As of early 2016, it is plausible that HPV vaccines provoke about 1 or 2 additional cases of Guillain-Barre syndrome per 100 000 vaccinated girls per year. This estimate is based on one study, in which 19 cases of Guillain-Barre syndrome occurred among 840 000 vaccinated girls. Doubts remain over how real this risk is. However, Guillain-Barre syndrome is a serious and sometimes fatal condition. This relatively short-term harm must be taken into account when considering whether or not to vaccinate a patient, especially since it is still not known whether HPV vaccines reduce cervical cancer-related deaths, of which there are about a thousand a year in France, a country that lacks an organised nationwide screening programme. The statistical association between inflammatory bowel disease and HPV vaccines is highly tentative, and has little impact on the harm-benefit balance. The statistical association observed in the French study between thyroiditis and the HPV 16/18 vaccine constitutes low-level evidence, but it is consistent with some other weak evidence. As of early 2016, no significant link has been found between thyroiditis and the HPV 6/11/16/18 vaccine. The harm-benefit balance of HPV vaccination is difficult to determine from the evaluation of data currently available. This makes it difficult to present the options in a balanced manner to girls and their parents or others involved in the decision.
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