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Case report
Neck and supraclavicular lymphadenopathy secondary to 9-valent human papillomavirus vaccination
  1. Miguel Paiva Pereira,
  2. Pedro Flores and
  3. Ana Serrão Neto
  1. Centro da Criança e do Adolescente, Hospital CUF Descobertas, Lisboa, Portugal
  1. Correspondence to Dr Miguel Paiva Pereira; miguelpereira2112{at}


We present two clinical cases of lymphadenopathy after vaccination with the human papillomavirus (HPV) 9-valent vaccine: an asymptomatic 11-year-old boy with inferior cervical and supraclavicular lymphadenopathy, and a 13-year-old girl who presented with lymphadenopathy. In both cases, medical history was unremarkable and there was no recent infection, or other clinical findings. Both adolescents had received the HPV 9-valent vaccine in the previous week. In the first case, blood tests, ultrasonography and biopsy were performed, while in the second, a watchful waiting strategy was adopted. In both cases, the lymphadenopathy resolved spontaneously. The boy received the second dose of the vaccine 6 months later and lymphadenopathy reappeared. The Naranjo scale was applied, classifying the events as definite (in the case of the boy) and probable (girl) adverse drug reactions. The vaccine is safe, but recognising this minor adverse event is important to prevent unnecessary investigation and reduce patient and parental anxiety.

  • human papilloma virus
  • unwanted effects/adverse reactions
  • preventative paediatrics
  • vaccination/immunisation
  • immunological products and vaccines

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  • Contributors MPP’s contribution was planning, conducting, reporting, and analysing and interpreting data. PF contributed by planning, reporting and interpreting data. ASN was responsible for acquisition of data, conception and design. All the authors met the four conditions recommended by ICMJE. MPP, PF and ASN equally contributed to the current work, by acquisition, analysis and interpretation of data, drafting the work and revising it critically for important intellectual content. All the authors approved the final version published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.