A sudden onset of a pseudo-neurological syndrome after HPV-16/18 AS04-adjuvated vaccine: might it be an autoimmune/inflammatory syndrome induced by adjuvants (ASIA) presenting as a somatoform disorder?

Immunol Res. 2014 Dec;60(2-3):236-46. doi: 10.1007/s12026-014-8575-3.


In last centuries, vaccines reduced the incidence of several infectious diseases. In last decades, some vaccines aimed at preventing also some cancers, where viruses play a causative role. However, several adverse events have been described after vaccines, but a causal relationship has been established only in a minority of cases. Here, we describe a pseudo-neurological syndrome occurred shortly after the administration of the bivalent HPV vaccine. Some autoimmune disorders, including neurological demyelinating diseases, have been reported after HPV vaccines, but the patient showed no organic lesions. The patient was diagnosed as having a functional somatoform syndrome, which was supposed to be autoimmune/inflammatory syndrome induced by adjuvants (ASIA), seen the temporal link with vaccination and the presence of anti-phospholipid autoantibodies. Immunological mechanisms of vaccines-and of adjuvants-have not been completely elucidated yet, and although there is no evidence of statistical association with many post-vaccination events, a causal link with vaccine cannot be excluded in some individuals.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Hydroxide*
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / etiology*
  • Female
  • Humans
  • Inflammation / diagnosis
  • Inflammation / etiology*
  • Lipid A / analogs & derivatives*
  • Papillomavirus Vaccines / adverse effects*
  • Papillomavirus Vaccines / immunology*
  • Somatoform Disorders / diagnosis
  • Syndrome


  • ASO4 mixture
  • Lipid A
  • Papillomavirus Vaccines
  • Aluminum Hydroxide