Rotavirus Vaccines Shingles vaccines TB skin test Travel vaccines Vaccine eligibility 4. Vaccine ingredients Vaccine safety Vaccine Schedules Vaccine Status Reporting Regulation 8. Where to get immunized People aged 14 years or under at the time of their first HPV vaccination need two doses of the vaccine two injections. The two doses must be given at least six months apart. People aged 15 years and older need three doses of the vaccine over 6 months.
This is because younger people produce the best immune response to the vaccine. The original HPV vaccine was first given in the major vaccine studies in This research is ongoing. If booster shots are ever needed, people will be contacted by the Australian Immunisation Register which keeps records of everyone who received the vaccine. The vaccine program has already shown strong signs of success in reducing HPV infections, genital warts and pre-cancer of the cervix. The HPV vaccine is a prescription medicine.
The minimum interval between the first and third doses is 5 calendar months. If the vaccination series is interrupted, the series does not need to be restarted.
I read that HPV vaccination rates are still low. What can we do as providers to improve these rates? Coverage levels for HPV vaccine are improving but are still inadequate. A summary of the NIS-Teen survey is available at www. First, studies have shown that missed opportunities are occurring. Second, research has shown that not receiving a healthcare provider's recommendation for HPV vaccine was one of the main reasons parents reported for not vaccinating their adolescent children.
CDC urges healthcare providers to increase the consistency and strength of their recommendation of HPV vaccine, especially when patients are age 11 or 12 years. The following resource can help providers with these conversations. Some parents resist HPV vaccination of their and year-olds because they are not sexually active. How should I counter this position? Explain to the parent that vaccination starting at 11 or 12 years will provide the best protection possible long before the start of any kind of sexual activity.
It is standard practice to vaccinate people before they are exposed to an infection, as is the case with measles and the other recommended childhood vaccines. Similarly, we want to vaccinate children before they get exposed to HPV. Studies of HPV vaccine indicate that younger adolescents respond better to the vaccine than older adolescents and young adults.
Healthy children vaccinated at this age will need only 2 doses of vaccine rather than 3 doses if vaccinated at an older age. Finally, numerous research studies have shown that getting the HPV vaccine does not make kids more likely to be sexually active or start having sex at a younger age. We have several males in our college health service whose records indicate that they received doses of Cervarix.
Can we count these doses as valid? Cervarix was not approved or recommended for use in males. Doses of Cervarix administered to males should not be counted and need to be repeated using 9vHPV. Are Pap smears still necessary for women who receive HPV vaccine? Vaccinated women still need to see their healthcare provider for periodic cervical cancer screening. The vaccine does not provide protection against all types of HPV that cause cervical cancer, so even vaccinated women will still be at risk for some cancers from HPV.
Do women and men whose sexual orientation is same-sex need HPV vaccine? HPV vaccine is recommended for females and males regardless of their sexual orientation. Should transgender persons receive HPV vaccine? ACIP recommends routine HPV vaccination for transgender persons as for all adolescents and young adults through age 26 years.
Clinicians should discuss the risks of HPV disease and benefits of HPV vaccination with unvaccinated or incompletely vaccinated transgender persons age 27 through 45 years. What immunocompromising conditions are an indication for a 3-dose HPV schedule? ACIP recommends vaccination with 3 doses of HPV vaccine for females and males age 9 through 26 years with primary or secondary immunocompromising conditions that might reduce cell-mediated or humoral immunity.
Examples include B lymphocyte antibody deficiency, T lymphocyte complete or partial defects, HIV infection, malignant neoplasm, transplantation, autoimmune disease, or immunosuppressive therapy. Is asplenia considered to be an indication for a 3-dose HPV schedule? The recommendation for a 3-dose HPV schedule also does not apply to children 9 through 14 years with asthma, chronic granulomatous disease, chronic liver disease, chronic renal disease, central nervous system anatomic barrier defects such as a cochlear implant , complement deficiency, diabetes, heart disease or sickle cell disease unless the person is receiving immunosuppressive therapy for the condition.
If a patient has been sexually active for a number of years, is it still recommended to give HPV vaccine or to complete the HPV vaccine series? HPV vaccine should be administered to people who are already sexually active. Ideally, patients should be vaccinated before onset of sexual activity; however, people who have already been infected with one or more HPV types will still be protected from other HPV types in the vaccine that have not been acquired.
I have a patient who was diagnosed with HPV types 16 and The patient received a properly spaced Gardasil series in when she was 25 years old. Did the HPV vaccine she received in fail to protect her? The most likely explanation for this situation is that the patient was exposed to at least HPV types 16 and 18 prior to vaccination.
The HPV vaccine is not effective in preventing infection from HPV types a person has been exposed to prior to vaccination. Will patients who have already had genital warts benefit from receiving HPV vaccine?
Vaccination will provide protection against infection with HPV serotypes the patient has not already acquired. It is important, however, that patients receive a full age-appropriate series of HPV vaccine to get full protection from genital warts. The minimum interval between doses is 5 calendar months.. A 3-dose schedule is recommended for people who start the series on or after the 15th birthday and for people with certain immunocompromising conditions such as cancer, HIV infection, or taking immunosuppressive drugs.
Has ACIP expressed a preference for the 2-dose over the 3-dose schedule for adolescents 9 through 14 years of age? ACIP recommends the 2-dose schedule for people starting the HPV vaccination series before the 15th birthday, as long as they are immunocompetent. If a dose of HPV vaccine is significantly delayed, do I need to start the series over? No, do not restart the series. You should continue where the patient left off and complete the series. Can the 4-day "grace period" be applied to the minimum intervals for HPV vaccine?
A 16 year old received the third dose of HPV vaccine 12 weeks after the second dose but only 4 months after the first dose. Should the third dose be repeated? If an HPV vaccine dose is administered at less than the recommended minimum interval then the dose should be repeated.
The repeat third dose should be repeated 5 months after the first dose or 12 weeks after the invalid third dose, whichever is later. Does the 2-dose HPV vaccine schedule need to be completed with the same vaccine, or can it include different vaccines such as bivalent or quadrivalent vaccine? The 2-dose schedule can be completed with any combination of HPV vaccine brands as long as dose 1 was given before age 15 years. If dose 1 of HPV vaccine was given before the 15th birthday and it has been more than a year since that dose was given, would the series be complete with just one additional dose?
Adolescents and adults who started the HPV vaccine series prior to the 15th birthday and who are not immunocompromised are considered to be adequately vaccinated with just one additional dose of HPV vaccine.
We have adolescents in our practice who have received the first 2 doses of the HPV series 1 or 2 months apart according to the 3-dose schedule. Can we consider their HPV vaccine series to be complete or do we need to give these patients a third dose? Is the 2-dose recommendation retroactive for children and teens vaccinated prior to ? Any person who ever received 2 doses of any combination of HPV vaccines can be considered fully vaccinated if dose 1 was given before the 15th birthday and the 2 doses were separated by at least 5 months.
I work with university students and many of them miss coming in on time for their next dose of HPV vaccine. What's the longest interval allowed before we need to start the series over? No vaccine series needs to be restarted because of an interval that is longer than recommended with the exception of oral typhoid vaccine in certain circumstances.
You should continue the series where it was interrupted. I have read that HPV vaccine should not be administered to pregnant women. Do we need to perform a pregnancy test prior to administering this vaccine to our patients? Currently, we ask about pregnancy prior to providing the vaccine. HPV vaccine is not recommended for use in pregnant women. HPV vaccines have not been associated causally with adverse outcomes of pregnancy or adverse events in the developing fetus.
However, if a woman is found to be pregnant after initiating the vaccination series, the remainder of the series should be delayed until completion of pregnancy. Pregnancy testing is not needed before vaccination. If a vaccine dose has been administered during pregnancy, no intervention is needed. We inadvertently gave HPV vaccine to a woman who didn't know she was pregnant at the time. How should we complete the schedule? You should withhold further HPV vaccine until she is no longer pregnant.
After the pregnancy is completed, administer the remaining doses of the series using the usual 2- or 3-dose schedule depending on the age at initiation of the series. Can HPV vaccine be administered at the same time as other vaccines? Yes, administration of a different inactivated or live vaccine, either at the same visit or at any time before or after HPV vaccine, is acceptable because HPV is not a live vaccine. If HPV vaccine is given subcutaneously instead of intramuscularly, does the dose need to be repeated?
No data exist on the efficacy or safety of HPV vaccine given by the subcutaneous route. All data on efficacy and duration of protection are based on a vaccine series administered by the intramuscular route.
In the absence of data on subcutaneous administration, CDC and the manufacturer recommend that a dose of HPV vaccine given by any route other than intramuscular should be repeated. There is no minimum interval between the invalid subcutaneous dose and the repeat dose. Contraindications are the following: HPV vaccine is contraindicated for persons with a history of immediate hypersensitivity to any vaccine component, including yeast.
The precaution to HPV vaccine is a moderate or severe acute illness with or without fever. Vaccination should be deferred until the condition improves. HPV vaccines are not recommended for use in pregnant women. If a woman is found to be pregnant after starting the vaccination series, the remainder of the 2 or 3-dose series depending on the age of first HPV vaccination should be delayed until completion of pregnancy.
If a woman has had HPV infection, can she still be vaccinated? Women who have evidence of present or past HPV infection may be vaccinated. They should be advised that the vaccine will not have a therapeutic effect on existing HPV infection or cervical lesions. Can a woman who is breastfeeding receive HPV vaccine? Is the history of an abnormal Pap test a contraindication to the HPV vaccine series?
Even a woman found to be infected with a strain of HPV that is present in the vaccine could receive protection from the other strains in the vaccine.
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