Vaccine panel recommends 2 doses of HPV vaccine for preteens

In a move that could simplify the logistics and cut the cost of routine human papillomavirus (HPV) vaccination, a federal vaccine advisory group today recommended reducing the number of doses from three to two for the preteen target group.

Studies have shown that two doses afford as much protection as two doses, and health officials hope fewer doses could boost HPV vaccination levels in boys and girls, which lag behind other recommended immunizations. According to CDC numbers for 2014, only 39.7% of girls had received all three recommended doses and only 21.6% boys had gotten the full series.

In July the US Centers for Disease Control and Prevention (CDC) warned that despite easy access to vaccination and screening, HPV-related cancers are on the rise. To prevent HPV-linked cancers of the cervix, vagina, anus, head, or neck, the agency has recommended routine HPV vaccination for girls and boys at age 11 or 12 and for other young people who weren't vaccinated earlier.

Group retains 3-dose recommendation for kids 15 and up

The Advisory Committee on Immunization Practices (ACIP), an outside expert group that advises the CDC, unanimously accepted the recommendation to move to two doses, based on an assessment from a work group tasked with studying the issue. The CDC typically accepts ACIP's recommendations, and the CDC said today in an e-mailed press release that CDC Director Tom Frieden, MD, MPH, approved the committee's recommendation shortly after the vote.

Following the vote, ACIP chair Nancy Bennett, MD, MD, professor of medicine at the University of Rochester School of Medicine and Dentistry, said, "This is a big step forward."

Frieden said safe, effective and long-lasting protection against HPV cancers with two visits instead of three means more Americans will be protected from cancer. "This recommendation will make it simpler for parents to get their children protected in time."

Based on the new HPV immunization schedule, the first of two doses should be administered at age 11 or 12, but could be given as young as age 9 and even at ages 13 and 14. The second dose would be given 6 to 12 months after the first dose. However, the recommendation doesn't apply to teens who don't receive their first dose until after their 15th birthday and through age 26. ACIP said that group should receive three doses over a 6-month period.

The CDC said it will provide guidance about the recommendation change to parents, healthcare professionals, and insurers.

Other ACIP developments

In other votes today, ACIP members recommended:

  • A routine hepatitis B vaccine dose within 24 hours of birth, replacing a permissive recommendation
  • A dose modification for Pfizer's meningococcal serogroup B vaccine (Trumenba), based on the Food and Drug Administration's approval earlier this year that the vaccine can be given in two doses rather than three, in line with the other approved meningitis B vaccine, Bexsoro, made by GlaxoSmithKline. ACIP said children ages 10 to 18 years old in high-risk groups should still receive three doses, but healthy adolescents can receive two doses

Members of ACIP meet tomorrow for the second and final day of their fall meeting. The group is slated for routine votes on childhood and adult immunization schedules and to discuss topics including pneumococcal vaccine, influenza, and respiratory syncytial virus (RSV).

See also:

Oct 19-20 ACIP meeting agenda

ACIP meeting webcast

Jul 7 CIDRAP News story "CDC: HPV-related cancers on the rise"

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