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Dear Health Professionals,
On January 20, 2023 the Washington State Immunization Information System (IIS) will update its guidance to reflect the recommendation to administer Human Papillomavirus (HPV) vaccine starting at age nine. Previous guidance from the Centers for Disease Control and Advisory Committee on Immunization Practices (ACIP) recommends routine HPV vaccination starting at age 11 or 12 years but notes that HPV vaccination may be given starting at age nine. Starting the HPV vaccination series at age nine is recommended by the American Cancer Society, American Academy of Pediatrics, Washington State Vaccine Advisory Committee, and the Washington State Department of Health (DOH).
In preparation for this change, we encourage you and your office to create a plan and implement the structural changes needed within your organization to start vaccinating at age nine, if you are not doing so already. An official letter from DOH will come after the IIS change has been implemented.
Recommendations for HPV Vaccination
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Age When Starting Vaccine Series
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# of Doses
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Dose Schedule
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9 through 14 years
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2
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0, 6-12 months
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15 through 45 years
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3
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0, 1-2 and 6 months
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9 through 15 and immunocompromised, including HIV positive
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HPV is a virus that causes many types of cancer in addition to other infections, but many HPV infections and future cancers can be prevented with a vaccine that can be given starting at age nine. Research has shown that starting the HPV vaccination series at age nine results in a stronger immune response than waiting to vaccinate at an older age. Starting HPV vaccine at age nine also provides more opportunities for patients to complete the 2-dose series before their 15th birthday. The following page provides FAQ’s and resources for HPV at nine.
Thank you for routinely recommending and administering HPV vaccine.
FAQ: HPV at Nine
- What was the process for making this decision?
- This change was proposed at a Vaccine Advisory Committee (VAC) meeting in July of 2022. The VAC’s motion to change HPV vaccination to age nine passed.
- Why was this change made?
- This change was made in response to growing evidence that administering HPV at nine yields several benefits over waiting until an older age to vaccinate.
- Is there any harm with starting HPV vaccine at age nine?
- No, administering the HPV vaccine at age nine is safe, and recommended by American Cancer Society, and American Academy of Pediatrics, and the Washington State Department of Health.
Resources
Start At 9 Toolkit (hpvroundtable.org)
HPV Provider Fact Sheet (cancer.org)
Why Age 9? Fact Sheet - National HPV Roundtable
Clinician & Health Systems Action Guides – National HPV Roundtable
HPV Vaccination Algorithm (DOH)
Why AAP recommends initiating HPV vaccination as early as age 9 | American Academy of Pediatrics
HPV At Nine (DOH)
Sincerely,
Office Of Immunization
Washington State Department of Health
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