Human papillomavirus (HPV) is the cause of most cases of cervical cancer, and some cancers of the ano-genital area, and the oropharynx. There are about 40 different types of HPV that can cause infection. Certain types can cause genital warts in women and men, as well.
In the News
The 2014 National Immunization Survey Teen Data show that while increasing, HPV vaccination rates remain low.
- Coverage with one or more doses of HPV vaccine for girls increased by 3.3 percentage points from 56.7% in 2013 to 60.0% in 2014.
- Coverage with one or more doses of HPV vaccine for boys increased by 8.1 percentage points from 33.6% in 2013 to 41.7% in 2014.
Resources on NIS Teen Data
- CDC Morbidity and Mortality Weekly Report: National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2014 (Exit site)
- CDC Preteen and Teen Vaccines (Exit site)
- Teen Vaccination Coverage (Exit site)
9-valent HPV Vaccine
The 2015 Red Book HPV Chapter is now available! (Exit site PDF 266kb)
Last year a new HPV vaccine, Gardasil 9, was licensed by the FDA. Read the FAQs below to learn more.
What is the difference between the 9-valent HPV vaccine and the other HPV vaccines?
2-valent HPV, 4-valent HPV and 9-valent HPV vaccines all protect against HPV strains 16 and 18, the types that cause about 66% of cervical cancers and the majority of other HPV-attributable cancers in the United States. 9-valent HPV targets five additional cancer causing types, which account for about 15% of cervical cancers. 4-valent HPV and 9-valent HPV vaccines also protect against HPV 6 and 11, the types that cause genital warts.
| ||2-valent HPV vaccine (Cervarix)||4-valent HPV vaccine (Gardasil) ||9-valent HPV vaccine (Gardasil-9)|
|High risk HPV strains covered||16, 18||16, 18||16, 18, 31, 33, 45, 52, 58|
|Low risk HPV strains covered||N/A||6, 11||6, 11|
What are the ACIP recommendations for the 9-valent HPV vaccine?
In February 2015 the ACIP voted to add the 9-valent HPV vaccine to the current HPV vaccine recommendations. They did not express a preference for one HPV vaccine product over another.
What should I do with patients who started the HPV vaccine series with 2-valent HPV or 4-valent HPV vaccine?
ACIP recommends that any appropriate HPV vaccine (2v, 4v or 9v for females and 4v or 9v for males) can be used to continue or complete the HPV vaccine series.
Is additional vaccination with 9-valent HPV vaccine recommended for persons who have completed a 3-dose series of either quadrivalent or bivalent HPV vaccine?
There is no ACIP recommendation for routine additional 9-valent HPV vaccination of persons who previously completed a quadrivalent or bivalent vaccination series.
Why is the use of 9-valent HPV vaccine off-label in males over the age of 15?
Merck sought and received FDA approval for 9-valent HPV vaccine for females ages 9-25 and males ages 9-15. They have since submitted additional data on males ages 16-26, and are also seeking FDA approval for this age group. The ACIP has reviewed this data and has recommended off-label use for males ages 16-26.
Providing a Strong Recommendation
Finally, the AAP asks that pediatricians provide a strong recommendation for HPV vaccine. Studies have shown that parents trust their pediatrician's guidance; unfortunately, some providers report not issuing a strong recommendation for HPV vaccine. Be sure to give a strong recommendation for all vaccines on the current immunization schedule and not merely mention that they are available. Rates of vaccination remain low for a variety of reasons. One of the best things you can do to help encourage better uptake rates is to answer parents' questions about the vaccine, and strongly recommend adolescents are vaccinated with HPV vaccine at 11-12 years of age, before being exposed to the virus.