The human papillomavirus infection (HPV) vaccine should be administered in 2 doses for children between 9 and 12 years of age, according to updated guidelines from the American Cancer Society (ACS).

Members of the ACS’s Guideline Development Group performed a content review of 2 new 2019 recommendations from the Federal Advisory Committee on Immunization Practices. According to a press release, despite broad general agreement with the recommendations, there were some areas of difference in the context of cancer prevention goals and nationwide efforts to increase vaccine use.

The updates address 3 key concerns, including the age at which the vaccine should be administered, how a catch-up vaccination should be harmonized, and whether shared clinical decision-making about the vaccination is recommended for adults aged 27-45 years.

The guidelines emphasize that both girls and boys should get 2 doses of the HPV vaccine between ages 9 and 12, because this timeline is expected to achieve higher on-time vaccination rates, resulting in increased cancer prevention.

“We’re seeing evidence that starting vaccination at age 9 or 10 has potential benefits that are expected to lead to higher vaccination rates, resulting in increased numbers of cancer prevented compared to starting at ages 11 and 12,” said Debbie Saslow, PhD, managing director of HPV and gynecological cancers, in a statement. “It’s for that reason we felt it was important to say that starting at age 9 or 10 is more than OK; it’s preferable to achieve the full cancer-preventing potential of this vaccine.”

Children and adults older than 12 years and younger than 26 years who have not received the vaccine should get vaccinated, although the guidelines noted that vaccination of young adults will not prevent as many cancers as vaccination of children and teens. According to the press release, providers should counsel patients aged 22 to 26 years that the vaccination may be less effective in lowering their cancer risk.

Finally, the ACS does not recommend vaccination for anyone older than 26 years, including shared clinical decision-making. This recommendation is based on the low efficacy and low cancer prevention potential for this population, the burden of decision-making on both patients and clinicians, and the lack of sufficient guidance on which individuals might benefit.

“The combination of HPV vaccination and cervical cancer screening has the potential to prevent tens of thousands of cancers caused by HPV each year in this country and to eliminate cervical cancer as a public health problem in the coming decades,” the authors said in a statement.

REFERENCE
American Cancer Society Updates Guideline for HPV Vaccination [news release]. American Cancer Society; July 8, 2020. http://pressroom.cancer.org/HPVguideline2020. Accessed July 8, 2020.