hpv md chapter banner


The AAP and CDC have both recommended vaccination starting at eleven to twelve years of age for both boys and girls; however, the vaccine still remains poorly utilized.Two vaccines are available in the US. Both provide protection against HPV strains 16 and 18. These 2 strains account for about 70% of the HPV cancers in the US. One of the vaccines also protects against HPV strains 6 and 11- the cause of almost all genital warts. To be protective, the vaccines must be given prior to exposure with that HPV strain. That is one of the reasons the vaccines should be given prior to any sexual contact. In addition, vaccinating young teens has also been shown to give a more robust immunologic response than waiting until they are older. Over 100 million doses have been given worldwide so far without a safety signal, making it one of the safest vaccines available. Several studies published so far have shown the antibody response to persist. The vaccine is already reaping benefits with studies showing a significant reduction in HPV disease and cervical dysplasia. The real anticipated payoff will occur in the next decades when cancers caused by this virus will hopefully become as unusual as smallpox, polio, and all of the other illnesses we now prevent with vaccines.
Orange County AAP Chapter, CME Committee Chair, Dr. Harry Pellman

Who else should get the HPV vaccine?

In addition to girls and boys aged 11 or 12 years, HPV vaccines are also recommended for teen boys and girls who did not get the vaccine when they were younger, teen girls and young women through age 26, as well as teen boys and young men through age 21. The vaccine is also recommended for gay and bisexual men (or any man who has sex with a man). It is also recommended for men and women with compromised immune systems (including people living with HIV/AIDS) through age 26, if they did not get fully vaccinated when they were younger.
Centers for Disease Control and Prevention

GARDASIL is a vaccine indicated in females 9 through 26 years of age for the prevention of cervical, vulvar, and vaginal cancers and for males and females 9 through 26 years of age for the prevention of anal cancer, precancerous or dysplastic lesions, and genital warts caused by human papillomavirus (HPV) Types 6, 11, 16, and 18. GARDASIL does not eliminate the necessity for women to continue to undergo recommended cervical cancer screening. Recipients of GARDASIL should not discontinue anal cancer screening if it has been recommended by a health care professional. GARDASIL has not been demonstrated to provide protection against diseases from vaccine and non-vaccine HPV types to which a person has previously been exposed through sexual activity. GARDASIL is not intended to be used for treatment of active external genital lesions; cervical, vulvar, vaginal, and anal cancers; or cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), vaginal intraepithelial neoplasia (VaIN), or anal intraepithelial neoplasia (AIN). GARDASIL has not been demonstrated to protect against diseases due to HPV types not contained in the vaccine. Not all vulvar, vaginal, and anal cancers are caused by HPV, and GARDASIL protects only against those vulvar, vaginal, and anal cancers caused by HPV Types 16 and 18.

Select Safety Information

GARDASIL is contraindicated in individuals with hypersensitivity, including severe allergic reactions to yeast, or after a previous dose of GARDASIL. Because vaccinees may develop syncope, sometimes resulting in falling with injury, observation for 15 minutes after administration is recommended. Syncope, sometimes associated with tonic-clonic movements and other seizure-like activity, has been reported following vaccination with GARDASIL. When syncope is associated with tonic-clonic movements, the activity is usually transient and typically responds to restoring cerebral perfusion. GARDASIL is not recommended for use in pregnant women. The most common adverse reaction was headache. Common adverse reactions that were observed among recipients of GARDASIL at a frequency of at least 1.0% and greater than placebo were fever, nausea, dizziness; and injection-site pain, swelling, erythema, pruritus, and bruising.

Dosage and Administration

GARDASIL should be administered in 3 separate intramuscular injections in the deltoid region of the upper arm or in the higher anterolateral area of the thigh over a 6-month period with the first dose at an elected date, the second dose 2 months after the first dose, and the third dose 6 months after the first dose. Refrigerate on arrival. Vial and Standard Syringe for GARDASIL Should not have been frozen.

Storage and Handling

Store refrigerated at 2°C to 8°C (36°F to 46°F); DO NOT FREEZE. Protect from light. GARDASIL can be out of refrigeration (at temperatures at or below 25°C/77°F) for a total time of not more than 72 hours. Rotate stock so that the earliest-dated vaccine is used first. Ensure that the refrigerator is plugged into an outlet in a protected area where it cannot be disconnected accidentally. Record refrigerator and freezer temperatures twice a day in a temperature log. All vaccines must be discarded after the expiration date; expired or damaged Vaccines for Children (VFC) vaccines must be returned to your State Immunization Program.Maryland Chapter American Academy of Pediatrics Merckvaccines.com