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Updates on 09/06/2018

Human papillomavirus (HPV)

Recommendations

The following replaces the existing Recommendations listed in Chapter 4.6 Human Papillomavirus:

  1. All individuals (males and females) who commence vaccination at the age of 9 to 14 years, except immunocompromised individuals (refer to (b) below), should receive two doses of 9vHPV vaccine given 6–12 months apart (0, 6–12 months).
  2. The following population groups should receive three doses of 9vHPV vaccine given at 0, 2 and 6 months:
    1. immunocompromised individuals (males and females) at any age;
    2. males and females who receive their first dose of 9vHPV after turning 15 years of age.

Table 1: Comparison of the ATAGI current and proposed recommendations for HPV vaccination

Recommendation

Vaccine

Cohort

Number of doses

Schedule of doses

Previous

2vHPV vaccine (females only)

4vHPV† vaccine
(males and females)

Commencing vaccination
aged 9–18 years

3 doses

0, 1 and 6 months
(2vHPV vaccine)

0, 2 and 6 months
(4vHPV vaccine)

Immunocompromised
aged 9–45 years

Current

9vHPV vaccine
(males and females)

Commencing vaccination
aged 9–14 years

2 doses

0, 6–12 months§

Immunocompromised
aged 9–45 years

3 doses

0, 2 and 6 months

Commencing vaccination
aged ≥15 years

*HPV vaccine may be administered from 9 years of age, however, the optimal time for vaccination is approximately 12–14 years, as provided under the school-based National Immunisation Program (NIP).

Both 2vHPV and 4vHPV vaccines have been registered in Australia. Only 4vHPV vaccine has been provided under the National Immunisation Program (NIP) since HPV vaccination was funded in 2007.

Immunocompromised individuals include those with primary or secondary immunodeficiencies (B lymphocyte antibody and T lymphocyte complete or partial deficiencies), HIV infection, malignancy, organ transplantation, autoimmune disease, or significant immunosuppressive therapy (but does not include asplenia or hypopsplenia).

§If an individual has received two doses of HPV vaccine with an interval of less than 5 months between dose 1 and dose 2, a third dose is required at least 12 weeks after the second dose, ensuring that the minimum intervals for 3 doses have been met. If the second dose is received at <6 months but ≥5 months after the first dose, a third dose is not required, as clinical trial data support this interval still being sufficiently immunogenic.

Minimum intervals recommended for a 3-dose schedule are at least 4 weeks between dose 1 and dose 2 and at least 5 months between dose 1 and dose 3.

c.9vHPV vaccine can be used to complete an HPV vaccination schedule commenced with either the 4vHPV or 2vHPVvaccine.

No catch up is recommended for individuals who have completed a full schedule (either age and interval appropriate 2- or 3- dose schedules) with either 4vHPV or 2vHPV. Refer to evidence following.