Human Papillomavirus Vaccine (HPV) Recommendations and Talking Points
Strongly recommend all routinely recommended adolescent vaccines.
 Many parents and adolescents are not aware that vaccine preventable diseases affect adolescents.
 Parents and patients are more likely to accept vaccines when healthcare providers strongly
recommend them.
 CDC, AAP, AAFP and ACOG recommend MCV, Tdap, and HPV vaccines routinely
o HPV vaccine is equally as important as the MCV and Tdap vaccines (which are or will be
required for school entry)
 Emphasize vaccine safety and efficacy
Use every encounter to evaluate immunization status and administer missing immunizations
 Adolescents seek healthcare infrequently
 Use pictures of vaccine preventable diseases and their effects to communicate the importance with
adolescents
Establish reminder systems and after-hour/weekend vaccination-only visits to make it easier for adolescent
patients to complete multi-dose vaccine series
 Paper, phone and electronic messages (text messages) can be effective in reminding patients for
needed vaccines
 Increasing access to vaccines can improve coverage levels
We would like you to introduce all recommended adolescent vaccines as a single straightforward
vaccination recommendation, similar to how you might recommend infant vaccines to a parent.
Example At the end of a 11yo clinic visit, “Today Miraya is due for three routine vaccines which
include meningitis vaccine; Tdap which is tetanus, diphtheria and whooping cough; and HPV
which is Human Papillomavirus vaccine. The nurse will be right in to administer those vaccines
and I look forward to seeing you next year.”
This brief statement is modeled after how infant vaccines are presented to parents and avoids the parent
sensing that adolescent vaccines recommendations are different (less important, questionable, etc)
because the doctors talks about them differently than infant vaccines.
We are not encouraging you to avoid discussing adolescent vaccines, rather we are encouraging providers to
allow parents who desire more information to initiate the discussion. If parents are undecided about the
HPV vaccine the following HPV-focused talking points may be helpful.
Talking points, if needed, for providers about HPV vaccine:
•
Has anyone you care about had cancer?
•
HPV can cause a number of cancers in men and women including cervical and throat
cancer.
•
HPV vaccine can reduce the chance of your son/daughter having a cancer experience.
•
HPV vaccine has been shown to be very effective in preventing HPV-related disease and
as safe as all the other vaccines we give to children.
I recommend HPV vaccination for all girls and boys starting at age 11 years.
•
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Girls and boys should begin the series at 11 -12 years of age so they get all 3 doses (shots) long
before any sexual activity begins.
HPV infection can occur in the first sexual contact with another person and vaccine produces a
stronger immune response when given at a younger age.
Vaccine Specific Recommendations
Human Papillomavirus (HPV) Vaccine
HPV can cause cervical cancer in women. HPV is also associated with several less common cancers, such as
vaginal and vulvar cancers in women, and anal and oropharyngeal (back of the throat, including base of
tongue and tonsils) cancers in both men and women. HPV can also cause genital warts and warts in the
throat. There is no cure for HPV infection, but some of the problems it causes can be treated.
Two HPV vaccines are licensed by the FDA. The bivalent HPV vaccine (Cervarix) prevents the two HPV types,
16 and 18, which cause 70% of cervical cancers. The quadrivalent HPV vaccine (Gardasil) prevents four HPV
types: HPV 16 and 18, as well as HPV 6 and 11, which cause 90% of genital warts. Quadrivalent vaccine has
also been shown to protect against cancers of the anus, vagina and vulva. Both vaccines are administered as
a 3-dose series over 6 months.
Routine HPV Vaccine Schedule: HPV vaccine may be given at the same time as other vaccines. Bivalent HPV
vaccine is recommended for girls and quadrivalent HPV vaccine is recommended for girls and boys 11 or 12
years of age. It may be given starting at age 9.
Catch-up Vaccine Schedule: Bivalent HPV vaccine is recommended for females 13-26 years old who have
not completed the 3-dose series. Quadrivalent HPV vaccine is recommended for the following people who
have not completed the 3-dose series: Females 13 through 26 years of age, Males 13 through 21 years of
age. It is recommended for men through age 26 who have sex with men or whose immune system is
weakened because of HIV infection, other illness, or medications. The vaccine may be given to men 22
through 26 years of age who have not completed the 3-dose series.
Meningococcal Conjugate Vaccine (MCV)
The vaccine prevents meningococcal infections which are uncommon but very serious infections that affect
adolescents and young adults. ACIP recommends the vaccine at 11-12 years of age with a booster at 16-18
years of age. Complications of meningococcal disease can lead to amputation of limbs, brain damage, loss of
hearing and even death. Proof of vaccination will be required for school entry in the 2015-16 school year.
Pertussis Vaccine (Tdap)
In 2012, record numbers of pertussis cases were reported nationally, in Illinois and in Chicago. Infants are at
greatest risk for hospitalization or death from pertussis and adolescents often spread pertussis to the infants
with whom they live and for whom they care. An adolescent infected with pertussis can be sick for a long
time and miss many days of school. All 6th through 12th grade students are required to show proof of having
received a single dose of Tdap. There is no minimum interval between Td and Tdap.
Varicella Vaccine (Varicella)
Adolescents are at increased risk for severe disease and complications from Varicella (chickenpox)
infections. Adolescents who have not had chickenpox disease need 2 doses of the vaccine separated by 3
months (if given before 13 years of age) or by 1 month (if given at 13 years or older) to be protected. In the
2014-15 school year, documentation of a second dose of varicella vaccine will be required for entry into
Kindergarten, 6th and 9th grade.
Measles, Mumps, Rubella Vaccine (MMR)
The first dose must be administered on or after the 1st birthday. The second dose must be administered at
least 28 days after the first dose. Providers should re-administer invalid doses. Two doses of MMR vaccine
are required for entry into kindergarten through 12th grades.
Hepatitis B Vaccine (HBV)
Review the immunization record’s intervals between HBV doses to assure that all doses are valid. The
Interval between dose 1 and 2 is 4 weeks, dose 2 and 3 is 8 weeks and dose 1 and 3 is 16 weeks. The
minimum age for the 3rd dose is 24 weeks. Three doses of hepatitis B vaccine are required for entry
kindergarten through 12th grades.