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Hpv
There are over 100 types of human papillomavirus (HPV), with some high-risk types causing cervical cancer and other cancers and diseases. Two HPV vaccines, Gardasil and Cervarix, protect against high-risk HPV types 16 and 18, which cause 70% of cervical cancers. Gardasil also protects against low-risk types 6 and 11, which cause 90% of genital warts. The vaccines are recommended for females ages 11-26 and males ages 11-26, with a 3 dose schedule, to protect against HPV infections and related diseases. Cervical cancer screening is still important for vaccinated females due to other high-risk HPV types not covered by the vaccines.
Hpv
- 1. Adult Immunization 2010 HumanPapillomavirus Vaccine Segment This material is in the public domain This information is valid as of May 25, 2010
- 2. Human Papillomavirus • Morethan 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 ofHPV 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 ofHPV 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 Scheduleand 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 consistentcondom 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 SpecialSituations • 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 andPrecautions • 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 andCervical 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 forImmunization 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