An interesting study published in this issue of Immunologic Research, by Hotta et al., analyzed forty-one patients who develop chronic fatigue syndrome (CFS) after HVP vaccine. All patients had at least two major criteria of the autoimmune/inflammatory syndrome induced by adjuvants or ASIA proposed by Shoenfeld et al. in 2011, and all patients had severe chronic epipharyngitis. Sixteen patients were treated with abrasive ZnCl2 procedure on epipharynx mucosa, and the authors observed significant improvement of CFS symptoms in 81.2 %, with a complete cure in four patients (25 %). These findings are relevant, because at this time, CFS is an untreatable disease opening the door for a clinical trial. The authors proposed that the possible explanations of improvement of patients treated with abrasive ZnCl2 could be related to hypothalamic pituitary adrenal (HPA) axis normalization, which probably it was previously altered after HPV vaccine with the consequent development of CFS, suggesting an abnormal immune neuroendocrine interaction...