The Advisory Committee on Immunization Practices (ACIP) recently released recommendations regarding the use of the HPV vaccine Gardasil®. These recommendations were published in the Morbidity and Mortality Weekly Report.
Human papillomaviruses (HPV) consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer. The types of HPV most commonly linked with cervical cancer are HPV 16 and HPV 18, but several other high-risk types contribute to cancer as well.
The types of HPV that cause cervical cancer or genital warts are transmitted sexually. HPV infection is extremely common and generally occurs soon after an individual becomes sexually active. Although most infections resolve on their own, some persist and can lead to precancerous or cancerous changes to the cervix, vulva, vagina, penis, and anus.
Gardasil prevents infection with four types of HPV-types 6, 11, 16, and 18. HPV types 16 and 18 cause roughly 70% of all cases of cervical cancer, and HPV types 6 and 11 account for roughly 90% of genital warts. Gardasil was approved by the U.S. Food and Drug Administration (FDA) in June 2006.
Following FDA approval of Gardasil, use of the vaccine was discussed by the Advisory Committee on Immunization Practices (ACIP). The members of the ACIP are appointed by the Secretary of the U.S. Department of Health and Human Services (HHS). The role of the ACIP is to advise the director of the Centers for Disease Control and Prevention (CDC) and the Secretary of HHS about vaccine usage and vaccine-preventable diseases.
The recommendations of the ACIP were published in the Morbidity and Mortality Weekly Report (MMWR) on March 12, 2007. These recommendations are similar to ACIP recommendations made shortly after the vaccine was licensed but include efforts to “update and clarify wording.”
The recommendations include the following points:
- The recommended age for routine vaccination of girls is 11–12 years.
- The vaccine can be given to girls as young as 9 years.
- Catch-up vaccination is recommended for girls and women between the ages of 13 and 26 years who were not vaccinated previously or who did not complete the full vaccine series (the vaccine is administered in three separate doses).
- Routine cervical cancer screening remains important following vaccination.
The ACIP’s recommendations often influence policy and practice, but are not directly linked with school and daycare entry laws. These laws are made by individual states.
The full text of the report is available at (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr56e312a1.htm "
Reference: Centers for Disease Control and Prevention. Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Early Release March 12, 2007;56:1-24.
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