, more than 170 million doses of<unk>  had been distributed worldwide. The vaccine was tested in thousands of females (ages 9 to 26). The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) consider the vaccine to be safe. It does not contain mercury, thiomersal, live viruses or dead viruses, but virus-like particles, which cannot reproduce in the human body. The vaccine has mostly minor side effects, such as pain around the injection area. Fainting is more common among adolescents receiving the<unk>  vaccine than in other kinds of vaccinations. Patients should remain seated for 15 minutes after they receive the HPV vaccine. There have been reports that the shot is more painful than other common vaccines, and the manufacturer Merck partly attributes this to the virus-like particles within the vaccine. General side effects of the shot may include joint and muscle pain, fatigue, physical weakness and general malaise. The FDA and the CDC said that with millions of vaccinations "by chance alone some serious adverse effects and deaths" will occur in the time period following vaccination, but they have nothing to do with the vaccine. More than twenty women who received the<unk>  vaccine have died, but these deaths have not been causally connected to the shot, as correlation does not imply causation. Where information has been available, the cause of death was explained by other factors. Likewise, a small number of cases of Guillain–Barré syndrome (GBS) have been reported following vaccination with<unk> , though there is no evidence linking GBS to the vaccine. It is unknown why a person develops GBS, or what initiates the disease. The FDA and the CDC monitor events to see if there are patterns, or more serious events than would be expected from chance alone. The majority (68%) of side effects data were reported by the manufacturer, but in about 90% of the manufacturer reported events, no follow-up information was given that would be useful to investigate the event further. In February 2009, the Spanish Ministry of Health suspended use of one batch of<unk>  after health authorities in the Valencia region reported that two girls had become ill after receiving the injection. Merck has stated that there was no evidence<unk>  was responsible for the two illnesses.
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