Adult Immunization 2006

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• Adult Immunization 2006
• Satellite Broadcast
• December 7, 2006
• Human Papillomavirus Vaccine Segment

Graphics subject to change This material in the
public domain
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Human Papillomavirus

• More than 100 types
• More than 60 cutaneous types
• Can lead to skin warts
• 40 mucosal types
• High risk types (particularly 16 and 18)
• cervical cell abnormalities
• certain anogenital cancers
• Low risk types (particularly 6 and 11)
• cervical cell abnormalities- usually resolve
  spontaneously and do not lead to cancer
• genital warts
• respiratory papillomatosis

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Natural History of HPV Infection
Up to Decades
Within 1 Year
1-5 Years
InitialHPV Infection
Persistent Infection
CIN 2/3
Cervical Cancer
CIN 1
Cleared HPV Infection
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Cancer Attributable to HPV - 2002
Attributable Fraction 100 90 40 40 12
Estimated Cases 12,000 3,700 4,480 1,000 10,000
Cancer Cervical Anal Vulvar/vaginal Penile Oral/ph
arynx
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HPV-associated Conditions
Estimated 70 30-50 10

• HPV 16, 18
• Cervical cancer
• High/low grade cervical
• abnormalities
• Anal, Vulvar, Vaginal, Penile
• Head and neck cancers
• HPV 6, 11
• Low grade cervical
• abnormalities
• Genital warts
• RRP

10 90 90
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Human PapillomavirusVaccine Recommendations

• Women 19-26 years of age are recommended to
  receive the HPV series if they have not already
  received it

provisional (as of December 2007)
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Human PapillomavirusVaccine

• 3 dose series
• Administered intramuscularly
• Schedule 0, 2 months, and 6 months
• Minimum intervals
• dose 1-2 4 weeks
• dose 2-3 12 weeks

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Human PapillomavirusVaccine

• Effective only in preventing infection, not in
  curing disease, or treating a current infection
• Recommended for all women in the approved age
  range (through 26 years) regardless of sexual
  history, prior HPV infection, or prior disease

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Human Papillomavirus VaccineContraindications
and Precautions

• Severe allergic reaction to a vaccine component
  or following a prior dose
• Moderate or severe acute illness
• Defer HPV vaccine until after pregnancy