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CC May 2017 9-valent Human Papilloma virus (HPV) vaccination

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echoecho's version from 2017-06-27 02:14

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Question Answer
What is the most common STD?HPV
How many new HPV infections occur annually?14 million
How many people are infected in the US?79 million
Are the majority of HPV infections asymptomatic or symptomatic?asymptomatic
However, infection with oncogenic types (primarily types ___ and ___) can cause what types of cancers?1) types 16 and 18; 2) cervical, anogenital, oropharyngeal cancers
Differentiate between the two HPV vaccines available for use?1) Cervarix (HPV2) protects against types 16 and 18;; 2) Gardasil (HPV9) that protects against types 16, 18, 6, 11, 31, 33, 45, 52, 58 (other high-risk strains)
Prior to the release of HPV9, _____ was available?HPV4
HPV2 was discontinued by GlaxoSmithKlein in 10-2016 and while both HPV2 and HPV4 vaccines may still be available and can be used until their expiration dates, after 5-2017, only _____ vaccine will be available in the USA?HPV9
True or false, HPV9 is indicated for a males and females?true
Do persons immunized with HPV2 or HPV4 need additional doses of HPV9 vaccine?no
While HPV9 has an indication for females and males 9-26 years of age, the ACIP (Advisory Committee on Immunization Practices) recommends ROUTINE vaccination of female starting at age ___ or ___ years and vaccination of females ___ to ___ years of age?1) 11; 12 2)13; 26
ACIP recommends ROUTINE immunization of males starting at age ___ or ___ years and vaccination of those ___ to ___ years of age?1) 11;12 2) 13;21
What is the indication to initiate HPV9 administration at age 9 years?children with a hx of sexual assault or abuse
List the indications for HPV9 vaccination to individuals 22-26 years of age?1) young men who have sex with men, including young men who identify as gay or bisexual or who intend to have sex with men 2) young adults who are transgender 3) young adults with certain immunocompromising deficiency, T-lymphocyte complete or partial defects, HIV, malignant neoplasm, transplantation, autoimmune disease or immunosuppressive therapy
*** In Dec 2016, the ACIP revised its recommendation on dosing schedule for HPV9 vaccine. Prior to this change, the recommendation was a 3 regimen with doses given at 0, 1 and 6 months, what is the new recommendation?1) reduces the regimen to 2 doses for females and males who receive their first dose of vaccine prior to 15 years (9-14 years of age) 2) the second dose is given 6-12 months after the first dose
Why was the schedule for HPV9 changed?based on the noninferior immunologic response to 2 disease in the younger age group
Persons who received their first dose of vaccine before age 15 year and before the change in recommendation are considered completely vaccinated if they received what?2 doses of vaccine 6-12 months apart
Those > 15 years of age should still receive ____ doses of vaccine?3
For persons where the vaccine schedule was interrupted, the number of doses needed is determined by what?age of the individual when the first dose of vaccine was given
Is the 3-dose schedule still recommended for persons 9-26 years of age with immunocompromising conditions as mentioned in the above questions?yes
List the conditions that are not considered immunocompromised when administering HPV9 vaccine and can receive the 2 dose regimen unless they are receiving immunosuppressive therapy?asplenia, asthma, chronic granulomatous disease, chronic liver disease, chronic renal disease, central nervous system anatomic barrier defects (cochlear implant), complement deficiency, diabetes, heart disease or sickle cell disease
Do vaccinated females still need pap smears at recommended intervals?yes
Should people with genital warts still be vaccinated?yes
Should people in the recommended age ranges still be vaccinated even if they have been sexually active for a long time and have multiple partner?yes
Despite significant benefits of this vaccine, acceptance has been less than optimal, parent often wish to delay vaccine to later adolescence because their child is not sexually active. Providers need to inform parents about what facts?1) the vaccine is more effective in younger individuals and individuals who are HPV-naïve 2) antibody titers are significantly lower in those with previous exposure 3) provider's attitude regarding the vaccine plays an important role. The CDC urges all providers to "increase the consistency and strength of how they recommend HPV vaccine"
Parents/patients often wish to delay administration stating that they "will think about it". While informed decision making is important, studies have found that delaying administration is associated with an immunization rate of ___% compared to administration at the time of the visit?57%
While informed decision making is important, studies have found that delaying administration is associated with an immunization rate of ____% compared to administration at the time of the visit?57%
What attitudes regarding vaccine play an important role?physician attitudes
The CDC urges all healthcare providers to do what?"increase the consistency and strength of how they recommend HPV vaccine"
*** SUMMARY = The ___-valent HPV vaccine affords protection against the types of HPV most commonly associated with anogenital, cervical and oropharyngeal malignancies as well as genital warts?9
*** SUMMARY = A ___-dose regimen is now recommended for those whose initial dose of vaccine is given prior to the age of 15?2
*** SUMMARY = Certain immunocompromising conditions preclude the use of the ___-dose regimen and necessitate the use of the 3-dose regimen?2
*** SUMMARY = Vaccination rates against HPV continue to be ____. The CDC urges all healthcare providers to do what?1) low 2) "increase the consistency and strength of how they recommend HPV vaccine"
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