ATLANTA — The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommended a bivalent human papillomavirus vaccine as an alternative to the quadrivalent vaccine for the prevention of cervical cancer and related precancerous conditions in women and girls aged 9–26 years. ACIP made the recommendation at its annual fall meeting
The bivalent human papillomavirus (HPV) vaccine (GlaxoSmithKline's Cervarix) was recently approved by the Food and Drug Administration. The vaccine provides clinicians with another option to vaccinate adolescent girls and young women against diseases caused by HPV types 16 and 18. But unlike the quadrivalent vaccine, the bivalent vaccine is not designed to protect against genital warts, noted Dr. Lauri Markowitz of the CDC, who presented the ACIP recommendations for the use of the bivalent vaccine.
The quadrivalent vaccine (Merck & Co.'s Gardasil) protects against genital warts associated with HPV types 6 and 11, in addition to protecting against diseases caused by HPV types 16 and 18.
ACIP recommended against a statement of no preference between the bivalent and quadrivalent vaccines after a lively debate. Instead, the recommendations will present the information about the two vaccines without a statement of preference or a statement of nonpreference. The recommendations state that the two vaccines can be used interchangeably to complete the three-dose series, but that using the same vaccine for the entire series is preferable. The bivalent vaccine, like the quadrivalent vaccine, is not a live vaccine, and it can be given simultaneously with other vaccines.
“Now women have two choices when it comes to a cervical cancer vaccine,” Dr. Sandra Fryhofer, an internist in private practice in Atlanta, Georgia, and the American College of Physicians liaison to ACIP, said in an interview. The bivalent vaccine contains an adjuvant, AS04, that “adds a little immunogenic punch,” she said. And now that clinicians have the option to choose between two vaccines, “we hope that the cost will come down,” Dr. Fryhofer added.
ACIP also voted to harmonize the age ranges for the two vaccines, with first doses given at ages 11–12 years and recommended second and third doses at 1–2 months and 6 months after the first dose. The recommended minimum dosing intervals remained as 4 weeks between the first and second dose and 12 weeks between the second and third doses. The vaccine can be initiated as young as 9 years, and catch-up vaccination is recommended for females aged 13–26 years.
The committee voted to add the bivalent vaccine to the CDC's Vaccines for Children program. For more information, visit www.cdc.gov/vaccines/recs/acip
The bivalent vaccine is not designed to protect against genital warts, noted Dr. Lauri Markowitz of the CDC.
Source Parker Smith/Elsevier Global Medical News