Feature Article: Vaccination against HPV Just Got Easier

Vaccine news can come in various forms — a new vaccine, a change to the number of doses, or a change to who should get it. As parents, it is important to keep up with the news and make sure our families are protected against vaccine-preventable diseases.

Recently, this job got a bit easier for parents of adolescents. At its October meeting, the Advisory Committee on Immunization Practices (ACIP), the group that advises the Centers for Disease Control and Prevention (CDC) about immunizations, changed the recommended HPV vaccination schedule to decrease the number of doses needed for adolescents. Here is what you should know:

What is the new dosing schedule?

• Adolescents and teens who get the HPV vaccine before they turn 15 only need two doses separated by six to 12 months.
• Teens who start the HPV vaccine when they are 15 years or older need three doses with the second dose one to two months after the first dose, and the third dose six months after the first dose.
• Any adolescent or teen who is considered to be immune-compromised should get the three-dose regimen.
• Adolescents and teens younger than 15 years of age who already had two doses need a third dose if the first two doses were not at least five months apart. If the doses were separated by five or more months, they do not need a third dose.

Why did the CDC make this change?

The original studies with the HPV vaccine were completed with the three-dose schedule (0, one to two, and six months). However, because some teens were not getting all of the doses, the manufacturers completed additional studies to see if two doses (0 and six months) would be capable of inducing a protective immune response. They found that in adolescents and teens younger than 15 years of age, the vaccine was sufficiently protective after two doses separated by six to 12 months; however, because the vaccine does not work as well in older teens and young adults, two doses were not sufficient in that age group.

Although the revised recommendations are a bit more complex, the CDC felt it was important to make the change so that those who started the vaccine at the recommended age did not need to get the third dose — making it easier for the teens, their parents, and their healthcare providers.

What if my child had a different version of the HPV vaccine?

Because the only HPV vaccine available in the U.S. is a version that protects against nine types of HPV (HPV-9), some parents wonder whether individuals who previously received earlier versions (HPV-2 or HPV-4) should be revaccinated. Although the CDC has not recommended revaccination, it is understandable why some may consider the option of being vaccinated with HPV-9. Because additional doses are not harmful and because the newer version protects against five to seven additional types of HPV, it makes sense that some people will choose to get HPV-9. In this case, people who were previously immunized with HPV-2 or HPV-4 should get two doses of HPV-9 with the second dose given at least six months after the first. The use of HPV-9 in those who already received HPV-2 or HPV-4 will prevent an additional 3,000 cases of cancer and hundreds of deaths every year.

What if my child had the three-dose schedule previously?

Most of those who received three doses of the vaccine will be adequately protected against HPV and do not need to be concerned about having received an extra dose of vaccine. In general, extra doses of a vaccine are not harmful. The extra dose is similar to being exposed to the virus in nature — for your immune system, it is an additional opportunity to build immunity against the virus. The difference with an extra dose of vaccine is that you know your immune system was exposed. With natural contact, you do not know you were exposed.