POPLINE Document Number: 313293
Author(s):
Markowitz LE
Dunne EF
Saraiya M
Lawson HW
Chesson H
Source citation:
MMWR. Morbidity and Mortality Weekly Report, 2007 Mar 23;56(11):1-24. (Recommendations and Reports)
Abstract:
These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States. Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women. The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types. The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13-26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended. (author's)
Keywords:
United StatesIndex page
Recommendations
Epidemiologic Methods
Target Population
Children
Immunization
Viral Diseases
CDC
Administration and Dosage
Sexually Transmitted Disease Prevention
Seroconversion
Product Approval
Safety
Side Effects
Best Practices
North America
Americas
Developed Countries
Research Methodology
Program Design
Programs
Organization and Administration
Youth
Age Factors
Population Characteristics
Demographic Factors
Population
Primary Health Care
Health Services
Delivery of Health Care
Health
Diseases
USPHS
Government Agencies
Organizations
Political Factors
Sociocultural Factors
Drugs
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Medicine
Sexually Transmitted Diseases
Reproductive Tract Infections
Infections
Immunity
Immune System
Physiology
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