From the Guidelines
The American Cancer Society (ACS) recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates and increase the numbers of cancers prevented 1.
Key Recommendations
- Routine HPV vaccination is recommended at age 11 or 12 years, but can be given starting at age 9 years 1.
- Vaccination is recommended for all persons through age 26 years who are not adequately vaccinated 1.
- Catch-up HPV vaccination is not recommended for adults aged older than 26 years 1.
- The ACS does not endorse the recommendation for shared clinical decision making for adults aged 27-45 years because of the low effectiveness and low cancer prevention potential of vaccination in this age group 1.
Special Considerations
- Pregnancy testing is not needed before vaccination, but HPV vaccination should be delayed until after pregnancy 1.
- Persons who are breastfeeding or lactating can receive HPV vaccine 1.
- Cervical cancer screening guidelines and recommendations should be followed, regardless of vaccination status 1.
Rationale
The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented 1. Vaccination has shown no sign of protection waning over time, and thus earlier vaccination would still confer protection throughout adolescence and early adulthood 1. The ACS does not endorse the recommendation for shared clinical decision making for adults aged 27-45 years because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on selection of individuals who might benefit 1.
From the Research
HPV Vaccine Recommendations
The Human Papillomavirus (HPV) vaccine is recommended for individuals aged 9-26 years and adults aged 27-45 years who may be at risk of new HPV infection and benefit from vaccination 2. The primary target population for HPV vaccination is girls aged 9-14 years, prior to their becoming sexually active, to undergo a two-dose schedule, and girls ≥ 15 years of age, to undergo a three-dose schedule 2.
Target Population
- Girls aged 9-14 years: two-dose schedule 2, 3
- Girls ≥ 15 years of age: three-dose schedule 2, 3
- Males aged 11 or 12 years: routine vaccination with quadrivalent HPV vaccine (HPV4) 4
- Males aged 13 through 21 years: vaccination if not previously vaccinated 4
- Men who have sex with men and immunocompromised persons (including those with HIV infection): vaccination through age 26 years if not previously vaccinated 4, 5
Vaccine Schedules
- Two-dose schedule for girls and boys who initiate the vaccination series at ages 9 through 14 years 3
- Three-dose schedule for persons who initiate the vaccination series at ages 15 through 26 years and for immunocompromised persons 3