Human papillomavirus (HPV) vaccine and autonomic disorders: a position statement from the American Autonomic Society

Clin Auton Res. 2020 Feb;30(1):13-18. doi: 10.1007/s10286-019-00608-w. Epub 2019 Sep 2.


Introduction: Human papillomavirus (HPV) vaccination has been anecdotally connected to the development of dysautonomia, chronic fatigue, complex regional pain syndrome and postural tachycardia syndrome.

Objectives: To critically evaluate a potential connection between HPV vaccination and the above-noted conditions.

Methods: We reviewed the literature containing the biology of the virus, pathophysiology of infection, epidemiology of associated cancers, indications of HPV vaccination, safety surveillance data and published reports linking HPV vaccination to autonomic disorders.

Results: At this time, the American Autonomic Society finds that there are no data to support a causal relationship between HPV vaccination and CRPS, chronic fatigue, and postural tachycardia syndrome to other forms of dysautonomia.

Conclusion: Certain conditions are prevalent in the same populations that are vaccinated with the HPV vaccine (peri-pubertal males and females). This association, however, is an insufficient proof of causality.

Keywords: Autonomic dysfunction; Consensus statement; HPV; Postural tachycardia syndrome; Vaccine.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Autonomic Nervous System Diseases / chemically induced
  • Autonomic Nervous System Diseases / diagnosis
  • Autonomic Nervous System Diseases / epidemiology*
  • Fatigue Syndrome, Chronic / chemically induced
  • Fatigue Syndrome, Chronic / diagnosis
  • Fatigue Syndrome, Chronic / epidemiology
  • Humans
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / administration & dosage*
  • Papillomavirus Vaccines / adverse effects
  • Postural Orthostatic Tachycardia Syndrome / chemically induced
  • Postural Orthostatic Tachycardia Syndrome / diagnosis
  • Postural Orthostatic Tachycardia Syndrome / epidemiology
  • Primary Dysautonomias / chemically induced
  • Primary Dysautonomias / diagnosis
  • Primary Dysautonomias / epidemiology
  • Societies, Medical / trends*
  • United States / epidemiology


  • Papillomavirus Vaccines