambridge, Massachusetts;7. VA San Diego Healthcare System, San Diego, California |
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| Abstract: | IntroductionThe Department of Defense encourages service members ≤26 years of age to receive the human papillomavirus (HPV) vaccine. Although this vaccine is not recommended in pregnancy, inadvertent vaccination may occur. The objective of this study was to assess whether active duty US military women who received the quadrivalent HPV vaccine (4vHPV) during pregnancy were at increased risk for adverse maternal or infant outcomes.MethodsThe study population included active duty US military women aged 17–28 years with at least one pregnancy between 2007 and 2014, and the infants resulting from those pregnancies. Pregnancies, live births, and outcomes were identified using medical codes in administrative medical records. Exposure to 4vHPV during pregnancy was ascertained from personnel immunization records. Multivariable regression models were used to calculate risk estimates and 95% confidence intervals for the maternal outcomes of spontaneous abortion, preeclampsia/eclampsia and preterm labor, and the infant outcomes of preterm birth, birth defects, growth problems in infancy or in utero, and infant sex.ResultsOverall, 90,600 pregnancies and 75,670 singleton infants were identified. Approximately 2% of pregnancies and infants were exposed to 4vHPV during pregnancy. After adjustments, no positive associations were detected between inadvertent exposure to 4vHPV during pregnancy and any adverse pregnancy or infant outcomes.DiscussionOur findings add to an established body of literature demonstrating the safety of 4vHPV when inadvertently administered during pregnancy. Although 4vHPV is no longer administered in the US, its use continues overseas; therefore, safety studies remain important. Furthermore, such studies can provide reassurance to women inadvertently exposed to nonavalent HPV vaccine (9vHPV) in pregnancy, which protects against four of the same antigens as 4vHPV, since safety of 9vHPV has not yet been established in pregnant women. |
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| Keywords: | Quadrivalent HPV vaccine Vaccine safety Pregnancy Infant health US military |
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