Committee Opinion No. 467: Human Papillomavirus Vaccination

Abstract

The U.S. Food and Drug Administration has approved both a bivalent and quadrivalent human papillomavirus (HPV) vaccine. The Advisory Committee on Immunization Practices has recommended that HPV vaccination routinely be given to girls when they are 11 years or 12 years old. The vaccine can be given to individuals as young as 9 years; catch-up vaccination is recommended in females aged 13 years through 26 years. The American College of Obstetricians and Gynecologists endorses these recommendations. Although obstetrician-gynecologists are not likely to care for many girls in the initial vaccination target group, they are critical to the catch-up vaccination period. Both HPV vaccines are most effective if given before any exposure to HPV infection (ie, before sexual activity). However, sexually active girls and women can receive some benefit from the vaccination because exposure to all HPV types prevented by the vaccines is unlikely in females aged 13 years through 26 years. Vaccination with either HPV vaccine is not recommended for pregnant women. It can be provided to women who are breastfeeding. The need for booster vaccination has not been established but appears unnecessary. Health care providers are encouraged to discuss with their patients the benefits and limitations of the HPV vaccine and the need for routine cervical cytology screening for those aged 21 years and older.