 In the Netherlands, the human Papillomavirus HPV vaccination will be added to the National Vaccination Program for girls to protect against the development of cervical cancer. The vaccine protects against HPV type 16 18, which cause about 75 of cervical cancer. Studies have shown that the vaccine is effective in healthy subjects in preventing infection by HPV 16 18. However, no evidence exists on the immunogenicity and safety of HPV vaccination in patients with an immune system disorder, such as primary humoral immunodeficiency i.e. hypogammaglobulinemia or autoimmune diseases. Concerns exist that vaccination may cause an aggravation of the underlying disease. In addition, the immune response to vaccination may be diminished due to immunosuppressive therapy or the underlying disease. 