HPV Immunization
Recommendation for Immunization
Age:
How often:
9-26
One series of three shots, with 2nd shot 1-2 months after first, and 3rd shot 6 months after first
Gender: Female (optional for males)

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 11,000 women will get invasive cervical cancer in 2007. About 3,600 women will die of this disease in 2007. This vaccine will prevent most cases of cervical cancer and genital warts. It is also protective against many vaginal and vulvar cancers. HPV also causes genital warts and cancers in men, and the FDA has recently approved the Gardasil® version to prevent male genital warts.

In the future this vaccine may be recommended for older unvaccinated women, pending further research. In addition, the vaccine may ultimately be recommended for boys and men, pending further research. Vaccination of men could limit overall spread of HPV and may also reduce the risks of certain oral, anal, and penile cancers.


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
  • Smoking
  • Alcohol use
  • Stress and other infections like herpes or HIV concurrently


Available brands of this vaccine include:
  • Gardasil®
  • Cervarix®

Citations
  1. "Recommended Immunization Schedule for Persons Aged 0 Through 18 Years --- United States, 2010." MMWR Weekly. Centers for Disease Control and Prevention. January 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5851a6.htm?s_cid=mm5851a6_e.
  2. "Recommended Adult Immunization Schedule --- United States, 2010." MMWR Weekly. Centers for Disease Control and Prevention. January 2010. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5901a5.htm?s_cid=mm5901a5.
  3. "What are the key statistics about cervical cancer?" American Cancer Society. September 2009. www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_cervical_cancer_8.asp.
  4. "HPV Vaccine Questions and Answers." U.S. Department of Health and Human Services. Centers for Disease Control Prevention. June 2008. www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm.
  5. "HPV (Human Papillomavirus) Vaccine What You Need to Know." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Immunization and Respiratory Diseases. Vaccine Information Statement (Interim). February 2007. http://www.immunize.org/vis/hpv.pdf.
  6. "Genital Warts." Medline Plus. A Service of the U.S. National Library of Medicine and the National Institutes of Health. November 2009. http://www.nlm.nih.gov/medlineplus/ency/article/000886.htm.
  7. "Gardasil [Human Papilloma Virus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant]." Merck & Co., Inc. 2009. http://www.merck.com/product/usa/pi_circulars/g/gardasil/gardasil_pi.pdf.
  8. "Cervarix: Highlights of Presribing Information." GlaxoSmithKline. 2009. http://us.gsk.com/products/assets/us_cervarix.pdf.
  9. "HPV Vaccine- Questions and Answers." Centers for Disease Control and Prevention. December 2009. http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm.
  10. "Reports of Health Concerns Following HPV Vaccination. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. June 2009. http://www.cdc.gov/vaccinesafety/Vaccines/HPV/gardasil.html.
  11. "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.
  12. "Vaccine Excipient and Media Summary, Part 2." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. April 2009. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf.
  13. "Thimerosol in Vaccines." U.S. Food and Drug Administration. Center for Biologics Evaluation and Research. November 2009. http://www.fda.gov/cber/vaccine/thimerosal.htm.

Created: 7/2/2007
Last Modified: 3/13/2010