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CLINICAL STAFF

 

 

During its February 2015 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended the 9-valent HPV vaccine as one of three HPV vaccines that can be used for HPV vaccination of females, and one of two vaccines that can be used for HPV vaccination of males. The 9-valent HPV vaccine protects against 9 HPV types. The additional protection means that the 9-valent HPV vaccine can increase the percentage of cervical cancers prevented, and will also help prevent other HPV-attributable cancers and diseases.

 

The Maryland Vaccines for Children (VFC) Program will be providing the 9-valent HPV vaccine to its providers in July 2015. Information on VFC eligibility, recommended schedules and intervals, reimbursement, and a VFC plan for distribution is included below.

 

 

 

VFC HPV Eligibility

Gender and Age	Bivalent HPV vaccine (HPV2)	Quadrivalent HPV vaccine (HPV4)	9-valent HPV vaccine (HPV9)
Females, 9 through 18 years	Eligible	Eligible	Eligible
Males, 9 through 18 years	Not eligible	Eligible	Eligible

 

Recommended Schedule and Intervals

 

 

ACIP recommends that routine HPV vaccination be initiated at age 11 or 12 years for all three recommended vaccines. The vaccination series can be started beginning at age 9 years. Vaccination for VFC-eligible children is recommended for females and males 13 through 18 years of age who have not been previously vaccinated or who have not completed the full series.

 

HPV2, HPV4 and HPV9 are each administered in a 3-dose schedule. The second dose is administered at least 1 to 2 months after the first dose and the third dose at least 6 months after the first dose.

 

If providers do not know, or do not have available the HPV vaccine product previously administered, or are in clinical settings transitioning to HPV9 any available HPV vaccine product may be used to continue or complete the series for females; HPV9 or HPV4 may be used to continue or complete the series for males.

 

The use of HPV9 vaccine for persons who have previously completed a full HPV vaccine series was discussed at the June 2015 ACIP meeting.

 

ACIP did not take a vote either to recommend or to not recommend routine revaccination of persons who have previously received a full series of either the 2- or 4-valent HPV vaccine.

 

The benefit of protection against the 5 additional types included in HPV9 is primarily for females for protection against cervical cancers and precancers. Only a small percentage (about 4%) of HPV-associated cancers in males are caused by the 5 additional types included in the 9-valent vaccine. However, a study has shown no serious safety concerns among females revaccinated with HPV9 after a series of HPV4.

 

Without an ACIP recommendation, the Maryland VFC Program cannot cover the expense of revaccination for persons who are fully vaccinated with HPV vaccine.