New Gardasil (HPV 9) Dosing Guidelines- 1/02/017
Federal health authorities have approved a two-dose schedule for HPV vaccine for adolescents under age 15 years.
Subsequent research shows a two-dose schedule for younger adolescents provides effective, long-lasting protection from HPV-related cancers, according to a report from the Centers for Disease Control and Prevention (CDC). “Based on the available immunogenicity evidence, a 2-dose schedule (0, 6-12 months), will have efficacy equivalent to a 3-dose schedule (0, 1-2, 6 months) if the HPV vaccination series is initiated before the 15th birthday,” according to the report.
The American Academy of Pediatrics (AAP) and CDC recommend HPV vaccine as part of routine immunization for males and females at age 11 or 12 years, and that vaccination starting at 11 or 12 years will provide the best protection possible long before the start of any kind of sexual activity.
HPV is associated with cervical, vulvar, and vaginal cancer in females, penile cancer in males, and anal and oropharyngeal cancer in both females and males
The vaccine, now available as the 9-valent Gardasil 9, traditionally has been given in a three-dose series, but in October 2016, the Food and Drug Administration approved a two-dose series for children ages 9-14. The CDC’s latest move modified the ACIP’s recommendations for a two-dose schedule for girls and boys who start the series at age 9-14 (before the age of 15 years). Those children should receive the second dose six to 12 months after the first dose.
For those starting the series at age 15-26 and for immunocompromised people, a three-dose series is recommended. The second dose should be given one to two months after the first dose, and the third dose should be given six months after the first dose.
Those who already started the series with any HPV vaccine will be considered adequately vaccinated if they
- started before their 15th birthday and received two doses, with the second dose six to 12 months after the first,
- started before their 15th birthday and received three doses at the recommended dosing schedule or
- started on or after their 15th birthday and received three doses at the recommended dosing schedule.
A schedule that has been interrupted does not need to be restarted, and the 9-valent vaccine may be used to complete a series started with a quadrivalent or bivalent vaccine (Cervarix – GSK).
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