Table 9: Overview of FDA-Approved Vaccines and CDC-Recommended Vaccination Schedules ** Gardasil 9 is the only HPV Vaccine which is distributed in the United States ** Gardasil 9 Gardasil
Cervarix
Types of HPV the vaccine targets
HPV types 16, 18, 6, 11, 31, 33, 45, 52, and 58, which cause several types of cancer and genital warts.
HPV types 16,18, 6 and 11 which cause several types of cancer and genital warts.
HPV types 16 and 18 which cause several types of cancer. Routine vaccination for girls ages 11 to 12 years. Catch-up vaccination for teen girls and young women through age 26.
Who should get the vaccine?
• Routine vaccination for girls and boys ages 11 to 12 years. • At the physician’s discretion, the vaccine can be administered as early as 9 years (NCI, 2015b). • Catch-up vaccination for teen girls and young women through age 26. • Catch-up vaccination for teen boys and young men through age 21. • Gay, bisexual, and other men who have sex with men through age 26. • People with compromised immune systems (including people living with HIV/AIDS) through age 26.
When should the vaccine be given?
No matter the vaccine type, there are two- three injections in the vaccine series: • Three Dose Series: ○ Dose 1. ○ Dose 2 – administered 1 to 2 months after Dose 1. (4 week minimum between Dose 1 and 2. ○ Dose 3 – administered 6 months after Dose 1. • Two Dose Series: ○ Dose 1. ○ Dose 2: 6-12 months after the initial dose with a minimum interval of 5 months between doses.
Note . Adapted from Luria Lynette and Cardoza-Favarato Gabriella. Human Papillomavirus. StatPearls Publishing. Last updated January 24, 2022. https://www.ncbi.nlm.nih.gov>books>NBK448132; Johnson Traci C. HPV WebMD. August 11, 2022. https://www.webmd. com>...>HPV/GenitalWarts; Centers for Disease Control and Prevention. Administering HJPV Vaccine. Last Reviewed November 16, 2021j. https://www.cdc.gov>vaccines>vpd>hpv>hcp>admi...; Centers for Disease Control and Prevention. HPV Vaccine Schedule and Dosing. Last Reviewed November 1, 2021k. https://www.cdc.gov>hcp>schedules-recom
responsible for 95% of HPV-positive oropharyngeal cancers, it is reasonable to believe that preventing the transmission of HPV 16 may prevent future oral cancer cases as well (Sanyaolu, et al., 2019; American Dental Association, 2022). However, while definitive evidence for the vaccine’s ability to prevent oral HPV infections is sparse (Tumban, 2019; Kreimer, et al., 2020). and it will likely take decades before any potential benefit of the HPV vaccination in regard to oral cancer prevention is known (Ducatman, 2018). early results from an NCI-sponsored clinical trial in Costa Rica suggest that the vaccine might be effective in reducing prevalence of oral HPV infections (Kreimer, et al., 2020; Taberna, et al., 2017). The proportion of HPV-related oropharyngeal cancers that can be prevented with the widespread administration of the vaccine is lacking the data needed to establish a definitive oncogenic benefit. (American Dental Association, 2022). The President’s Cancer Panel listed acceleration of HPV vaccine uptake as a stated objectives but as of 2017 despite a slight increase in vaccination coverage, the number of adolescents ages 13 to 17 receiving the HPV vaccine remained substantially lower than expected (Rimer, 2018). There is continued concern associated with vaccine uptake. Since the HPV vaccine has become available in 2006, 270 million doses have been administered worldwide inclusive of 135 million doses in the United States (American Cancer Society, 2018; CDC,2021e). Over time, public and professional concerns over the safety and efficacy of the vaccine have declined. However, between the years of 2008-2020 only 52.6 % of males and only 56.4% of females 13-15 years of age have received the recommended 2 or 3 doses of the HPV vaccine as recommended at the time of vaccination (National Institute of Health/ National Cancer Institute, 2022). A wide variation exists in HPV vaccination coverage at the state level. The national immunization
It is important to note that optimal vaccine efficacy is achieved only when the vaccine is administered prior to exposure – ideally before an individual becomes sexually active (Luria & Cardoza-Favarato, 2022; National Cancer Institute, 2019; Kaiser Family Foundation, 2021). Individuals receiving the vaccine after initiating sexual activity will not be protected from any HPV type acquired before receiving the vaccine. In addition, the vaccine cannot cure established HPV infections (CDC, 2017a). The HPV vaccines are safe with the benefits of vaccination outweighing the potential risks and side effects (CDC, 2021e). Although these vaccines have been effective in preventing infection with the specific HPV types they were developed to target, it is important to note that each vaccine’s goal is to prevent genital-related warts and cancers; none of the vaccines were developed to prevent any type of oral cancer (Sanyaolu, et al., 2019). However, because the vaccines create immunity against HPV 16, the type of HPV Vaccine uptake Vaccine uptake is a term used to describe the level or extent of use of a vaccine in a specific population. For example, when a vaccine is widely accessed by the intended population(s), it is described as having a high uptake rate . Vaccines with low uptake rates, such as th e HPV vaccine, are not being adequately accessed by groups they are intended to protect (College of Physicians of Philadelphia, n.d.). A stated goal of Healthy People 2030, an initiative of the U.S. Department of Health and Human Services, is to fully vaccinate (all 3 injections) 80% of adolescents by the year 2030 (National Institute of Health, 2022). Vaccinations in general have been successful however the public’s response to the HPV vaccine has been less than enthusiastic. HPV vaccination has significantly lagged behind that children and adolescents are required to receive (O’Leary & Nyquist, 2019). It is estimated that by 2020 among adolescents aged 13-15, 52.6 % of males and 56.4 % of females had received 2 or 3 doses of the HPV vaccine (NationalInstituteofHealth,2022).
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