Human Papillomavirus 9 Valent Vaccine

Human Papillomavirus 9 Valent Vaccine Brand Name– Gardasil 9

What is Human Papillomavirus 9 Valent Vaccine

Human papillomavirus 9 valent vaccine (Gardasil 9) is a recombinant vaccine indicated for the prevention of human papillomavirus (HPV) infections and their associated diseases.

It is only effective against the following 9 HPV types contained within the vaccine: 6, 11, 16, 18, 31, 33, 45, 52, and 58.

The vaccine is only prophylactic and will not treat an active HPV infection. To offer the greatest protection, it is recommended to administer the vaccine prior to exposure (i.e., before onset of sexual activity).

Patients with previous HPV exposure may still benefit from vaccination, although there is no evidence of protection from disease caused by the HPV types they are PCR positive or seropositive for at baseline.

The duration of protection has not been clearly defined; data indicate no loss of protection 8 to 10 years after vaccination.

The human papillomavirus 9-valent vaccine is FDA-approved for use in both females and males age 9 to 45 years

Indications

  • human papillomavirus (HPV) infection prophylaxis

General information on immunization against human papillomavirus (HPV)

  • Ideally, vaccinate before sexual activity onset.
  • Children 9 to 12 years: Routine vaccination with 2 doses of HPV vaccine if series is initiated before age 15. Administer vaccine series beginning at age 9 for children and youth with any history of sexual abuse or assault; vaccination may be administered starting at age 9, even in the absence of a high risk condition. Children who are HIV positive or immunosuppressed for other reasons should receive 3 doses.
  • Adults and Adolescents 13 to 18 years: Catch-up vaccination is recommended for adults and adolescents age 13 to 18 who have not initiated or completed the 2- or 3-dose series. A 3 dose series is recommended for adults and adolescents who receive the first dose on or after their 15th birthday. Additionally, adults and adolescents who are HIV positive or immunosuppressed for other reasons should receive 3 doses.
  • Adults 19 to 26 years: Routine vaccination recommended if not previously vaccinated.
  • Adults 27 to 45 years: Catch-up HPV vaccination is not recommended for all patients over 27 years. ACIP recommends shared clinical decision making regarding the decision to vaccinate this population. Patients at highest risk are those having a new sex partner.

Side Effects

  1. abdominal pain
  2. acute disseminated encephalomyelitis
  3. anaphylactoid reactions
  4. arthralgia
  5. asthenia
  6. bleeding
  7. bronchospasm
  8. chills
  9. diarrhea
  10. dizziness
  11. edema
  12. erythema
  13. fatigue
  14. fever
  15. Guillain-Barre syndrome
  16. headache
  17. hematoma
  18. hemolytic anemia
  19. influenza
  20. injection site reaction
  21. lymphadenopathy
  22. malaise
  23. muscle paralysis
  24. myalgia
  25. myelitis
  26. nausea
  27. pancreatitis
  28. pruritus
  29. pulmonary embolism
  30. purpura
  31. seizures
  32. syncope
  33. thrombosis
  34. urticaria
  35. vomiting

Monitoring Parameters

  • pap smear
  • pelvic exam

Contraindications

  • agammaglobulinemia
  • anticoagulant therapy
  • breast-feeding
  • children
  • coagulopathy
  • fever
  • hemophilia
  • human immunodeficiency virus (HIV) infection
  • hypogammaglobulinemia
  • immunosuppression
  • infants
  • neonates
  • neoplastic disease
  • pregnancy
  • radiation therapy
  • severe combined immunodeficiency (SCID)
  • syncope
  • thrombocytopenia
  • vitamin K deficiency
  • yeast hypersensitivity

Interactions

  • Ocrelizumab
  • Siponimod
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