Key Points for Improving HPV Vaccination Rates and Saving Lives

For Healthcare Providers: Key Points for Preventing HPV Infection Through Vaccination

Preventing HPV infection is key!

On average, there are 33,700 new cancers caused by HPV each year in the U.S.¹

Almost all of these could be prevented with HPV vaccine.

Don’t miss an opportunity to prevent cancers. Recommend the HPV vaccine just as you do other vaccines; this is key for all boys and girls. Vaccination between ages 9-12 is recommended by the AAP. Aim to have boys and girls fully vaccinated before age 13.

The vaccine is most effective when administered between the ages of 9-12 — it gives the highest level of protection with just two shots. Also, adolescents have busy schedules and may not come to your office often so the earlier the vaccine series is started the more opportunities you have to give all needed vaccine doses.

Waiting is risky. An adolescent may not come back t o your office again for several years, possibly after they are already infected.
HPV infection can be transmitted from direct intimate skin to skin contact, not just intercourse.

If your patient is not already fully vaccinated, bundle the recommendation for HPV vaccine with your recommendation for other vaccines due at age 11 or 12.

An effective recommendation requires "bundling," ie, recommending the HPV vaccine in the same way at the same visit as Tdap and meningococcal vaccines. You can do this by saying:

"Your child needs 3 vaccines today — Tdap, HPV and meningococcal vaccines," or
"Today your child should have 3 vaccines, which are designed to protect him/her from tetanus, diphtheria and pertussis; cancers caused by HPV; and some forms of meningitis."

Most parents want the HPV vaccine for their children.

Your recommendation matters a lot to parents.
Parents ask questions to gain your reassurance that they are making the right decision.
Be respectful of their concerns. Use simple answers focused on cancer prevention.
Recommend HPV vaccine at every visit type, including well and sick visits.
Continue to offer the vaccine if the series has not been started or completed.

Ensure your practice has a system in place to bring back patients to complete the series.

Tell parents that this is a 2 or 3-dose series. If a child begins the series before age 15 and does not have specific health conditions, he/she will only need 2 doses.
Schedule the next vaccine dose before the patient leaves the office.
Recall patients using your electronic medical record or immunization registry. Letters, postcards, or phone/text messages all work. Ask parents how they want to be reminded. (State health departments may be able to help.)
Standing orders are effective and efficient.

What is the HPV vaccine schedule?

Most boys and girls who start the series before age 15 need only 2 doses.

Dose 1: Recommend beginning at age 9
Dose 2: Give 6-12 months after dose 1

If a child begins the series on his/her 15^th birthday or later, or has an immunocompromising condition, he/she will need 3 doses:

Dose 1: Give as soon as possible
Dose 2: Give 1-2 months after dose 1
Dose 3: Give 6 months after dose 1 (at least 12 weeks after dose 2)

HPV vaccination is recommended for females through age 26 years and for males through age 21 years of age who were not previously immunized. Males 22 through 26 years of age may be immunized. HPV vaccination is also recommended for the following individuals, according to the CDC²:

Young men who have sex with men, including young men who identify as gay or bisexual or who intend to have sex with men through age 26;
Young adults who are transgender through age 26; and
Young adults with certain immunocompromising conditions (including HIV) through age 26.

¹Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/hpv/statistics/cases.htm
²Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/parents/vaccine.html

_{Updated December 2018}