From the Guidelines
I strongly recommend that both the 11-year-old female and 17-year-old male receive the HPV (Human Papillomavirus) vaccination, as it provides protection against HPV types that cause most cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers, as well as genital warts. The standard regimen for the 11-year-old female would be Gardasil 9, administered as a 2-dose series with doses given 6-12 months apart, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1. For the 17-year-old male, a 3-dose series is recommended, with the second dose given 1-2 months after the first, and the third dose given 6 months after the first, as the vaccine series was initiated after the age of 14 years 1.
HPV Vaccination Benefits
The HPV vaccine stimulates the immune system to produce antibodies against specific HPV types, providing protection before potential exposure. According to the Centers for Disease Control and Prevention (CDC), the lifetime risk of acquiring an HPV infection is over 80%, and an estimated 79 million people in the United States are currently infected with HPV 1. The vaccine has been shown to be highly effective in protecting against cervical, vulvar, and vaginal cancer precursor lesions related to the included HPV types, with a 97% effectiveness rate against the 5 additional types included in the 9-valent vaccine 1.
Vaccine Safety and Administration
Side effects of the HPV vaccine are generally mild and may include pain at the injection site, fever, headache, and fatigue. The vaccine has an excellent safety profile with over a decade of monitoring data, and the protection it provides against HPV-related cancers far outweighs any potential risks 1. The ACIP recommends routine vaccination with the HPV vaccine for individuals 11 through 12 years of age, and also recommends vaccination for 13- through 26-year-old females and 13- through 21-year-old males who have not been vaccinated previously or who have not completed the series 2, 1.
Importance of Early Vaccination
The rationale for administering the HPV vaccine routinely at the 11- through 12-year-old visit is based on data from vaccine trials, epidemiologic studies of HPV infection, and sexual behavior, which indicate that the greatest protection will be achieved by giving the vaccine before the adolescent becomes sexually active 1. There is a remarkably high incidence of HPV infection after sexual initiation, with the cumulative incidence of HPV infection nearly 40% within the first 2 years after first having sexual intercourse among college women and almost 60% among college men 1.
Healthcare Provider Recommendation
Healthcare provider recommendation and physician attitude play a major role in the decision to vaccinate against HPV, with a strong endorsement being more influential than a weak one 1. Parents prefer clear, unambiguous recommendations, and offering the HPV vaccine without strongly recommending it appears to confuse and frustrate parents 1. By strongly recommending the HPV vaccine and emphasizing its importance in cancer prevention, healthcare providers can increase vaccination rates and protect against HPV-related cancers.
From the FDA Drug Label
Effectiveness of GARDASIL 9 against persistent infection and disease related to vaccine HPV types in 9- through 15-year-old girls and boys was inferred from non-inferiority comparison conducted in the PPI population in Study 2 of GMTs following vaccination with GARDASIL 9 among 9- through 15-year-old girls and boys with those among 16- through 26-year-old girls and women.
Study Supporting the Effectiveness of GARDASIL 9 against Vaccine HPV Types in 16- through 26-Year-Old Boys and Men Effectiveness of GARDASIL 9 against persistent infection and disease related to vaccine HPV types in 16- through 26-year-old boys and men was inferred from non-inferiority comparison conducted in the PPI population in Study 7 of GMTs following vaccination with GARDASIL 9 among 16- through 26-year-old HM with those among 16- through 26-year-old girls and women.
The recommendations for HPV vaccination are as follows:
- For an 11-year-old female, the vaccine is recommended as it has been shown to be effective in 9- through 15-year-old girls 3.
- For a 17-year-old male, the vaccine is recommended as it has been shown to be effective in 16- through 26-year-old boys and men 3. Key points to consider:
- The vaccine has been shown to be effective in preventing persistent infection and disease related to vaccine HPV types in both females and males.
- The vaccine is recommended for females and males between the ages of 9 and 26 3.
From the Research
HPV Vaccination Recommendations
- The Advisory Committee on Immunization Practices (ACIP) recommends that preteens, including 11-year-old females, receive 3 doses of human papillomavirus (HPV) vaccine 4.
- For a 17-year-old male, the ACIP recommends catch-up vaccination for HPV if not previously vaccinated 5, 6.
- The 9-valent HPV vaccine is recommended by the ACIP for girls and boys aged 11-12 years 7.
Vaccination Schedule
- The ACIP recommends that adolescents aged 11-12 years routinely receive tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal conjugate (MenACWY); and human papillomavirus (HPV) vaccines 5, 6.
- A booster dose of MenACWY vaccine is recommended at age 16 years 5, 6.
- Shared clinical decision-making is recommended for the serogroup B meningococcal vaccine (MenB) for persons aged 16-23 years 5, 8.
Importance of Vaccination
- HPV vaccination can significantly reduce the incidence of anogenital cancer and genital warts 7.
- Ensuring that routine immunization services for adolescents are maintained or reinitiated is essential to continuing progress in protecting persons and communities from vaccine-preventable diseases and outbreaks 6.