Vaccinating adolescents and young adults: problems with coincidental pathologies and safety assessments
There is likely to be an increased focus on the vaccination of adolescents both for new vaccines, such as human papillomavirus vaccines, and for some previously available vaccines. The committee was presented with preliminary modelling work performed using health utilization data from a health maintenance organization (a type of private health insurer) in the United States. This work indicates there is a high likelihood of the coincidental occurrence of various pathologies in close proximity to vaccinations. This is especially the case for gynaecological and autoimmune disorders, and such observations may lead to public concern about vaccine safety. The Committee recognized that this issue deserves more attention. Countries moving towards introducing vaccines aimed at adolescents and young adults should endeavour to secure population-specific and age-specific baseline rates of specific conditions in the relevant age-group (for example, rates of autoimmune disease). This will assist any investigation of safety issues that may surface. Any signal generated by surveillance will require thorough investigation using appropriate epidemiological methods before conclusions can be drawn.