Willame, Corinne, Gadroen, Kartini, Bramer, Wichor et al. · The Pediatric infectious disease journal · 2020 · DOI
Researchers reviewed 22 studies that tracked the safety of HPV vaccines (which prevent certain cancers) in millions of people after the vaccines were approved for use. They looked specifically at whether these vaccines were linked to autoimmune diseases—conditions where the immune system attacks the body. Overall, they found no clear connection between HPV vaccines and most rare diseases, though a few associations (both positive and negative) were noted.
This review is relevant to ME/CFS patients and researchers because chronic fatigue syndrome was among the rare outcomes specifically assessed in the context of vaccine safety monitoring. Understanding whether vaccines are associated with post-vaccination fatigue syndromes informs both clinical counseling and the development of better surveillance systems for rare adverse events.
This study does not prove that HPV vaccines cause or do not cause ME/CFS definitively; it found a negative association in the pooled analysis, but heterogeneous study designs and outcome definitions weaken causal inference. Observational studies cannot exclude unmeasured confounding, and the absence of clear association does not rule out rare or subset-specific effects. The review cannot establish mechanisms or identify which patient populations might be at higher risk.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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Primary citation
Willame, Corinne, Gadroen, Kartini, Bramer, Wichor, Weibel, Daniel, & Sturkenboom, Miriam (2020). Systematic Review and Meta-analysis of Postlicensure Observational Studies on Human Papillomavirus Vaccination and Autoimmune and Other Rare Adverse Events.. The Pediatric infectious disease journal. https://doi.org/10.1097/INF.0000000000002569
BibTeX
@article{mecfsatlas-willame-2020-systematic-review,
author = {Willame, Corinne and Gadroen, Kartini and Bramer, Wichor and Weibel, Daniel and Sturkenboom, Miriam},
title = {Systematic Review and Meta-analysis of Postlicensure Observational Studies on Human Papillomavirus Vaccination and Autoimmune and Other Rare Adverse Events.},
journal = {The Pediatric infectious disease journal},
year = {2020},
doi = {10.1097/INF.0000000000002569},
note = {PubMed: 31876615},
url = {https://www.mecfsatlas.com/evidence/willame-2020-systematic-review},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/willame-2020-systematic-review
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