New HPV Vaccine Recommendation

Just this week, the CDC released a new recommendation about the HPV vaccine.  Since 2006 a vaccine protecting against the human papillomavirus (HPV) has been available for girls aged 9-26.  In 2011 this vaccine was also approved for boys.

Human papillomavirus is the virus that causes cervical cancer in women, penile cancer in men, and genital warts and head and neck cancers in both men and women.  It is sexually transmitted and can be transmitted from mother to baby during birth.  It is estimated that up to 80% of women who are sexually active will contract the HPV virus.

In 2013 (the latest year for which statistics are available) almost 12,000 women were diagnosed with cervical cancer and over 4000 women died from it.  About 19,000 cancers in women and 8000 cancers in men per year are caused by HPV.  Cervical cancer used to be the leading cause of death from cancer in women, but the use of the Pap smear has dramatically decreased the impact of cervical cancer on women over the last 40 years.

Now we have a vaccine that even further reduce the cases of cervical and other cancers and the number of women and men who lose their lives.  Since the introduction of the vaccine, cases of HPV infection with the strains of virus covered by the vaccine has decreased by 56%.

Unfortunately, according to research published in 2013, only about 1/3 of girls between 13 and 17 had been fully vaccinated.  Other countries, such as Rwanda, have vaccinated over 80% of their teenage girls.  However, even with such low vaccination rates in the US, infection rates went down from 11.5% to 5.1%.

In order to increase the percentage of teenagers who are vaccinated and further reduce infection rates, researchers have been studying a two-dose vaccine schedule for the HPV vaccine.  They have found that two doses is as effective for younger teenagers as the traditional three-dose schedule.

The new recommendation for teens who start the vaccine series before their 15th birthday is to have two doses 6-12 months apart.  If the patient starts the series at age 15 or older, they should receive the traditional three doses with the second and third doses 2 and 6 months after the first shot, respectively.

It is important to realize that we don’t have to restart the vaccine schedule at any point.  So if your teenager had the first shot and didn’t get back for the last two, we just continue at whatever point we started.

For instance if a parent had their teen get their first shot at 12 years (which is when we typically recommend the vaccine) but then had second thoughts and didn’t continue, that’s OK.  We would simply give a second dose and call it a day, no matter how old the patient is, as long as they are under 26.

The two-dose schedule for HPV vaccination should make it easier to get our teenagers protected against a preventable, cancer-causing infection.

QUESTION: Do you think the new two-dose vaccine schedule will improve HPV vaccination rates in American teenagers?

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