Human Papillomavirus Vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Recommendations and Reports

August 29, 2014 / 63(rr05);1-30

Lauri E. Markowitz1

Eileen F. Dunne1

Mona Saraiya2

Harrell W. Chesson1

C. Robinette Curtis3

Julianne Gee4

Joseph A. Bocchini, Jr5

Elizabeth R. Unger6

1Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC

2Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC

3Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC

4Immunization Safety Office, National Center for Emerging and Zoonotic Infectious Diseases, CDC

5Louisiana State University Health Sciences Center, Shreveport, Louisiana

6Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC

Corresponding preparer: Lauri E. Markowitz, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. Telephone: 404-639-8359; E-mail: lem2@cdc.gov.

Summary

This report summarizes the epidemiology of human papillomavirus (HPV) and associated diseases, describes the licensed HPV vaccines, provides updated data from clinical trials and postlicensure safety studies, and compiles recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) for use of HPV vaccines.

Persistent infection with oncogenic HPV types can cause cervical cancer in women as well as other anogenital and oropharyngeal cancers in women and men. HPV also causes genital warts. Two HPV vaccines are licensed in the United States. Both are composed of type-specific HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein using recombinant DNA technology produces noninfectious virus-like particles (VLPs). Quadrivalent HPV vaccine (HPV4) contains four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18. Bivalent HPV vaccine (HPV2) contains two HPV type-specific VLPs prepared from the L1 proteins of HPV 16 and 18. Both vaccines are administered in a 3-dose series.

ACIP recommends routine vaccination with HPV4 or HPV2 for females aged 11 or 12 years and with HPV4 for males aged 11 or 12 years. Vaccination also is recommended for females aged 13 through 26 years and for males aged 13 through 21 years who were not vaccinated previously. Males aged 22 through 26 years may be vaccinated. ACIP recommends vaccination of men who have sex with men and immunocompromised persons (including those with HIV infection) through age 26 years if not previously vaccinated.

As a compendium of all current recommendations for use of HPV vaccines, information in this report is intended for use by clinicians, vaccination providers, public health officials, and immunization program personnel as a resource. ACIP recommendations are reviewed periodically and are revised as indicated when new information and data become available.