Hpv
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Hpv

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Hpv Presentation Transcript

  • 1. Adult Immunization 2010 Human Papillomavirus Vaccine Segment This material is in the public domain This information is valid as of May 25, 2010
  • 2. Human Papillomavirus • More than 100 types – More than 60 cutaneous types  Can lead to skin warts – 40 mucosal types  high risk types (particularly 16 and 18) – cervical cell abnormalities – certain anogenital cancers  Low risk types (particularly 6 and 11) – cervical cell abnormalities- usually resolve spontaneously and do not lead to cancer – genital warts – respiratory papillomatosis
  • 3. Natural History of HPV Infection Up to Decades Within 1 Year Initial HPV Infection 1-5 Years Persistent Infection CIN 1 Cleared HPV Infection CIN 2/3 Cervical Cancer
  • 4. Natural History of HPV Infection Up to Decades Within 1 Year Initial HPV Infection 1-5 Years Persistent Infection CIN 1 Cleared HPV Infection CIN 2/3 Cervical Cancer
  • 5. HPV-associated Conditions HPV 16, 18 Cervical cancer High/low grade cervical abnormalities Anal, Vulvar, Vaginal, Penile Head and neck cancers HPV 6, 11 Low grade cervical abnormalities Genital warts RRP Estimated % 70% 30%-50% 10% 10% 90% 90%
  • 6. Human Papillomavirus Vaccines • HPV4 (Gardasil) – contains types 16 and 18 (high risk) and types 6 and 11 (low risk) • HPV2 (Cervarix) – contains types 16 and 18 (high risk) • Both vaccines are supplied as a liquid in a single dose vial or syringe • Neither vaccine contains an antibiotic or a preservative
  • 7. Human Papillomavirus Vaccines • HPV4 vaccine is approved for – females 9 through 26 years of age for the prevention of cervical cancers, precancers and genital warts – males 9 through 26 years of age for the prevention of genital warts • HPV2 vaccine is approved for – females 10 through 25 years of age for the prevention of cervical cancers and precancers – not approved for males or for the prevention of genital warts
  • 8. HPV Vaccine Schedule and Intervals • HPV4- 0, 2, 6 months • HPV2- 0, 1, 6 months • ACIP recommends- 0, 1 to 2, 6 months • ACIP has not defined a maximum interval between HPV vaccine doses • If the interval between doses is longer than recommended continue the series where it was interrupted
  • 9. Correct and consistent condom use may have a protective effect on HPV acquisition, reduce the risk for HPV-associated diseases, and mitigate the adverse consequences of infection with HPV. This statement is required by section 317 of the Public Health Service Act, 42 U.S.C., 243
  • 10. HPV Vaccine Recommendations • Recommended age for routine HPV vaccination is 11 or 12 years • Vaccination is recommended for females 13 through 26 years of age not previously vaccinated or who have not completed the full 3-dose series • The 3 dose series of HPV4 may be administered to males 9 through 26 years of age to reduce their likelihood of acquiring genital warts
  • 11. HPV Vaccine Special Situations • Females 26 years of age or younger with equivocal or abnormal Pap test, positive HPV DNA, or genital warts may be vaccinated – vaccine will have no effect on existing disease or infection • Females 26 years of age or younger who are lactating and breastfeeding, or are immunocompromised may be vaccinated • Vaccination not recommended for pregnant women – pregnancy testing is not needed before vaccination
  • 12. HPV Vaccine Contraindications and Precautions • Severe allergic reaction to a vaccine component or following a prior dose – yeast (HPV4) – latex (HPV2 prefilled syringe) • Moderate or severe acute illness
  • 13. HPV Vaccine Adverse Reactions • Local reaction 20% - 90% (pain, redness, swelling) • Temperature 100°F 10% - 13% or higher • Serious adverse events None
  • 14. HPV Vaccine and Cervical Cancer Screening • Cervical cancer screening recommendations have NOT changed for females who receive HPV vaccine • Females who are vaccinated could subsequently be infected with a high-risk HPV type not in either vaccine • Females who were sexually active prior to vaccination could have been infected with a vaccine-type HPV before vaccination • Healthcare providers who administer HPV vaccine should educate women about the importance of cervical cancer screening
  • 15. National Center for Immunization and Respiratory Diseases Contact Information • Telephone • Email • Website (800) CDC-INFO nipinfo@cdc.gov http://www.cdc.gov/vaccines/ • Broadcast Updates and Resources Web Page http://www.cdc.gov/vaccines/ed/webcasts.htm