Human Papillomavirus (HPV)

Key Information

• HPV Infections: Most common sexually transmitted infections, often asymptomatic and resolving without treatment.
• Types: High-risk HPV types (e.g., 16, 18, 31) can lead to cancers (cervical, anogenital, head, neck). Low-risk types (e.g., 6, 11) can cause genital warts.
• Vaccines: CERVARIX® (HPV2) and GARDASIL® 9 (HPV9) protect against various cancers. HPV9 also protects against genital warts.
• Adverse Events: Commonly reported adverse events include injection site pain, swelling, redness, and syncope.

Recommendations for Use

• Girls and Women (9 to <27 years):
  • HPV2 or HPV9: Recommended for prevention of cervical cancer and precursors.
  • HPV9: Also recommended for prevention of vulvar, vaginal, anal cancers, and genital warts.
• Boys and Men (9 to <27 years):
  • HPV9: Recommended for prevention of anogenital warts, penile and anal cancer.
• Men who have sex with men (MSM): HPV9 is recommended due to high burden of HPV infection.
• Individuals 27 years and older: HPV2 or HPV9 may be administered to those at ongoing risk.

Immunization Schedule

• For Immunocompetent, Non-HIV Infected Adolescents (9 to <15 years):
  • 2-dose schedule: HPV2 (females only) or HPV9 at months 0 and 6/12.
  • 3-dose schedule: HPV2 (females only) or HPV9 at months 0, 1/2, and 6.
• For Individuals 15 years and older, Immunocompromised, or HIV-infected:
  • 3-dose schedule: HPV2 (females only) or HPV9 at months 0, 1/2, and 6.

Safety and Adverse Events

• Common: Injection site pain, swelling, redness.
• Less Common: Fatigue, myalgia, headache, fever, nausea.
• Serious: Anaphylaxis is rare; syncope can occur, especially in adolescents.

Special Populations

• Pregnancy: Not recommended; delay until after pregnancy if vaccination series is initiated.
• Breastfeeding: No reported adverse events; vaccination is allowed.
• Immunocompromised: A 3-dose schedule is recommended, with possible reduced efficacy.