Hpv

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Hpv

  1. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 13. HPV Vaccine Adverse Reactions • Local reaction 20% - 90% (pain, redness, swelling) • Temperature 100°F 10% - 13% or higher • Serious adverse events None
  14. 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. 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

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