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As a provider, you will need to be prepared to answer questions about HPV vaccine from parents/guardians and patients. Therefore, based on the provided resources and your understanding of immunization recommendations, How can you explain why HPV is recommended and at what age(s).

HPV

Human papillomavirus (HPV) is an infection transmitted through skin-to-skin contact, primarily sexual contact. According to the Centers for Disease Control and Prevention (CDC) (2021), more than 42 million people are infected with HPV types that are known to cause cancer and about 13 million people, including teens, are infected each year.

HPV affects both males and females.
HPV is highly contagious.
Most people with HPV have no visible signs (Hemingway et al., 2024).
HPV is associated with warts located on the anus and genital organs. The warts are known as condylomata acuminata. Their presence is not required to transmit HPV.
There is no cure for HPV.
Depending on the strain, the virus places patients at an increased risk of developing cancers later in life regardless of the age the virus first occurred (Hemingway et al., 2024). Different cancer types include anal, vulvar, vaginal, cervical, penile, oral, and oropharyngeal cancers (Hemingway et al., 2024).
HPV usually goes away in 2 years.
Unresolved HPV increases the chance of developing genital warts and cancers.

Prevention

The 9-valent HPV vaccine, Gardasil 9 and 9vHPV, can prevent more than 90% of cancers caused by HPV (Hemingway et al., 2024).

The vaccine has been proven safe and can prevent cancers linked to HPV.
The HPV vaccine is available for patients ages 9 to 45 years.
The HPV vaccine series is recommended between ages 11 and 12 years.
Children who receive the vaccine in between the ages of 9 to 14 will require two vaccines, with the second one due 6-12 months after the first injection.
Patients 15 years of age and older will require 3 vaccines; the second dose will be due 1-2 months after the initial vaccine and the third dose will be due 6 months after the first vaccine.
Vaccine effectiveness ranges from 74%-93% in children 9-14 years of age and 12%-90% in adolescents ages 15-18 (Ellingson et al., 2023).
Routine or catch-up vaccination is recommended for all individuals up to age 26 (Hemingway et al., 2024).
Side effects of the HPV vaccine may include pain, redness, swelling, fever, headache, nausea, or muscle or joint pain.
Condoms do not protect against HPV.

Maryâ€™s mother does not believe that her daughter needs HPV vaccine because she is not sexually active. She is concerned about her daughter viewing this vaccine as a license to practice unsafe sex.

How can you answer the questions in a sensitive way but still provide recommendations for the vaccine.

I understand your concerns and why you may have them. I want you to remember that the goal of the vaccine is to prevent cancer-causing infections and cancers linked to HPV, not to influence sexual behaviors. I want to assure you that at her age, the vaccine is much more effective at preventing cancers compared to the effectiveness if she were to receive it at an older age. The CDC recommends HPV vaccinations at the age of 11 to 12. Although HPV is mainly transmitted during sexual intercourse, there are non-sexual ways of transmission (Pecta et al., 2020). It can be transmitted through fingers, the mouth, clothes, utensils, and furniture (Pecta et al., 2020). Although they are not as common as sexual contact, they should still be considered. Receiving the HPV vaccine is much like receiving any other vaccine. We donâ€™t plan to encounter different infections, but if we do we have immunization to protect us against those infections.

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