Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021)
Introduction: in 2014 hundreds of teenage women in the rural municipality of El Carmen de Bolivar (Colombia) experienced strange symptoms after being vaccinated with Gardasil, one of the vaccines against Human Papillomavirus (HPV). Health authorities did not find a causal link between the vaccinatio...
- Autores:
-
Baltar-Moreno, Adolfo
Puello-Sarabia, Cielo
Carrazco-Delgado, Brenda Fernanda
- Tipo de recurso:
- Fecha de publicación:
- 2022
- Institución:
- Universidad Tecnológica de Bolívar
- Repositorio:
- Repositorio Institucional UTB
- Idioma:
- spa
- OAI Identifier:
- oai:repositorio.utb.edu.co:20.500.12585/12398
- Acceso en línea:
- https://hdl.handle.net/20.500.12585/12398
- Palabra clave:
- Psychosomatic Illness;
Hysteria;
Spirit Possession
LEMB
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by-nc-nd/4.0/
| id |
UTB2_ca1b7d12867ba659b5014a488c7392ed |
|---|---|
| oai_identifier_str |
oai:repositorio.utb.edu.co:20.500.12585/12398 |
| network_acronym_str |
UTB2 |
| network_name_str |
Repositorio Institucional UTB |
| repository_id_str |
|
| dc.title.spa.fl_str_mv |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| dc.title.alternative.spa.fl_str_mv |
Revisão narrativa do caso da vacina contra o HPV em El Carmen de Bolívar, Colômbia (2014-2021) Revisión narrativa del caso de la vacuna contra el VPH en El Carmen de Bolívar, Colombia (2014-2021) |
| title |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| spellingShingle |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) Psychosomatic Illness; Hysteria; Spirit Possession LEMB |
| title_short |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| title_full |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| title_fullStr |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| title_full_unstemmed |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| title_sort |
Narrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021) |
| dc.creator.fl_str_mv |
Baltar-Moreno, Adolfo Puello-Sarabia, Cielo Carrazco-Delgado, Brenda Fernanda |
| dc.contributor.author.none.fl_str_mv |
Baltar-Moreno, Adolfo Puello-Sarabia, Cielo Carrazco-Delgado, Brenda Fernanda |
| dc.subject.keywords.spa.fl_str_mv |
Psychosomatic Illness; Hysteria; Spirit Possession |
| topic |
Psychosomatic Illness; Hysteria; Spirit Possession LEMB |
| dc.subject.armarc.none.fl_str_mv |
LEMB |
| description |
Introduction: in 2014 hundreds of teenage women in the rural municipality of El Carmen de Bolivar (Colombia) experienced strange symptoms after being vaccinated with Gardasil, one of the vaccines against Human Papillomavirus (HPV). Health authorities did not find a causal link between the vaccination and the symptoms, so they attributed the phenomenon to a possible massive psychogenic reaction. The families of those affected rejected this hypothesis. The case revealed the existence of a controversy among the Colombian scientific community about the safety of the vaccine. The persistence over time of the health problem and its massive nature influenced a drastic decline in vaccination coverage, and the Constitutional Court ruled in 2017 on the mandatory use of informed consent during the vaccination procedure. Methodology: an updated comprehensive narrative review of the literature published between 2014 and 2021 is presented. A synthesis of the scientific information available in Medline, Pubmed, Cochrane, Scielo, Redalyc and Google Scholar was performed. Results: 37 texts were identified, and a categorization of analysis was established in 4 groups: a possible massive psychogenic reaction, a possible adverse reaction to the vaccine, the need to broaden the epistemological approach to understand the phenomenon and a controversy in the Colombian scientific field. Conclusions: the review shows that the application of the HPV vaccine has generated a public health problem whose nature is still controversial, due to the difficulty in identifying an etiological diagnosis of the symptoms of those affected. © 2022 Pontificia Universidad Javeriana. All rights reserved. |
| publishDate |
2022 |
| dc.date.issued.none.fl_str_mv |
2022 |
| dc.date.accessioned.none.fl_str_mv |
2023-07-21T20:51:37Z |
| dc.date.available.none.fl_str_mv |
2023-07-21T20:51:37Z |
| dc.date.submitted.none.fl_str_mv |
2023 |
| dc.type.coarversion.fl_str_mv |
http://purl.org/coar/version/c_b1a7d7d4d402bcce |
| dc.type.coar.fl_str_mv |
http://purl.org/coar/resource_type/c_2df8fbb1 |
| dc.type.driver.spa.fl_str_mv |
info:eu-repo/semantics/article |
| dc.type.hasversion.spa.fl_str_mv |
info:eu-repo/semantics/draft |
| dc.type.spa.spa.fl_str_mv |
http://purl.org/coar/resource_type/c_6501 |
| status_str |
draft |
| dc.identifier.citation.spa.fl_str_mv |
Baltar-Moreno, A., Puello-Sarabia, C., & Carrazco-Delgado, B. F. (2022). Revisión narrativa del caso de la vacuna contra el VPH en El Carmen de Bolívar, Colombia (2014-2021). Revista Gerencia y Políticas de Salud, 21, 1-21. |
| dc.identifier.uri.none.fl_str_mv |
https://hdl.handle.net/20.500.12585/12398 |
| dc.identifier.doi.none.fl_str_mv |
10.11144/Javeriana.rgps21.rncv |
| dc.identifier.instname.spa.fl_str_mv |
Universidad Tecnológica de Bolívar |
| dc.identifier.reponame.spa.fl_str_mv |
Repositorio Universidad Tecnológica de Bolívar |
| identifier_str_mv |
Baltar-Moreno, A., Puello-Sarabia, C., & Carrazco-Delgado, B. F. (2022). Revisión narrativa del caso de la vacuna contra el VPH en El Carmen de Bolívar, Colombia (2014-2021). Revista Gerencia y Políticas de Salud, 21, 1-21. 10.11144/Javeriana.rgps21.rncv Universidad Tecnológica de Bolívar Repositorio Universidad Tecnológica de Bolívar |
| url |
https://hdl.handle.net/20.500.12585/12398 |
| dc.language.iso.spa.fl_str_mv |
spa |
| language |
spa |
| dc.rights.coar.fl_str_mv |
http://purl.org/coar/access_right/c_abf2 |
| dc.rights.uri.*.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.accessrights.spa.fl_str_mv |
info:eu-repo/semantics/openAccess |
| dc.rights.cc.*.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 Internacional |
| rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://purl.org/coar/access_right/c_abf2 |
| eu_rights_str_mv |
openAccess |
| dc.format.extent.none.fl_str_mv |
22 páginas |
| dc.format.mimetype.spa.fl_str_mv |
application/pdf |
| dc.publisher.place.spa.fl_str_mv |
Cartagena de Indias |
| dc.source.spa.fl_str_mv |
Revista Gerencia y Politicas de Salud |
| institution |
Universidad Tecnológica de Bolívar |
| bitstream.url.fl_str_mv |
https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/1/54574701018.pdf https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/2/license_rdf https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/3/license.txt https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/4/54574701018.pdf.txt https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/5/54574701018.pdf.jpg |
| bitstream.checksum.fl_str_mv |
f71ec2813378ee4a9e90c4761fb51202 4460e5956bc1d1639be9ae6146a50347 e20ad307a1c5f3f25af9304a7a7c86b6 35f2c04ce42378ae9931ca7b5717eb00 e4eac35a7c831f0ced78e53f9c34c48d |
| bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 MD5 MD5 |
| repository.name.fl_str_mv |
Repositorio Institucional UTB |
| repository.mail.fl_str_mv |
repositorioutb@utb.edu.co |
| _version_ |
1814021676645482496 |
| spelling |
Baltar-Moreno, Adolfo608036da-ae1f-44b5-a896-953cc096bd8dPuello-Sarabia, Cielodc14b6fb-c425-44a1-8715-55bcc5ec7d29Carrazco-Delgado, Brenda Fernanda923125a2-4c83-4684-95d5-31e97bbe7b9d2023-07-21T20:51:37Z2023-07-21T20:51:37Z20222023Baltar-Moreno, A., Puello-Sarabia, C., & Carrazco-Delgado, B. F. (2022). Revisión narrativa del caso de la vacuna contra el VPH en El Carmen de Bolívar, Colombia (2014-2021). Revista Gerencia y Políticas de Salud, 21, 1-21.https://hdl.handle.net/20.500.12585/1239810.11144/Javeriana.rgps21.rncvUniversidad Tecnológica de BolívarRepositorio Universidad Tecnológica de BolívarIntroduction: in 2014 hundreds of teenage women in the rural municipality of El Carmen de Bolivar (Colombia) experienced strange symptoms after being vaccinated with Gardasil, one of the vaccines against Human Papillomavirus (HPV). Health authorities did not find a causal link between the vaccination and the symptoms, so they attributed the phenomenon to a possible massive psychogenic reaction. The families of those affected rejected this hypothesis. The case revealed the existence of a controversy among the Colombian scientific community about the safety of the vaccine. The persistence over time of the health problem and its massive nature influenced a drastic decline in vaccination coverage, and the Constitutional Court ruled in 2017 on the mandatory use of informed consent during the vaccination procedure. Methodology: an updated comprehensive narrative review of the literature published between 2014 and 2021 is presented. A synthesis of the scientific information available in Medline, Pubmed, Cochrane, Scielo, Redalyc and Google Scholar was performed. Results: 37 texts were identified, and a categorization of analysis was established in 4 groups: a possible massive psychogenic reaction, a possible adverse reaction to the vaccine, the need to broaden the epistemological approach to understand the phenomenon and a controversy in the Colombian scientific field. Conclusions: the review shows that the application of the HPV vaccine has generated a public health problem whose nature is still controversial, due to the difficulty in identifying an etiological diagnosis of the symptoms of those affected. © 2022 Pontificia Universidad Javeriana. All rights reserved.22 páginasapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://purl.org/coar/access_right/c_abf2Revista Gerencia y Politicas de SaludNarrative review of the HPV vaccine case in El Carmen de Bolivar, Colombia (2014-2021)Revisão narrativa do caso da vacina contra o HPV em El Carmen de Bolívar, Colômbia (2014-2021)Revisión narrativa del caso de la vacuna contra el VPH en El Carmen de Bolívar, Colombia (2014-2021)info:eu-repo/semantics/articleinfo:eu-repo/semantics/drafthttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/version/c_b1a7d7d4d402bccehttp://purl.org/coar/resource_type/c_2df8fbb1Psychosomatic Illness;Hysteria;Spirit PossessionLEMBCartagena de IndiasSantos dice que efectos de VPH es «sugestión colectiva» (2014) Redacción Digital CM&. noticias.canal1.com.co [Internet]. Aug 31; Disponible en https://noticias.canal1.com.co/nacional/santos-dice-que-efectos-de-vph-es-sugestion-colectiva/Brote de evento de etiología desconocida en el municipio de El Carmen de Bolívar, Bolívar, 2014 Informe Ejecutivo (Ene 16 2015) [Internet]. Bogotá; 2015. Disponible en https://www.ins.gov.co/Direcciones/Vigilancia/Investigacindebrotes/BrotedeeventodeetiologíadesconocidaenelmunicipiodeElCarmendeBolívar,Bolívar.pdfChaves-Ortiz, V, Yepes, F, Hernández, LJ. Informe de la autoridad danesa de salud y medicamentos (2015) Rev Gerenc y Políticas Salud, 14 (29), pp. 193-196. [Internet] https://doi.org/10.11144/Javeriana.rgyps14-29.iads(2016) Vacuna contra el VPH, ¿tan buena como la pintan? semana.com [Internet]. Mar 21; Disponible en https://www.semana.com/nacion/articulo/vacuna-contra-vph-academia-nacionalde-medicina-pide-cambiar-protocolo/466302/Olivero, J, Pomares, F, Manjarrés, A, Valdelamar, JC, Sierra, L, Coronado, N (2018) Evaluación de los efectos de los procesos de vacunación contra el virus del papiloma humano en adolescentes en Carmen de Bolívar [Internet]. Cartagena de Indias; Disponible en https://pompiliomartinez.files.wordpress.com/2018/07/informe-nic3b1as-de-el-carmen.pdfNóblega, M, Gutiérrez, G, Gómez, M. Criterios Homologados de Investigación en Psicología (CHIP) (2020) Revisiones Integrativas de Literatura [Internet]. Disponible en https://departamento.pucp.edu.pe/psicologia/wp-content/uploads/2020/09/chip-ril.pdfGrillo-Ardila, C.F. El carmen de bolívar: A lesson not to be forgotten (2014) Revista Colombiana de Obstetricia y Ginecologia, 65 (3), pp. 202-205. Cited 3 times. http://www.scielo.org.co/pdf/rcog/v65n3/en_v65n3a01.pdf doi: 10.18597/rcog.56Salazar, LJ, Benavides, MR, Boogaard, S, Marín, Y. Estrategias latinoamericanas para la vacunación contra el virus del papiloma humano-una revisión temática (2017) Rev Hacia la Promoción la Salud [Internet], 22 (2). Cited 10 times. https://doi.org/10.17151/hpsal.2017.22.2.10Palencia-Sánchez, F., Echeverry-Coral, S.J. Social considerations affecting acceptance of HPV vaccination in Colombia. A systematic review (2020) Revista Colombiana de Obstetricia y Ginecologia, 71 (2), pp. 178-194. Cited 6 times. https://www.scielo.br/pdf/rbof/v79n3/0034-7280-rbof-79-03-0207.pdf doi: 10.18597/RCOG.3448Benavides, M, Salazar, L. Razones que pueden explicar la reducción en la cobertura de vacunación contra VPH en Colombia (2017) CES Salud Pública, 8 (1). Cited 6 times. [Internet] https://doi.org/10.21615/4423Jácome, A. Enfermedad psicogénica masiva después de una campaña de vacunación. Episodios anteriores y aproximación al caso colombiano (2014) Rev Med, 36 (3). [Internet]. Disponible en http://revistamedicina.net/ojsanm/index.php/Medicina/article/view/106-9/0Dubé, E., MacDonald, N.E. Vaccination resilience: Building and sustaining confidence in and demand for vaccination (2017) Vaccine, 35 (32), pp. 3907-3909. Cited 11 times. www.elsevier.com/locate/vaccine doi: 10.1016/j.vaccine.2017.06.015Simas, C., Munoz, N., Arregoces, L., Larson, H.J. HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia (2019) Human Vaccines and Immunotherapeutics, 15 (1), pp. 163-166. Cited 35 times. http://www.tandfonline.com/loi/khvi20 doi: 10.1080/21645515.2018.1511667Idrovo, A.J., Pinilla-Monsalve, G.D., Manrique-Hernández, E.F. Mass psychogenic illness following HPV immunization in Carmen de Bolivar, Colombia (2014): more uncertainty is required (2019) Human Vaccines and Immunotherapeutics, 15 (5), pp. 1199-1200. Cited 3 times. http://www.tandfonline.com/loi/khvi20 doi: 10.1080/21645515.2019.1577676Simas, C., Munoz, N., Arregoces, L., Larson, H.J. HPV vaccine confidence and cases of mass psychogenic illness following immunization in Carmen de Bolivar, Colombia (2019) Human Vaccines and Immunotherapeutics, 15 (1), pp. 163-166. Cited 35 times. http://www.tandfonline.com/loi/khvi20 doi: 10.1080/21645515.2018.1511667Vorsters, A., Bosch, F.X., Bosch, F.X., Bonanni, P., Franco, E.L., Baay, M., Simas, C., (...), Muñoz, N. Prevention and control of HPV infection and HPV-related cancers in Colombia- a meeting report (2020) BMC Proceedings, 14, art. no. 8. Cited 11 times. http://www.biomedcentral.com/bmcproc/ doi: 10.1186/s12919-020-00192-2Mauro, A.B., Fernandes, E.G., Miyaji, K.T., Arantes, B.A., Valente, M.G., Sato, H.K., Sartori, A.M.C. Adverse events following Quadrivalent HPV vaccination reported in Sao Paulo State, Brazil, in the first three years after introducing the vaccine for routine immunization (March 2014 to December 2016) (2019) Revista do Instituto de Medicina Tropical de Sao Paulo, 61, art. no. e43. Cited 7 times. http://www.scielo.br/pdf/rimtsp/v61/1678-9946-rimtsp-61-S1678-9946201961043.pdf doi: 10.1590/s1678-9946201961043Shapiro, G.K., Surian, D., Dunn, A.G., Perry, R., Kelaher, M. Comparing human papillomavirus vaccine concerns on Twitter: A cross-sectional study of users in Australia, Canada and the UK (2017) BMJ Open, 7 (10), art. no. e016869. Cited 35 times. http://bmjopen.bmj.com/content/early/by/section doi: 10.1136/bmjopen-2017-016869Hviid, A., Thorsen, N.M., Valentiner-Branth, P., Frisch, M., Mølbak, K. Association between quadrivalent human papillomavirus vaccination and selected syndromes with autonomic dysfunction in Danish females: Population based, self-controlled, case series analysis (2020) The BMJ, 370, art. no. m2930. Cited 14 times. http://www.bmj.com/ doi: 10.1136/bmj.m2930Téllez-Pedroza, M. (2014) The controversy over the use of HPV vaccine in Colombia, centered on the +adverse vaccine reactions/mass hysteria” event in El Carmen de Bolívar. Cited 2 times. [Internet]. Universidad Nacional de Colombia; 2018. Disponible en https://repositorio.unal.edu.co/handle/unal/63740Maldonado Castañeda, OJ. (2015) Making evidence, making legitimacy: The introduction of HPV (Human Papillomavirus) vaccines in Colombia [Internet]. Cited 4 times. University of Lancaster; Disponible en https://eprints.lancs.ac.uk/id/eprint/74365/Mezza, M. (2019) What do epidemiologists do? Investigating a controversial symptomatology in Colombia [Internet] University of Amsterdam; Disponible en https://www.academia.edu/40529959/What_do_epidemiologists_do_Investigating_a_controversial_symptomatology_in_ColombiaMezza, M., Blume, S. Turning suffering into side effects: Responses to HPV vaccination in Colombia (Open Access) (2021) Social Science and Medicine, 282, art. no. 114135. www.elsevier.com/locate/socscimed doi: 10.1016/j.socscimed.2021.114135Dennis, R.A.G. Discussion of human papillomavirus prophylactic vaccination (Open Access) (2019) Revista de Bioetica y Derecho, (45), pp. 111-125. Cited 2 times. http://revistes.ub.edu/index.php/RBD/article/view/25048/28655 doi: 10.1344/rbd2019.0.25048Murillo, R, Muñoz, N. Cartas a la directora (2016) Rev Gerenc y Polit Salud, 15 (30). Cited 3 times. [Internet]. Disponible en https://revistas.javeriana.edu.co/index.php/gerepolsal/article/view/17167/13786http://purl.org/coar/resource_type/c_6501ORIGINAL54574701018.pdf54574701018.pdfapplication/pdf1089302https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/1/54574701018.pdff71ec2813378ee4a9e90c4761fb51202MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83182https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/3/license.txte20ad307a1c5f3f25af9304a7a7c86b6MD53TEXT54574701018.pdf.txt54574701018.pdf.txtExtracted texttext/plain58464https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/4/54574701018.pdf.txt35f2c04ce42378ae9931ca7b5717eb00MD54THUMBNAIL54574701018.pdf.jpg54574701018.pdf.jpgGenerated Thumbnailimage/jpeg3492https://repositorio.utb.edu.co/bitstream/20.500.12585/12398/5/54574701018.pdf.jpge4eac35a7c831f0ced78e53f9c34c48dMD5520.500.12585/12398oai:repositorio.utb.edu.co:20.500.12585/123982023-07-22 00:18:27.011Repositorio Institucional UTBrepositorioutb@utb.edu.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 |