News & Views: Two Versus Three Doses of HPV Vaccine

During its October meeting, the Advisory Committee on Immunization Practices (ACIP), the group that advises the Centers for Disease Control and Prevention (CDC) about immunizations, recommended a change to the HPV vaccination schedule. Here is what you need to know.

New dosing schedules

• Individuals less than 15 years old: two doses separated by 6 to 12 months
• Individuals 15 to 26 years old: three doses according to the original schedule (0, 1 to 2 months, and 6 months)
• Immune-compromised individuals 9 to 26 years old: three doses according to the original schedule
• Individuals 9 to 14 years old who already received two doses: if the two doses were separated by less than five months, a third dose is needed

Why two doses?

The three-dose HPV series is a prime-prime-boost. The third dose is important for the development of immunologic memory. Because younger recipients have a better immunologic response than older ones, when two-dose regimens were compared with the three-dose series, two doses were sufficient in the younger group, but not in older recipients.

Because fewer doses are always preferred, and because getting adolescents and younger teens into offices for two visits instead of three may be easier, the two schedules based on age at receipt were recommended.

Other news related to HPV vaccines

By the end of 2016, the only HPV vaccine that will be available in the U.S. will be HPV-9. This should help to streamline HPV vaccination programs moving forward. However, some people still wonder whether individuals who previously received other versions of HPV vaccine should be revaccinated. The CDC has not recommended revaccination; however, some families or individuals may wish to explore this option. Knowing that vaccination with HPV-9 can protect these individuals against five additional types of HPV (which would account for about 4,000 cases and 800 cancer-related deaths), it is easy to understand how parents (or doctors) could choose to give HPV-9 following a completed series with HPV2 or HPV4, even though it is not the current CDC recommendation. If so, you may wonder what dosing schedule to follow. People who have previously been immunized with HPV-2 or HPV-4 only need the 0 and 6 to 12 month doses of HPV-9.

Resources

• Web information
  • CDC’s media release
  • VEC’s A Look at Each Vaccine
• Print information
  • VEC’s print materials will be updated soon.
  • CDC VIS  — not yet updated.