A north coast doctor has published a paper in the British Medical Journal warning that the premature menopause of a healthy 16-year-old girl may be linked to the Gardasil vaccination.
Dr Deirdre Little and her co-author, obstetrician Dr Harvey Ward from the University of NSW, are urging further testing of the Australian vaccine for the sexually transmitted human papillomavirus (HPV), which causes cervical cancer.
"Fertility is not a small matter. It should not be placed at risk by an absence of published research," said Dr Little.
When a 16-year-old patient came to her North Bellingen surgery in 2009 complaining of having lost her period and experiencing hot flushes, six months after being given three Gardasil vaccinations, Dr Little had doubts.
But further investigation raised real concerns of a link. The doctors warn there may be a group of young women who should not be given the vaccine, which has been administered to teenage girls across Australia since 2007. It is due to be given to boys from next year.
"It's important to be certain that fertility is protected at all costs, as premature menopause in a teenager is one of the most disastrous consequences," said Dr Ward.
"We need to be certain that a vaccine does not diminish egg-bearing capacity."
Premature menopause is rare in girls so young. But if there is a problem with the vaccine, Dr Little says it may go undetected because one third of teenage girls are on the pill, which prevents ovulation and masks the symptoms of ovarian failure. The doctors say further studies are needed.
Dr Little notified the Therapeutic Goods Administration (TGA) of a "possible adverse event following HPV vaccination". She says while there have been no other notifications of premature menopause, four cases of "scant periods" have been reported.
Dr Little is an advocate of vaccination, which she regards as a "gift to medicine", but is worried that Gardasil had been rushed into use without the "rigorous standards" applied to established vaccines.
Vaccine-maker CSL recorded a record profit this year because of higher than expected royalty payments from Gardasil as the vaccine spreads around the globe.
One case of premature menopause may not mean anything but the consequences for young women are so dire that further research is warranted.