Henschke, Nicholas, Bergman, Hanna, Buckley, Brian S et al. · The Cochrane database of systematic reviews · 2025 · DOI
This large review looked at whether HPV vaccines (which prevent certain cancers) are safe and effective by studying millions of people across many countries. The researchers found that HPV vaccination significantly reduces cervical cancer and related precancerous conditions, especially when given to young teens, and that the vaccine is not associated with chronic fatigue syndrome, ME, or other serious conditions that some people worry about.
This systematic review is directly relevant to ME/CFS research because it provides the highest-quality evidence available that HPV vaccination does not increase the risk of chronic fatigue syndrome or myalgic encephalomyelitis—conditions that have been subject to substantial public concern and misinformation. For patients with ME/CFS considering vaccination or investigating potential triggers, this evidence offers reassurance based on analysis of multiple large population studies rather than anecdotal reports.
This review does not prove that HPV vaccination cannot trigger ME/CFS in rare individual cases, as population-level studies cannot detect extremely rare adverse events and the authors note that no studies specifically examined community rates of serious adverse events. The absence of an association in large populations does not eliminate the possibility of idiosyncratic reactions in susceptible individuals, though it indicates such reactions, if they occur, are not attributable to the vaccine at a detectable population level. Additionally, this study is about HPV vaccination specifically and does not speak to other vaccines or medications.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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