Vaccination Against HPV JAMA Dermatology

TAKE-HOME MESSAGE

• The CDC's Advisory Committee on Immunization Practices (ACIP) has issued an update on recommendations regarding HPV vaccination. Catch-up vaccination is now recommended for patients through age 26 years, and the ACIP recommends shared clinical decision-making between patients and their physicians for those aged 27 to 45 years who may benefit from vaccination.

• The ACIP stresses that the HPV vaccination is prophylactic and does not treat already acquired HPV infections. However, vaccination may provide protection against other HPV types not yet acquired. Of note, private insurance plans must cover ACIP–recommended vaccinations.

– Caitlyn T. Reed, MD

 Dermatology

Written by

 

 

Alfredo Siller Jr., MD

Written by

 

 

Joseph Jebain MD

Written by

 

 

Stephen K. Tyring MD, PhD

The Advisory Committee on Immunization Practices (ACIP) now recommends that both men and women aged 26 years or younger who did not receive their routine adolescent human papillomavirus (HPV) vaccine should receive it as a catch-up vaccine, and the clinician should utilize shared decision-making for those patients who are between 27 and 45 years of age. So, how do we as clinicians ultimately help the patient make that informed decision?

We can start the conversation by assuring our patients that the vaccine is safe and effective, but the vaccine is less effective for patients who have already been exposed to vaccine-type HPV. Given that the risk of being already exposed to vaccine-type HPV increases with age, we can then elaborate that the reason the vaccine is not automatically recommended for all adults up to age 45 years is largely because the potential benefit is not worth the cost on a large scale, although it may be worth it for them in particular to receive the vaccine.

The key and next step for evaluating this newly eligible age group of patients is to assess each individual patient's risk factors for acquiring a new HPV infection. If a patient has increased risk factors for acquiring a new HPV infection (eg, multiple sexual partners), then they would likely benefit from receiving the vaccine, and we can recommend they receive it. For patients at low risk for acquiring a new HPV infection, we can recommend that it may not be as beneficial for them to receive the HPV vaccine, unless they anticipate their risk may increase in the future.

Abstract 

CLINICAL QUESTION

Who should receive human papillomavirus (HPV) vaccination?

BOTTOM LINE

Catch-up vaccination is now recommended for all persons through age 26 years. For persons aged 27 through 45 years, clinicians and patients should now jointly decide whether HPV vaccination is appropriate. Routine HPV vaccination at age 11 or 12 years (or as early as age 9 years) continues to be recommended.

JAMA Dermatology

Vaccination Against Human Papillomavirus

JAMA Dermatol 2020 Aug 19;[EPub Ahead of Print], DH Marks, KA Katz 

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.