{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T20:59:59Z","timestamp":1772657999631,"version":"3.50.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>Published case series have suggested a potential association between human papillomavirus (HPV) vaccination and primary ovarian insufficiency (POI). We describe POI incidence and estimate POI risk after HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap); inactivated influenza (II); and meningococcal conjugate (MenACWY) vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We searched Kaiser Permanente Northwest electronic health records for outpatient diagnoses suggestive of POI in female patients aged 11 to 34 years between 2006 and 2014. We reviewed and adjudicated the medical record to confirm diagnoses and estimate symptom onset dates. We excluded cases with known causes and calculated the incidence of idiopathic POI. We estimated risk by calculating hazard ratios and 95% confidence intervals (CIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>From a cohort of 199\u2009078 female patients, we identified 120 with diagnoses suggestive of POI. After adjudication and exclusion of 26 POI cases with known causes, we confirmed 46 idiopathic POI cases. POI incidence was low in 11- to 14-year-olds (0.87 per 1\u2009000\u2009000 person-months) and increased with age. One confirmed case patient received the HPV vaccine 23 months before the first clinical evaluation for delayed menarche. The adjusted hazard ratio was 0.30 (95% CI: 0.07\u20131.36) after HPV, 0.88 (95% CI: 0.37\u20132.10) after Tdap, 1.42 (95% CI: 0.59\u20133.41) after II, and 0.94 (95% CI: 0.27\u20133.23) after MenACWY vaccination.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>We did not find a statistically significant elevated risk of POI after HPV, Tdap, II, or MenACWY vaccination in this population-based retrospective cohort study. These findings should lessen concern about POI risk after adolescent vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2018-0943","type":"journal-article","created":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T07:25:12Z","timestamp":1534836312000},"source":"Crossref","is-referenced-by-count":44,"title":["Primary Ovarian Insufficiency and Adolescent Vaccination"],"prefix":"10.1542","volume":"142","author":[{"given":"Allison L.","family":"Naleway","sequence":"first","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen F.","family":"Mittendorf","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie A.","family":"Irving","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle L.","family":"Henninger","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Crane","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Smith","sequence":"additional","affiliation":[{"name":"Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew F.","family":"Daley","sequence":"additional","affiliation":[{"name":"Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;"},{"name":"Department of Pediatrics, School of Medicine, University of Colorado, Aurora, Colorado; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julianne","family":"Gee","sequence":"additional","affiliation":[{"name":"Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2018,9,1]]},"reference":[{"issue":"3","key":"2021120916234479900_B1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/OLQ.0b013e318286bb53","article-title":"Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008.","volume":"40","author":"Satterwhite","year":"2013","journal-title":"Sex Transm Dis"},{"issue":"11","key":"2021120916234479900_B2","first-page":"300","article-title":"Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices.","volume":"64","author":"Petrosky","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"33","key":"2021120916234479900_B3","doi-asserted-by":"crossref","first-page":"874","DOI":"10.15585\/mmwr.mm6633a2","article-title":"National, regional, state, and selected local area vaccination coverage among adolescents aged 13-17 years - United States, 2016.","volume":"66","author":"Walker","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5","key":"2021120916234479900_B4","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1001\/archpediatrics.2009.50","article-title":"Sociocultural issues in the introduction of human papillomavirus vaccine in low-resource settings.","volume":"163","author":"Bingham","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"1","key":"2021120916234479900_B5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.pec.2009.12.006","article-title":"Everything you always wanted to know about HPV (but could not ask your doctor).","volume":"81","author":"Verhoeven","year":"2010","journal-title":"Patient Educ Couns"},{"issue":"3","key":"2021120916234479900_B6","first-page":"641","article-title":"HPV vaccine acceptance among women in the Asian Pacific: a systematic review of the literature.","volume":"11","author":"Young","year":"2010","journal-title":"Asian Pac J Cancer Prev"},{"key":"2021120916234479900_B7","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1186\/1471-2458-12-629","article-title":"Acceptance patterns and decision-making for human papillomavirus vaccination among parents in Vietnam: an in-depth qualitative study post-vaccination.","volume":"12","author":"Cover","year":"2012","journal-title":"BMC Public Health"},{"issue":"1","key":"2021120916234479900_B8","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s10903-014-9996-8","article-title":"Understanding HPV vaccination among Latino adolescent girls in three U.S. regions.","volume":"17","author":"Glenn","year":"2015","journal-title":"J Immigr Minor Health"},{"key":"2021120916234479900_B9","doi-asserted-by":"crossref","first-page":"bcr2012006879","DOI":"10.1136\/bcr-2012-006879","article-title":"Premature ovarian failure 3 years after menarche in a 16-year-old girl following human papillomavirus vaccination.","volume":"2012","author":"Little","year":"2012","journal-title":"BMJ Case Rep"},{"issue":"4","key":"2021120916234479900_B10","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/aji.12151","article-title":"Human papilloma virus vaccine and primary ovarian failure: another facet of the autoimmune\/inflammatory syndrome induced by adjuvants.","volume":"70","author":"Colafrancesco","year":"2013","journal-title":"Am J Reprod Immunol"},{"key":"2021120916234479900_B11","first-page":"235","article-title":"Primary ovarian insufficiency: an update.","volume":"6","author":"Cox","year":"2014","journal-title":"Int J Womens Health"},{"key":"2021120916234479900_B12","unstructured":"Sears\u2008A\n          . \u201cThey\u2019ve been robbed of their womanhood:\u201d two sisters face one life-changing diagnosis. 2014. 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