Table 4.

Pooled risk ratios of solicited systemic symptoms

Comparison	Studies, n	Subjects, n	Pooled RR [95% CI]	Reference
Arthralgia
2vHPV vaccine vs Hepatitis vaccine	5	15,470	1.38 [1.12, 1.70]	[34, 35, 37, 41, 47]
2vHPVvaccine vs Placebo	6	4246	1.03 [0.40, 2.69]	[27, 33, 36, 40, 44, 47]
Fatigue
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.13 [1.05, 1.22]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	7	5315	1.23 [1.04, 1.44]	[27, 31, 33, 36, 40, 44, 47]
Fever
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.17 [1.05, 1.29]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	7	5315	1.11 [0.95, 1.28]	[27, 31, 33, 36, 40, 44, 47]
Gastrointestinal symptoms
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.03 [0.97, 1.10]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	7	10,796	1.46 [1.06, 2.02]	[27, 31, 33, 40, 43, 44, 47]
4vHPV vaccine vs Placebo	2	1990	0.92 [0.77, 1.11]
Rash
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.43 [1.15, 1.77]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	7	10,796	1.26 [0.80, 1.99]	[27, 31, 33, 40, 43, 44, 47]
Urticaria
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.21 [1.05, 1.39]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	6	9727	1.04 [0.52, 2.08]	[27, 33, 40, 43, 44, 47]
Headache
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.09 [1.01, 1.18]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	7	10,796	1.62 [0.83, 3.19]	[27, 31, 33, 40, 43, 44, 47]
4vHPV vaccine vs Placebo	4	2396	1.01 [0.85, 1.19]	[26, 38, 46]
Myalgia
2vHPV vaccine vs Hepatitis vaccinea	5	15,470	1.07 [0.72 1.58]	[34, 35, 37, 41, 47]
2vHPV vaccine vs Placebo	6	9727	1.54 [1.31, 1.81]	[27, 33, 40, 43, 44, 47]

Abbreviations: HPV human papillomavirus, 2vHPV bivalent human papillomavirus, 4vHPV quadrivalent human papillomavirus, RR risk ratio, CI confidence interval

^aFour studies [34, 35, 37, 41] used hepatitis A and one study [47] used hepatitis B vaccine as control