|Recommendation for Immunization |
One series of three shots preferably starting at age 11 or 12, with 2nd shot 1-2 months after first, and 3rd shot 6 months after first
|Gender: ||Female and Male |
1. What is this vaccine?
This is a vaccine to prevent infection with some strains of the human papilloma virus, HPV.
2. Why is this vaccine important?
In the United States, about 15,000 women will get HPV related cancers (mostly cervical cancer) every year. This vaccine will prevent most cases of cervical cancer and genital warts. It is also protective against many vaginal and vulvar cancers.Girls who were not immunized at age 11-12 should be immunized as soon as possible and by age 26. HPV also causes genital warts and about 7000 cancers in men (anal, oropharyngeal, and penile) annually in the U.S. In 2009, the FDA approved the Gardasil® version to prevent male genital warts and in December of 2011 the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices formally recommended that all boys receive the vaccine series to help prevent genital warts and certain cancers. While the vaccine is approved for ages 9-26, the preferred age to begin the series is 11-12. Boys who have not been immunizaed at that age should have the series given between the ages of 13 and 21, and up to age 26 for men with HIV or men having sex with men.
In the future this vaccine may be recommended for older unvaccinated individuals, pending further research.
3. How is this vaccine given?
The vaccine is given in the deltoid muscle of the arm or the upper outer thigh muscle.
4. What are the risks and special considerations of this vaccine?
Safety in pregnancy and breastfeeding has not been proven. The vaccine can cause some reactions including pain, swelling, or itching at the site of injection; also fever, nausea, or dizziness can occur. Rare serious reactions including Guillain-Barré syndrome have been reported, but it is not yet clear if the vaccine was the cause.
Individuals with prior severe reactions to this vaccine may not be able to receive another dose. There is some controversy about giving this to people with yeast allergy. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness.
Gardasil®, by Merck, is a vaccine that protects against 4 different strains of HPV: 16 and 18 (which cause 70% of cervical cancer) and 6 and 11 (which cause 90% of genital warts cases). Cervarix®, by GlaxoSmithKline, is another version that protects agains HPV: 16 and 18. This vaccine is recommended for girls as a series of 3 shots, with the first shot preferably between 11 and 12 years of age. The 2nd dose should be given 1-2 months after the first dose and the 3rd dose 6 months after the 1st dose. Gardasil is also licensed for boys aged 9 to 26 years and may given on the same dosing schedule to prevent genital warts. Adult dosing follows the same schedule.
In theory, it is best to be immunized prior to sexual activity to get optimal protection from the vaccine, but the CDC recommends that females already sexually active still get the vaccine. Individuals who have already been infected with one or more strains covered by the vaccine may get less benefit from the vaccine, but should still receive it. Immune response may not be as effective in people with immune compromise.
5. Risk factors for contraction of disease
- Multiple sex partners
- Early age at first sexual activity
- Alcohol use
- Stress and other infections like herpes or HIV concurrently
Available brands of this vaccine include:
- Gardasil® approved for ages 9-26 in females and males
- Cervarix® approved for girls ages 9-25
- "Recommended Adult Immunization Schedule --- United States, 2011." Centers for Disease Control and Prevention. 2011. http://www.cdc.gov/vaccines/recs/schedules/downloads/adult/adult-schedule.pdf.
- "Recommended Immunization Schedule for Persons Aged 0 Through 6 Years--United States 2011." Centers for Disease Control and Prevention. 2011. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/0-6yrs-schedule-pr.pdf.
- "Recommended Immunization Schedule for Persons Aged 7 Through 18 years--United States 2011." Centers for Disease Control and Prevention. 2011. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/7-18yrs-schedule-pr.pdf.
- "Catch Up Immunization Schedule for Persons Aged 4 months Through 18 years Who Start Late or Who Are More Than One Month Behind." Centers for Disease Control and prevention. 2011 http://www.cdc.gov/vaccines/recs/schedules/downloads/child/catchup-schedule-pr.pdf.
- "What are the key statistics about cervical cancer?" American Cancer Society. October 2011. http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-key-statistics.
- "HPV Vaccines." U.S. Department of Health and Human Services. Centers for Disease Control Prevention. December 2011. http://www.cdc.gov/hpv/vaccine.html.
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- "Genital Warts." Medline Plus. A Service of the U.S. National Library of Medicine and the National Institutes of Health. December 2010. http://www.nlm.nih.gov/medlineplus/ency/article/000886.htm.
- "Gardasil [Human Papilloma Virus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]." Merck & Co., Inc. 2011. http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf.
- "Cervarix: Highlights of Presribing Information." GlaxoSmithKline. July 2011. http://us.gsk.com/products/assets/us_cervarix.pdf.
- "HPV Vaccine- Questions and Answers." Centers for Disease Control and Prevention. April 2011. http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm.
- "Reports of Health Concerns Following HPV Vaccination. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. October 2011. http://www.cdc.gov/vaccinesafety/Vaccines/HPV/gardasil.html.
- "Vaccine Excipient and Media Summary." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-1.pdf.
- "Vaccine Excipient and Media Summary, Part 2." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. March 2010. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf.
- "Thimerosol in Vaccines." U.S. Food and Drug Administration. Center for Biologics Evaluation and Research. March 2010. http://www.fda.gov/cber/vaccine/thimerosal.htm.
- "ACIP Expands HPV Vaccine Recommendation to Adolescent Boys." American Academy of Family Practice. October 2011. http://www.aafp.org/online/en/home/publications/news/news-now/health-of-the-public/20111026acip-hpv-hepb.html.
- "Recommendations on the Use of Quadrivalent Human Papilloma Virus Vaccine in Males--Advisory Committee on Immunization Practices (ACIP), 2011." Morbidity and Mortality Weekly Report (MMWR). December 23, 2011. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm.
Last Modified: 1/2/2012