Administering HPV Vaccine

Dosage and Schedule

• CDC recommends routine vaccination of girls and boys at ages 11 or 12.
• The vaccination series can be started at age 9 years
• HPV vaccines are administered as a 2-dose series (0, 6-12 months) for most persons who initiate vaccination at ages 9 through 14 years, and a 3-dose series (0, 1-2, 6 months) for persons who initiate at ages 15 through 26 years, and for immunocompromised persons.

Vaccine Information

Below are the HPV vaccines that are licensed by the U.S. Food and Drug Administration (FDA) since 2006.

	Quadrivalent/4vHPV (Gardasil)	9-valent/9vHPV (Gardasil 9)
Manufacturer	Merck	Merck
Year Licensed	June 2006 for females, and October 2009 for males	December 2014 for males and females
HPV types protected against by vaccine	HPV types 6, 11, 16, and 18	HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58
Adjuvant in vaccine	AAHS: 225 μg amorphous aluminum hydroxyphosphate sulfate	AAHS: 500 μg amorphous aluminum hydroxyphosphate sulfate
Recommended for...	Females and males ages 11 or 12 (can start at age 9 years) Females ages 13 through 26 and males ages 13 through 21 who have not been adequately vaccinated previously Males ages 22 through 26 with certain immunocompromising conditions; gay, bisexual, and other men who have sex with men (MSM); and transgender persons who have not been adequately vaccinated previously	Females and males ages 11 or 12 (can start at age 9 years) Females ages 13 through 26 and males ages 13 through 21 who have not been adequately vaccinated previously Males ages 22 through 26 with certain immunocompromising conditions; gay, bisexual, and other men who have sex with men (MSM); and transgender persons who have not been adequately vaccinated previously
Contraindicated for...	People with immediate hypersensitivity to yeast	People with immediate hypersensitivity to yeast

• Quadrivalent and 9-valent HPV vaccines protect against HPV 16 and 18, HPV types that cause about 66% of cervical cancers and the majority of other HPV-attributable cancers in the United States.
• 9-valent HPV vaccine targets five additional cancer-causing types, which account for about 15% of cervical cancers.
• Quadrivalent and 9-valent HPV vaccine also protect against HPV 6 and 11, HPV types that cause most anogenital warts.

The additional five types in 9-valent HPV vaccine account for a higher proportion of HPV-associated cancers in women compared with men, and also cause cervical precancers in women. Therefore, the additional protection from 9-valent HPV vaccine will mostly benefit women.

For more information on immunization schedules, see the Child and Adolescent Immunization Schedule and the Adult Immunization Schedule.

Preparation for Administration

• Shake well before use. Thorough agitation immediately before administration is necessary to maintain suspension of the vaccine.
• Do not dilute or mix with other vaccines.
• After thorough agitation, HPV is a white, cloudy liquid.
• Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.
• Do not use the product if particulates are present or if it appears discolored.

For full instructions on dosage preparation, see the 9vHPV [23 pages] or 4vHPV [28 pages] package inserts.

Vaccine Administration

HPV vaccines should be administered intramuscularly in the deltoid region of the upper arm or in the higher anterolateral area of the thigh. The preferred site of administration is the deltoid region of the upper arm. Do not administer this product intravenously, intradermally, or subcutaneously.

Recommended number of doses	Recommended dosing schedule	Population
2	0, 6–12 months*	Persons initiating vaccination at ages 9 through 14 years, except immunocompromised persons
3	0, 1–2, 6 months**	Persons initiating vaccination at ages 15 through 26 years, and immunocompromised persons initiating vaccination at ages 9 through 26 years

HPV vaccine may be given at the same time as other vaccines.

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