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CDC approves 2-dose HPV vaccine schedule :

December 15, 2016

Federal health authorities have approved a two-dose schedule for HPV vaccine for adolescents under age 15 years.

New research shows a two-dose schedule for younger adolescents provides effective, long-lasting protection from HPV-related cancers and is economical, according to a report from the Centers for Disease Control and Prevention (CDC).

The Academy’s recommendation, to be published Feb. 7, is expected to mirror the guidance released Thursday in the Morbidity and Mortality Weekly Report.

The Academy and CDC recommend HPV vaccine as part of routine immunization for males and females at age 11 or 12 years, although it can be started as early as 9 years.

The vaccine, now available as the 9-valent Gardasil 9, traditionally has been given in a three-dose series, but in October, the Food and Drug Administration approved a two-dose series for children ages 9-14. The CDC’s Advisory Committee on Immunization Practices (ACIP) followed suit later that month saying a two-dose schedule could help improve vaccination rates. Only about 42% of teen girls and 28% of teen boys receive all three doses.

The CDC’s latest move codifies ACIP’s recommendations for a two-dose schedule for girls and boys who start the series at age 9-14. Those children should receive the second dose six to 12 months after the first dose.

“Based on the available immunogenicity evidence, a 2-dose schedule (0, 6-12 months), will have efficacy equivalent to a 3-dose schedule (0, 1-2, 6 months) if the HPV vaccination series is initiated before the 15th birthday,” according to the report.

For those starting the series at age 15-26 and for immunocompromised people, a three-dose series is recommended. The second dose should be given one to two months after the first dose, and the third dose should be given six months after the first dose.

Those who already started the series with any HPV vaccine will be considered adequately vaccinated if they

  • started before their 15th birthday and received two doses with the second dose six to 12 months after the first,
  • started before their 15th birthday and received three doses at the recommended dosing schedule or
  • started on or after their 15th birthday and received three doses at the recommended dosing schedule.

A schedule that has been interrupted does not need to be restarted, and the 9-valent vaccine may be used to complete a series started with a quadrivalent or bivalent vaccine. ACIP does not have a recommendation as to whether those who were fully vaccinated with a quadrivalent or bivalent vaccine should receive the 9-valent vaccine, but the Academy has said it will work with the CDC to determine if such guidance can be developed.

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