Meta Analysis Of Safety Of Nine-valent HPV Vaccine And Quadrivalent HPV Vaccine

Background: Cervical cancer is one of the four major malignant tumors of women.According to statistics,the number of new cases of cervical cancer is about five hundred and twenty thousand and about two hundred and sixty thousand patients were dead because of it.The death rate of cervical cancer is ranking the second in the world,just behind the breast cancer.Epidemiological studies have shown that cervical cancer vaccine is the first vaccine in the world to prevent cancer,quadrivalent HPV vaccine can prevent 70% of cervical cancer and nine-valent HPV vaccine can prevent about 90% of cervical cancer.Objective:To compare the safety of nine-valent HPV vaccine and quadrivalent HPV vaccine.Methods:According to the requirement of evidence-based medicine(EBM),a lot of academic databases were retrieved for randomized controlled trials related to the population who vaccinate 9-valent HPV vaccine and quadrivalent HPV vaccine,including the Cochrane Library,EMBASE,PubMed,Web of Science,Wiley Online Library,CBM,CNKI,and Wanfang Database.The deadline of retrieve was Feb 2019.The statistical analysis of the data is carried out by RevMan 5.3 software provided by Cochrane Collaborative Network.Results: 5 studies were included in the Meta-analysis.21680 vaccinators were enrolled,10838 vaccinated with 9-valent HPV vaccine and 10838 with quadrivalent HPV vaccine.The results of meta-analysis showed that the incidence of local adverse events of 9-valent HPV vaccine was higher than that of quadrivalent vaccine(OR=1.66,95%CI1.53-1.80),The difference was statistically significant(P < 0.00001).Conclusion:The incidence of adverse events at the site of injection after9-valent HPV vaccine vaccination was higher than that of quadrivalent HPV vaccine group,and the main manifestations were pain,erythra,pruritus and rash at the injection site.The incidence of systemic adverse events was similar to that of quadrivalent HPV vaccine group.There was no significant difference between the two groups.The main manifestations were dizziness,headache,fatigue,nausea,vomiting,fever and so on.There were no vaccine-related deaths reported in this study.Rare subjects discontinue the vaccination because of adverse events(6 in the 9-valent HPV vaccine group and 4 in the quadrivalent HPV vaccine group).There were 9 cases in the 9-valent HPV vaccine group,5discontinuation was considered being related to vaccine-related events,5subjects withdraw the vaccination in the quadrivalent HPV vaccine group,and 3of them was considered being vaccine-related.