Interstitial lung disease associated with human papillomavirus vaccination

• Main Authors: Yasushi Yamamoto, Yoshihiro Kazebayashi, Noriko Hirai, Takaaki Sasaki, Yoshinobu Ohsaki
• Format: Article
• Language: English
• Published: Elsevier 2015-01-01
• Series: Respiratory Medicine Case Reports
• Subjects: Adverse drug reaction; Human papillomavirus vaccine; Interstitial lung diseases; Vaccination
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007115300083

Vaccinations against the human papillomavirus (HPV) have been recommended for the prevention of cervical cancer. HPV-16/18 AS04-adjuvanted vaccines (Cervarix) are said to have favourable safety profiles. Interstitial lung diseases (ILDs) can occur following exposure to a drug or a biological agent. We report a case of ILD associated with a Cervarix vaccination. A woman in her 40's, with a history of conisation, received three inoculations of Cervarix. Three months later, she presented with a cough and shortness of breath. Findings from a computed tomography of the chest and a transbronchial lung biopsy were consistent with non-specific interstitial pneumonia. Workup eliminated all other causes of the ILD, except for the vaccination. Over the 11 months of the follow-up period, her symptoms resolved without steroid therapy. The onset and spontaneous resolution of the ILD showed a chronological association with the HPV vaccination. The semi-quantitative algorithm revealed that the likelihood of an adverse drug reaction to Cervarix was “Probable”. The outcome was relatively good, but more attention should be paid to a potential risk for HPV vaccinations to cause ILDs. Wherever possible, chest radiographic examinations should be performed in order not to overlook any ILDs.