Primary ovarian insufficiency and human papilloma virus vaccines: a review of the current evidence

Am J Obstet Gynecol. 2020 Mar;222(3):239-244. doi: 10.1016/j.ajog.2019.08.045. Epub 2019 Aug 31.


Human papilloma virus is the primary causative agent for cervical cancer, and vaccination is the primary means of preventing anogenital cancers caused by human papilloma virus infection. Despite the availability of human papilloma virus vaccines for more than a decade, coverage rates lag behind those for other vaccines. Public concerns regarding safety of human papilloma virus vaccines have been identified as an important barrier to vaccination, including concerns that the human papilloma virus vaccine may cause primary ovarian insufficiency, driven in part by isolated reports of ovarian failure following the human papilloma virus vaccine. We summarize published peer-reviewed literature on human papilloma virus vaccines and primary ovarian insufficiency, reviewing information contained in the case reports and series. Healthcare providers should address any patient concerns about primary ovarian insufficiency and the human papilloma virus vaccine by acknowledging the case reports but noting the lack of association found in a recently published epidemiologic study of approximately 60,000 female individuals. Current evidence is insufficient to suggest or to support a causal relationship between human papilloma virus vaccination and primary ovarian insufficiency.

Keywords: human papilloma virus vaccination; premature ovarian failure; primary ovarian insufficiency.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Female
  • Humans
  • Papillomavirus Vaccines / adverse effects*
  • Population Surveillance
  • Primary Ovarian Insufficiency / diagnosis
  • Primary Ovarian Insufficiency / etiology*


  • Papillomavirus Vaccines