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Updated HPV Vaccine Guideline

New guidance recommends vaccinating boys and girls at ages 11 to 12

The American Cancer Society (ACS) has endorsed human papillomavirus (HPV) vaccination recommendations from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP), the principal source of guidance on U.S. immunization policy. An updated guideline from the ACS supports the ACIP recommendation to vaccinate males as well as females at ages 11 to 12 to protect against HPV infection, which is associated not only with cervical cancers, but also with penile, anal, oropharyngeal, and other cancers.

The report was published online in CA: A Cancer Journal for Clinicians.

The ACS first published a guideline for the use of prophylactic HPV vaccines for the prevention of cervical cancer and precancer in 2007. At that time, the vaccine was not approved for use in males, and there was insufficient evidence for vaccinations beyond the age of 18. Since then, additional studies have added to the evidence; new versions of the vaccine have been licensed for use in the U.S.; and there have been new immunization recommendations from the ACIP.

Studies indicate that vaccination will be as effective against cancers related to HPV in males as it is in females. Those cancers include penile cancer in males; cervical, vaginal, and vulvar cancer in females; and anal and oropharyngeal cancers in males and females. Vaccinating males may also provide additional protection to females.

A summary of the ACS recommendations follows:

  • Routine HPV vaccination of all children should be initiated at age 11 or 12. The vaccination series can be started as early as age 9.
  • Vaccination is also recommended for females ages 13 to 26 and for males ages 13 to 21 who have not been vaccinated previously or who have not completed the three-dose series. Males 22 through 26 years of age may also be vaccinated.
  • The guideline emphasizes that late vaccination for adolescents who were not vaccinated at the recommended age should be completed as soon as possible.
  • Individuals ages 22 to 26 who were not previously vaccinated should be informed that vaccination at older ages is less effective in lowering the risk of cancer, which is not specifically recommended by the ACIP.
  • The vaccination of females is recommended with any of the three available vaccines: 2vHPV, 4vHPV (as long as this formulation is available), or 9vHPV. Vaccination of males is recommended with 4vHPV (as long as this formulation is available) or 9vHPV.
  • Vaccination is also recommended through age 26 for men who have sex with men and for immunocompromised persons (including those with human immunodeficiency virus [HIV] infection) if they have not been vaccinated previously.

“HPV vaccination has the potential to prevent tens of thousands of cancers and hundreds of thousands of precancers each year,” said lead author Debbie Saslow, PhD. “It is critical that all stakeholders—families, health care providers, and others—make HPV vaccination a priority, so that prevention of the vast majority of cervical, vaginal, vulvar, anal, penile, and oropharyngeal cancers can become a reality.”

Source: ACS; July 19, 2016; and CA; July 19, 2016.

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