PREVENTION OF CERVICAL DYSPLASIA
BY VACCINATION
The 9 valent HPV recombinant vaccine [Gardasil-9] is recommended for all
females age 9–26, with target age 11–12.
Recommendations
The vaccine uses noninfectious particles to protect against 9 HPV types (6,
11, 16, 18, 31, 33, 45, 52, 58).
Three doses are given: initial, then two months later, then six months later, for
an approximate cost of $300.Administer to all females age 9–26, with target age 11–12. Efficacy is highest
before the patient’s immune system has been presented with HPV.
Testing for HPV is not recommended before vaccination. No easy method of
identifying all HPV types is currently available.
Continue regular Pap smears according to current guidelines because the
vaccine does not prevent against all HPV types that can cause genital warts or
cervical cancer.
Sexually active women can receive the vaccine. Women with previous
abnormal cervical cytology or genital warts also can receive the vaccine, but
it may be less effective. It can be given to patients with previous CIN, but
benefits may be limited.
The vaccine is not recommended for pregnant or immunosuppressed women.