American Cancer Society recommends routine HPV vaccination starting at age 9 years
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Health care providers should begin offering routine HPV vaccination to children as young as age 9 years in order to increase rates of on-time administration, according to an updated American Cancer Society guideline.
The guideline — published in CA: A Cancer Journal for Clinicians — also has been adapted to recommend providers inform individuals aged 22 to 26 years that vaccination may not prevent as many cancers as it would for children and teens. However, it does not support the 2019 Advisory Committee on Immunization Practices (ACIP) recommendation that vaccination be considered for certain adults aged 27 to 45 years.
“The ACIP updated their recommendations in June 2019, which is why the American Cancer Society went through our guideline process to endorse or adapt their update,” Debbie Saslow, PhD, managing director of cancer control interventions-HPV/GYN cancers at American Cancer Society, told Healio. “Routinely vaccinating boys and girls between ages 9 and 12 years will likely lead to higher vaccination rates than routinely vaccinating between ages 11 and 12 years. Many parents prefer completing the HPV vaccine series before their child needs to get other recommended vaccinations for those aged 11 to 12 years. In addition, many children also prefer to not get as many vaccinations all at once, and health care providers also find it easier.”
Although the ACIP update did not include a recommendation regarding routine vaccination for children aged 9 to 10 years, American Cancer Society found evidence of the benefits of vaccinating children starting at those ages, according to Saslow.
“It was always OK to vaccinate children aged 9 to 10 years, but now it is more than OK,” she said.
Regarding catch-up vaccination, the updated guideline endorses the ACIP’s recommendation to remove separate advice for males and females. It specifies that every individual who did not receive full HPV vaccination should have catch-up vaccinations up to age 26 years.
“American Cancer Society endorsed this updated recommendation, although we continue to recommend that individuals aged 22 to 26 years be informed that vaccination of young adults will not prevent as many cancers as vaccination of children and teens,” Saslow added.
The updated guideline also recommends against vaccination after age 26 years, because of its low effectiveness and poor potential to prevent cancer among these adults.
“The ACIP does not recommend vaccination for most individuals after age 26 years but does allow for shared clinical decision-making for individuals aged 27 to 45 years,” Saslow said. “Bottom line is that increased HPV vaccination rates mean more cancers prevented — which is the goal.”
For more information:
Debbie Saslow, PhD, can be reached at American Cancer Society, 250 Williams St., Suite 600, Atlanta, GA 30303; email: debbie.saslow@cancer.org.
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Anna R. Giuliano, PhD
I do not agree with the American Cancer Society position on HPV vaccination for those aged older than 26 years — which is contrary to CDC guidelines for this age group — to not even discuss the opportunity with their providers. We do not have enough data for individuals aged older than 26 years to make a definitive statement for or against vaccine effectiveness. For mid-adult men, there is no way to prevent oropharyngeal cancer caused by HPV other than to vaccinate. As the median age at diagnosis of oropharyngeal cancer is 60 years, it is likely that vaccination for those aged 27 to 45 years may have a positive impact on the rising incidence of this cancer, which affects more than 12,000 men per year in the U.S. alone. HPV vaccine effectiveness data to date support this concept, and every study that has examined population-level effectiveness of the vaccine to prevent oral HPV infection has found profound reductions among vaccinated populations.
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