Erica Gibson, MD, is an adolescent primary care physician at The University of Vermont Center and assistant professor at the Larner College of Medicine at UVM.

Erica Gibson, MD, is an adolescent medicine specialist at The University of Vermont Children’s Hospital and assistant professor at the Larner College of Medicine at UVM.

A new and improved HPV-9 Vaccine was approved for all adolescents in December 2014. HPV-9 stands for Human Papillomavirus 9-valent Vaccine. This new vaccine provides more protection from the cancers of the mouth, throat, cervix and anus that Human Papillomavirus (HPV) can cause; it continues to provide the same protection from genital warts that the original HPV-4 vaccine provides.

A few facts about Human Papillomavirus (HPV):

  • HPV is the most common sexually transmitted infection in the U.S.. It is so common that nearly all sexually active men and women get it at some point in their lives!
  • New research shows that some young people can become infected even before onset of sexual activity.
  • Most people become infected with HPV within 2-3 years of sexual contact.
  • Approximately 79 million people in the U.S. are infected with HPV, and approximately 14 million people in the U.S. will become newly infected with HPV each year.
  • An estimated 26,000 cancer cases are attributable to HPV yearly; about 17,000 in women and 9,000 in men.
  • Cervical cancer is the most common HPV-associated cancer among women; Mouth and throat cancers are the most common in men.

We know that nine main types of the over 100 strains of HPV virus cause the most disease:

  • HPV types 16 and 18 lead to 64% of HPV related cancers in women and men.
  • HPV types 6 and 11 lead to 90% of all genital warts
  • HPV types 31, 33, 45, 52, and 58 lead to 14% of HPV related cancers in women and 4% of HPV related cancers in men.

vacc-coverage-hpv-800x1035We now have three available HPV vaccines which provide protection for all or some of the 9 HPV types described above:

  • The new HPV-9 vaccine approved in 2014 for females and males
    • Covers all 9 HPV types: 16, 18, 6, 11, 31, 33, 45, 52, and 58
  • The original HPV-4 Vaccine approved in 2006 for females and in 2009 for males
    • Covers HPV types 16, 18, 6 and 11
  • An HPV-2 Vaccine approved in 2009 for females
    • Covers HPV types 16 and 18

Is the HPV-9 vaccine given as one shot only or do patients need multiple shots?

  • The HPV vaccine is administered as a series of 3 shots over time.
  • The first shot should be given initially at 11 or 12 years old.
  • A 2nd shot should be given 1-2 months after the first shot
  • A 3rd shot should be given 6 months after the first shot.
  • If the second or third doses of HPV vaccine are delayed they are still effective. For example, if a patient gets their first HPV shot at age 11 and does not return for a second shot for 6 months the vaccine series will still provide protection; the shot series does not need to be started all over again.

Why is it recommended that the HPV-9 vaccine series be started at such a young age (11-12 years old)?

  • Researchers have found response to the vaccine is better at this age than older ages.
  • In addition, we want to vaccinate children well before they get exposed to HPV.
  • New research shows that some young people are exposed to HPV even before they become sexually active.

Can patients older than 11 or 12 get the new HPV-9 vaccine?

  • Yes, the new HPV-9 vaccine is recommended for females ages 9 to 26
  • It is recommended for young men ages 9 to 15 at this time. The Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC) actually recommends this new vaccine for young men up to age 26.

If a patient started an HPV vaccine series with HPV-4 or HPV-2 can they finish the series with HPV-9?

  • If a vaccine series has been started with HPV-2 or HPV-4, it can be completed with HPV-9. As many practices finish their HPV-2 and HPV-4 supplies, they are moving to HPV-9

If a patient has already gotten an HPV vaccines series using HPV-4 or HPV-2, should they get another full series with HPV-9?

  • If a patient has already completed their HPV vaccine series with HPV-2 or HPV-4 it is not recommended at this time that they get a full repeat series with HPV-9

Do young women still need cervical cancer screening with Pap smears if they get the HPV vaccine series?

  • Yes, getting the HPV vaccines series is not a substitute for cervical cancer screening.
  • Protection from HPV is expected to be long lasting, but women still need to get regular cervical cancer screening with Pap smears starting at age 21.
  • While screening for anal cancer is available we do not have routine screening methods for the other cancers caused by HPV.

What are the side effects of HPV vaccine?

As with all new medications and vaccines, the side effects that accompany the HPV vaccine have now been studied for over a decade. Several mild to moderate side effects are known to occur with this HPV vaccine:

  • Reactions in the arm where the shot was given (pain, redness or swelling).
  • Mild to moderate fever (100-102 degrees).
  • Fainting (brief fainting spells can occur after any medical procedure; patients should be monitored for 15 minutes after any vaccine is given).

More information about the HPV vaccine can be found on the following web sites:

Erica Gibson, MD, is an adolescent medicine specialist at The University of Vermont Children’s Hospital and assistant professor at the Larner College of Medicine at UVM. 

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