HPV Vaccination Guideline Updated! Let Us Learn What the HPV Vaccine Is

The American Cancer Society’s guideline containing HPV (Human Papillomavirus) vaccination recommendations was revised in February 2017. HPV vaccination is particularly known among women as vaccination protecting against cervical cancer.

What we should know about HPV and its vaccine

• HPV is widespread worldwide and is also the most common sexually transmitted virus.
• More than %50 of sexually active women and men become infected with HPV at some point, and some may be infected repeatedly. Sexual intercourse is not essential for transmission; skin-to-skin contact is sufficient.
• HPV infection usually causes no symptoms and subsequently clears spontaneously. However, the HPV type matters: a small proportion of infections with certain types persist and may cause cancer, particularly of the cervix, but also the head and neck, anus and penis.
• Cervical cancer is the 2nd leading cause of cancer-related death among women worldwide.
• At least 13 HPV subtypes cause cancer (known as high-risk types), and there are more than 100 subtypes. HPV 6 and 11 most commonly cause genital warts, while HPV 16 and 18 cause cancer; these two cause more than %70 of cervical cancers.
• The quadrivalent HPV vaccine (Gardasil 4), also available in Türkiye, is an inactivated vaccine, not a live vaccine. It is effective against these 4 subtypes (6, 11, 16 and18) and can therefore prevent most cervical cancers. Because it does not protect against all HPV subtypes, vaccinated women should still undergo cervical cancer screening.

Who should receive HPV vaccination, and when?

• Vaccination is recommended at ages 9-26 for girls and women and 9-21 for males.
• Age matters for immunity from HPV vaccination. For both sexes, the ideal age is recommended as 11-12. However, your doctor may recommend vaccination from age 9.
• Vaccination before first sexual contact is important because children not yet exposed to HPV can potentially be protected against the 4 most common types with %100 effectiveness.
• For males in certain circumstances—immune-related disease or sexual contact with the same sex—vaccination is recommended up to age 26.

What Changed with the 2017 Update?

The American Centers for Disease Control and Prevention (CDC) revised recommendations for children aged 9-14 in February 2017. Instead of 3 vaccine doses, it stated that only 2 doses would provide sufficient immunity.

The American Cancer Society also announced support for the new recommendations prepared by the Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts conducting scientific studies.

Accordingly: 

• Routine HPV vaccination is recommended to begin at ages 11-12. For ages 9-14, a 2-dose schedule is planned, with the second dose 6 to 12 months after the first. 
• For children and young people aged 9-14 who received doses less than 6 months apart, after 2 doses a third is recommended. However, if at least 6 months separated the two doses in this age group, 2 doses are considered sufficient.
• Adolescents and young adults beginning vaccination at ages 15-26 should receive 3 doses to protect against cancer-causing HPV infections.
• Children and young people of both sexes aged 9-26 with weakened immune systems should complete three doses.

Early HPV vaccination is important, providing %60-80 protection against many cancers, particularly cervical cancer. Although information suggests recommendations up to age 45 in Australia, doubts remain about achieving the desired effectiveness after age 26. A vaccine effective against 9 HPV subtypes, called Gardasil 9, that we hope will soon become available, is expected to provide more effective HPV protection. In conclusion, vaccination is an effective and safe way to prevent HPV infection and many diseases it may cause.