史上最全辟谣：68个关于HPV疫苗的安全性质疑的答案！（上）

疑问1.ALS和HPV疫苗存在联系？

原文献：we don't know for sure if it's coincidence or if they're connected [to the vaccine.）

结论：不确定巧合还是与疫苗相关.样本太小，无法确定ASL和疫苗接种是否有关。

疑问2.HPV疫苗导致卵巢发育不全？

原文献：It is not known whether idiopathic POI developing progressively in young teens following HPV4 is related to this vaccination. Case reports do not and cannot establish causation.

结论：无法知晓疫苗接种和疫苗是否有关，这些病例报告不能也无法建立因果联系。

疑问3.HPV疫苗接种后很多人不得不住院和去急诊？

原文献：Our results are consistent with other large post-licensure safety and surveillance studies that found that HPV vaccines are safe.

结论：我们的结果和其他大型相关安全性试验的结果一致，HPV疫苗是安全的。

疑问4.接种HPV疫苗发现很多严重不良反应？

原文献：However, the results of the present study may have a number of potential limitations.

结论：该研究结果存在诸多限制，一共列举了六大方面的限制，所以得出的结果局限性太多。文献查询Pubmed：PMC4475239。

疑问5.HPV疫苗发现了安全性问题？

原文献：...but which do not report explicit diagnoses...the causal association between HPV vaccination and these AEs remains uncertain.

结论：没有明确的诊断报告……因果关系不确定……

疑问6.HPV疫苗导致了超敏反应？

原文献：True hypersensitivity to the quadrivalent human papillomavirus vaccine is uncommon, anaphylaxis being estimated at 1/190000 injections.

结论：四价宫颈癌疫苗的真实的超敏反应是不普遍的，接种的过敏反应大约是1/190000，比过敏性鼻炎患者比例都少。

疑问7.日本少女接种后导致交感神经功能障碍？

原文献：further extensive examinations are required.

结论：没有相关的证据，需要要进一步检查。

疑问8.接种HPV疫苗后出现POTS？

原文献：Further studies are necessary to investigate whether there is a causal relationship.

结论：不确定关联性，需要进一步研究。

疑问9.EMA发现HPV疫苗和CRPS和POTS存在关联？

原文献：Our assessment raises questions on the 

transparency and replicability of the PRAC's review.

结论：这篇文献更像是在质疑，没有给出证据。

疑问10.日本人打完疫苗出现各种问题？

原文献：Further large-scale studies are required to clarify the pathophysiology of these symptoms.

结论：需要进一步进行大规模研究, 从病理生理学上澄清这些症状出现的原因。

拿证据不足的内容作为“有力“””证据？顾问水分有点大。

疑问11.各种严重不良反应和HPV疫苗有关系？

原文献：Further work is urgently needed to elucidate the potential for a causal link between the vaccine and circulatory abnormalities.

结论：迫切需要进一步阐明疫苗与POTS异常之间存在因果关系的可能性。

疑问12.佐剂导致疫苗接种综合征？

原文献：Forty-five filled questionnaires from individuals living in 13 different countries were collected in a month's period. Mean (±SD) age at vaccination time was 14 ± 5 years.

结论：调查问卷才45份，可用样本数量太小，因此无法证明HPV疫苗佐剂可能带来的任何问题。

疑问13.HPV疫苗导致免疫系统疾病和POTS？

原文献：We also recommend further studies to ascertain whether or not the association between HPV vaccination and POTS is causal.

结论：我们还建议需要进一步研究, 以确定HPV 疫苗接种与POTS之间是否存在因果关系。

疑问14.接种HPV疫苗导致CRPS？（日文文献）

结论：这种情况被认为是一种外周交感神经紊乱引起的，结论见第10。

疑问15.接种HPV疫苗会导致闭经？

原文献：……that warrants further rigorous inquiry……

结论：和疫苗有时间逻辑关系，“有可能（potential）”与疫苗有关，需要进一步调查。

疑问16.接种HPV疫苗导致自身免疫性二型肝炎？

原文献：Although we do not provide evidence for a causal link.

结论：没有提供足够的证据证明肝炎和HPV疫苗有因果关系。

疑问17.HPV疫苗没有证据证明降低了宫颈癌发病率？

原文献：the combination of vaccine and screening gives the best security for our patients as well as being cost-effective.

结论：疫苗和筛查的结合为我们的患者提供了最好的保障, 同时也具有良好的成本效益。

疑问18.接种HPV疫苗导致瑞典宫颈癌疫苗高发？

原文献：The comment "Increased incidence of cervical cancer in Sweden: Possible link with HPV vaccination" (DOI: 10.20529/IJME.2018.037) was published online in the Indian Journal of Medical Ethics on April 30, 2018. The author gave his name and affiliation as Lars Andersson, department of Physiology and Pharmacology, Karolinska Institutet (KI), Sweden. On May 8, as soon as KI informed us that no such person worked there, we carried out a correction on the same day and the institution's name was removed as affiliation.

结论：论文造假，被撤稿。（这也能被陈一文当做证据，真可悲）

疑问19.接种HPV疫苗导致胰腺炎？

原文献：Vaccine-induced pancreatitis is likely an underdiagnosed condition and may often be masked by incidental presence of more commonly recognized causes, or it may simply be misdiagnosed as idiopathic pancreatitis.

结论：疫苗引起的胰腺炎很可能是因为诊断条件不足, 胰腺炎可能经常被偶然出现的更普遍的原因引起的，或者该患者可能只是被误诊为特发性胰腺炎。

疑问20.HPV疫苗诱发系统性红斑狼疮？

原文献：In this study, all patients had a personal or family history of autoimmune-rheumatic conditions suggesting genetic or epigenetic contributing components.

结论：在本研究中, 所有患者都有自身免疫疾病史或家族史, 遗传或者表观遗传可能是发病的原因。

被撤稿就相当于在学术界有了案底，顾问居然还敢拿出来？

疑问21.接种疫苗出现ITP？

原文献：Most commonly implicated infectious agents are: parvovirus B19, cytomegalovirus(CMV), toxoplasma, rubella virus, varicella-zoster virus, human immunodeficiency virus (HIV), streptococcal and staphylococcal infections, gram negative bacteria and Mycoplasma pneumoniae.

结论：最常见的成因是: 细小病毒 b19, 巨细胞病毒 (cmv), 弓形虫病毒, 风疹病毒, var 冰岛人病毒、爱滋病毒(hiv)、链球菌和葡萄球菌感染、格拉姆阴性杆菌 eria 和肺炎支原体等，而不是HPV疫苗。

疑问22.HPV疫苗和慢性疲劳综合症和肌痛性脑脊髓炎有关？

原文献：For the time being we can neither confirm nor dismiss a causal link between the vaccine and the disabling symptoms.

结论：目前我们既不能确认也不能否定疫苗与致残症状之间的因果关系，意思就是需要更多的研究。

疑问23.疫苗中的铝佐剂与小鼠行为异常？（本条特别鸣谢哈佛大学梁博士查证）

结论：虽然文献本身看不出任何问题，但是这项研究也非常有问题，包括接种疫苗的剂量、接种途径、动物模型的选择、蛋白质测定的相关内容，都无法证实这个研究结论的成立，同时作者也是一个反疫苗协会的【顾问】，立场存疑。

疑问24.躯体形式和自主神经功能障碍综合征与HPV疫苗有关？

原文献：our study highlighted some important post-vaccination phenomena temporally linked to HPV immunization, which needs further epidemiological analysis and biological investigations in order to establish or exclude a causal relation.

结论：我们的研究强调了一些重要的疫苗接种后现象, 这些现象在时间上与HPV免疫有关, 仍需要进一步的研究，用流行病学分析和生物调查的办法以建立或排除因果关系。

疑问25.疫苗接种导致原发性卵巢功能不全？

原文献：case reports cannot establish causation.

结论：病例报告无法确定二者的因果关系。

疑问26.疫苗导致自身免疫性疾病？

原文献：making it difficult to assess the role of HPV vaccine in these cases and no conclusive studies have been reported thus far.

结论：由于难以评估HPV疫苗在这些病例中的作用 , 因此目前并没有结论性的研究报告作出。

疑问27.关于宫颈癌不良反应的担心有必要吗？

结论：美国儿科医生协会（American College of Pediatricians，ACPeds）在美国是一个山寨协会，用反疫苗来标新立异，吸引眼球，和美国儿科学会（American Academy of Pediatrics，AAP）没有任何关系。

疑问28.疫苗接种后日本出现交感神经功能障碍？

结论：需要进一步检验结论，同第7、10、14条，没有证据。

疑问29.HPV疫苗导致急性散播性脑脊髓炎？

原文献：A nationwide survey examining the link between the clinical manifestations and HPV vaccines including a statistical analysis and the establishment of targeted treatments in Japan is urgently needed, as well as experimental research to clarify the pathophysiology.

结论：需要全国范围内的检查用来确定HPV疫苗和急性散播性脑脊髓炎之间的联系，意思就是证据不足。

疑问30.疫苗导致卵巢功能不全？

原文献：It is not known whether idiopathic Premature ovarian insufficiency (POI) developing progressively in young teens following HPV4 is related to this vaccination. Case reports do not and cannot establish causation.

结论：目前尚不清楚卵巢功能不全 (POI) 是否在青少年中接种HPV 4价疫苗有关。案例报告没有也不能确定因果关系。

实际上最新的文献已经否定了疫苗与包括POTS等疾病的关联

疑问31.接种HPV疫苗导致视网膜炎与视力丧失？

原文献：This case does not prove causation, but the temporal relationship between quadrivalent HPV vaccination and onset of an aggressive ampiginous choroiditis.

结论：这个病例并不能证明4价宫颈癌疫苗和无张力性脉络膜炎导致的视力丧失有因果联系。

疑问32.HPV疫苗和ACA（急性小脑性共济失调）有关？

原文献：in conclusion, ACA might be a rare side effect of the HPV-16/18 vaccine. This case also indicates that IA is a possible treatment for severe ACA unresponsive to steroid or IVIG therapies.

结论：ACA（急性小脑性共济失调）【可能是】HPV疫苗的一个罕见的副作用。需要注意的是：ACA has also been linked to vaccination against varicella zoster virus (VZV)2 and hepatitis B. ACA还与水痘、带状疱疹疫苗和乙型肝炎疫苗有关。

疑问33.疫苗和IA（青少年特发性关节炎）有关？

原文献：The authors concluded that the vaccine is well tolerated in JIA patients.

结论：作者认为患JIA（青少年特发性关节炎）的病人接种宫颈癌疫苗耐受性良好。

疑问34.接种HPV疫苗引发臂丛神经炎？

原文献：To the best of our knowledge, we present the first case of plexus brachialis neuritis following HPV vaccination.

结论：据我们所知，这是第一起HPV疫苗接种后引发的臂丛神经炎（接种2000万剂之后）。HPV疫苗引起的臂丛神经炎占其统计的所有疫苗引发比例为4/120，3.33%。

疑问35.HPV疫苗和ASSEs（严重自身免疫性副作用）的关系？

原文献：In conclusion，the present study provides epidemiological evidence supporting a significant relationship between HPV4 vaccine administration and SAAEs.

结论：本研究提供了流行病学证据支持HPV疫苗接种与ASSEs（严重自身免疫性副作用） 之间有重要联系，但是本文证据明显仍然不足。

疑问36.中枢系统CNS脱髓鞘和接种HPV疫苗有关？

原文献：No definitive conclusions can be made.

结论：没有明确的结论可以得出中枢系统CNS脱髓鞘和接种HPV疫苗有关。

疑问37.脱髓鞘和HPV疫苗有关？

原文献：In the second case, the development of sensory symptoms approximately 3 weeks before exposure to Gardasil poses the question of a pre-existing condition, unmasked by the trauma, reaching its full expression in coincidence with the vaccination.

结论：第二例脱髓鞘和HPV疫苗接种是巧合，全篇文章看来样本少，证据不足。

疑问38.还是脱髓鞘，和HPV疫苗有关吗？

原文献：So we suggest that vaccine may trigger an immunological mechanism leading to demyelinating events, perhaps in predisposed young.

结论：因此, 我们认为疫苗可能会引发一种免疫机制问题导致脱髓鞘事件, 也许是在年轻人身上更容易发生。但问题同36，37，证据不足。

疑问39.疫苗接种后导致淋巴结肿大有危险？

原文献：In addition, to prevent unnecessary lymph node biopsies and patient concern,clinicians must be aware that lymphadenopathy may occur after HPV vaccination. lymphadenopathy is not a life-threatening adverse effect and poses no serious consequences.

结论：此外, 为了防止不必要的病人的担忧，临床医生必须意识到HPV疫苗接种后可能发生淋巴结肿大。淋巴结肿大不会危急生命且没有严重的后果。

疑问40.EM（多形性红斑）和HPV疫苗有关？

原文献：In our patient, the temporal relationship between the development of EM and the vaccination suggests that the HPV vaccine probably was the causal agent.

结论：在我们的病例中, EM（多形性红斑）的发展和疫苗接种之间的关系表明HPV疫苗[可能是]原因，但该文献的问题依然是样本太小，证据不够充分。

很多时候，归因到疫苗的原因是时间关联。

疑问41.纤维肌痛样疾病和HPV疫苗有关？

原文献：We suggest that the medical community and regulatory agencies be aware of these possible adverse effects in order to define their real magnitude and, if indicated, to take corrective actions.

结论：我们建议医疗和监管机构意识到这些可能的不利影响（纤维肌痛样疾病），以确定其真正的规模, 如果是真的，须采取纠正措施。

疑问42.疫苗接种胃分化前恶性和恶性宫颈腺体病变？

原文献：The introduction of HPV vaccination will result in a relative increase in incidence of premalignant and malignant cervical glandular lesions exhibiting gastric differentiation and these will not be detected by HPV based screening programs.

结论：HPV疫苗接种的将导致胃分化前恶性和恶性宫颈腺体病变的发生率相对增加, 而HPV基础筛查不会发现这些变化。

疑问43.HPV疫苗有安全性问题吗？

原文献：We thus conclude that further reduction of cervical cancers might be best achieved by optimizing cervical screening (which carries no such risks) and targeting other factors of the disease rather than by the reliance on vaccines with questionable efficacy and safety profiles.

结论：因此, 我们的结论是:进一步减少宫颈癌的最佳途径可能是优化宫颈癌筛查, 并针对疾病的其他因素, 而不是依靠疗效可疑的疫苗和其安全问题。

疑问44.双侧葡萄膜炎与HPV疫苗的关系是什么？

原文献：Clinicians should be aware of a possible bilateral uveitis and papillitis following HPV vaccination.

结论：临床医生应意识到HPV疫苗接种后“可能”出现的双侧葡萄膜炎。

疑问45.疫苗诱发超敏反应？

原文献：True hypersensitivity to the quadrivalent human papillomavirus vaccine in Australian schoolgirls was uncommon and most tolerated subsequent doses.

结论：澳大利亚女学生对四价HPV疫苗的真正超敏反应并不常见 , 而且大多数人都能耐受随后的剂次。

疑问46.HPV疫苗与CRPS和POTS关系？

原文献：Clinicians should be aware of the possible association between HPV vaccination and the development of the puzzling CRPS POTS and/or fibromyalgia symptoms.

结论：临床医生应该意识到HPV疫苗接种与令人费解的CRPS（疫苗接种后复杂区域疼痛综合征）、POTS （姿势性直立性心动过速综合征）和纤维肌痛症状之间“可能”存在的联系。

疑问47.HPV疫苗引发免疫性血小板减少性紫癜（ITP）？

原文献：Therefore, although our observation suggests a causal relationship between HPV immunization and ITP, these ADR seem be extremely rare regarding large use of HPV vaccine.

结论：因此, 虽然我们的观察表明HPV接种和免疫性血小板减少性紫癜之间的存在关联, 这些ARD（副作用）在大量使用HPV疫苗中似乎是极其罕见的。

疑问48.接种HPV疫苗后出现KFD和日本脑炎？

原文献：Although the exact pathogenesis of the development of KFD following immunization remains unknown, this should be added to the list of potential triggers or factors associated with the development of KFD.

结论：虽然免疫接种后发生FKD确切发病机制尚不清楚, 但HPV接种还是应该增加到KFD相关的潜在触发因素列表。

疑问49.苔藓样药物疹与HPV疫苗关系？

原文献：Given that our patient never reacted to any previous vaccines and the time course of her reaction, we feel that this eruption has a high likelihood of being due to the HPV vaccine.

结论：考虑到我们的病人从来没有对以前的任何疫苗做出反应，和她的反应的时间过程，我们“觉得”苔藓样药物疹的爆发因为 HPV疫苗的可能性很高。

疑问50.HPV接种后的胰腺炎？

结论：又是一片被撤稿的文章。

对于宫颈癌，疫苗是最好的预防方式。