A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia
Pathophysiology
Certain types of human papillomavirus can cause squamous cell cervical cancer, cervical adenocarcinoma, and genital warts.
Vaccine Description
9vHPV(Gardasil™) HPV types 6,11,16,18, 31, 33, 45, 52 and 58
Dose & Route
0.5 mL given intramuscularly
Administration Schedule & Minimum Intervals
Dose Minimum Interval
If the HPV vaccine schedule is interrupted, the vaccine series does not need to be restarted.
2 Dose Schedule
(Person initiating the 1st dose prior to their 15th birthday)
Dose Minimum Interval
Dose 1……..0
Dose 2……..6-12 months started.
(5 months minimal interval from dose-1)
3 Dose Schedule
(Person initiating vaccine after their 15th birthday or immunocompromised persons)
Dose Minimum Interval
Dose 1………..0
Dose 2………..2 months after dose-1 (4 weeks)
Dose 3………..6 months
after dose-1 (12 weeks minimal interval from dose-2 and 24 weeks from dose-1)
- Also recommended for males and females ages 13 through 26 who did not receive the vaccine previously.
- May be given at the same visit with other vaccines.
- Should be given to persons with a previous history of HPV infection.
- Recommended for gay and bisexual men.
- 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.
- Can be given based on shared clinical decision making for males and females ages 27 through 45.
Minimum Age
Minimum age for all HPV vaccine is 9 years.
Contraindications
Anaphylactic reaction to any vaccine component or to previous dose of vaccine.
Precautions
- Not recommended for use in pregnant women
- Not intended for treatment of active genital warts or cervical cancer
- Moderate or severe acute illness with fever
Special Considerations
Remember there is a VIS just for HPV9.
Vaccination in no way should replace:
- routine, periodic cervical cancer screening.
- protective sexual behaviors.
- Syncope can occur after vaccination, most commonly among adolescents and young adults. To avoid serious injury related to syncope episode, observation for 15 minutes after administration is recommended.
- HPV vaccines are most effective for both males and females when given before first exposure to HPV through sexual contact.
- HPV vaccines are not recommended for use in pregnant women. However, pregnancy testing is not needed before vaccination. If a woman is found to be pregnant after initiating the vaccination series, no intervention is needed; the remainder of the 3-dose series should be delayed until completion of pregnancy.