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American Cancer Society Recommendations for Human Papilloma Virus (HPV) Vaccine Use to Prevent Cervical Cancer and Pre-cancers

Background

There are vaccines that can help protect young women from some HPV infections. So far, 2 vaccines have been studied and approved by the Food and Drug Administration (FDA). One vaccine protects against HPV types 6, 11, 16, and 18 (Gardasil®) and the other protects against types 16 and 18 (Cervarix®). In clinical trials, both vaccines prevented pre-cancer cell changes of the cervix caused by types 16 and 18. Gardasil also prevented genital warts caused by HPV types 6 and 11.

These vaccines are used to prevent cancer that can result from an HPV infection – before an abnormal Pap test develops. They will not treat or protect against cancer from an existing HPV infection. Each vaccine requires a series of 3 injections (shots) over a 6-month period. The injections are most often given in the muscle of the upper arm.

American Cancer Society recommendations

To work best, the HPV vaccine should be given before the young person has had any type of sexual contact with another person.

  • Routine HPV vaccination is recommended for girls 11 to 12 years old.
  • Girls as young as age 9 can get HPV vaccination.
  • HPV vaccination is also recommended for females 13 to 18 years old who have not started the vaccines, or who have started but not completed the series.
  • At this time there is not enough evidence to recommend for or against vaccinating every 19- to 26-year-old female. A decision about whether a woman aged 19 to 26 years should get the vaccine should be based on an informed discussion between the woman and her health care provider. This discussion should include the likelihood of previous HPV exposure and potential benefit from vaccination. The more sexual partners a woman has had, the less likely the vaccine will be helpful.

The lack of recommendation for vaccinating the 19 to 26-year old age group is based on the following evidence:

  • In clinical trials, women who averaged 2 to 4 sexual partners before they got vaccinated got less benefit from the vaccine in terms of reducing overall cervical cell changes. (The average number of sexual partners for women 19 to 26 is 3 to 4.)
  • The vaccine has not been tested in women who have had more than 4 sexual partners.
  • It is not known if vaccination is cost-effective in this age group.
  • At this time ACS has no recommendations for women over age 26 or for males of any age.

These vaccines protect against 70% of cervical cancers. But the vaccines don't protect against all cancer-causing types of HPV, so cervical cancer can happen even in women who have been vaccinated. Vaccinated and unvaccinated women should still to be screened for cervical cell changes with Pap tests and other tests, according to current ACS early detection guidelines.

To learn more about HPV and HPV vaccines

More information from your American Cancer Society

We have selected some related information that may also be helpful to you. These materials may be ordered from our toll-free number, 1-800-227-2345, or read on our Web site, www.cancer.org.

HPV and Cancer

HPV and HPV Testing

HPV Vaccines

What Women Should Know About Cervix Cancer and the Human Papilloma Virus (also in Spanish)

HPV Vaccine, Bivalent (for more on the Cervarix vaccine)

HPV Vaccine, Quadrivalent (for more on the Gardasil vaccine)

Cervical Cancer: Prevention and Early Detection (also in Spanish)

National organizations and Web sites*

Along with the American Cancer Society, other sources of information include:

Centers for Disease Control and Prevention (CDC)
Toll free number: 1-800-CDC-INFO (1-800-232-4636)
TTY: 1-888-232-6348
Web site: www.cdc.gov

    For information on infectious diseases, vaccines, cancer, and many other health topics

National Cancer Institute
Toll-free number: 1-800-4-CANCER (1-800-422-6237)
TTY: 1-800-332-8615
Web site: www.cancer.gov

    Has up-to-date information about cancer and cancer-related topics for patients, their families, and the general public

*Inclusion on this list does not imply endorsement by the American Cancer Society.

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.

Reference

Saslow D, Castle PE, Cox JT, et al. American Cancer Society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA Cancer J Clin. 2007;57:7-28.

Last Medical Review: 04/10/2013
Last Revised: 04/10/2013