In June 2019, the Advisory Committee on Immunization Practices (ACIP) voted in favor of catch-up HPV vaccination for men and women through age 26. ACIP did not recommend catch-up HPV vaccination for adults age 27 through age 45. Instead, ACIP recommended “shared clinical decision making” for men and women ages 27 through 45 years. What does this mean for you or your loved ones who fall in this age range and haven’t had the HPV vaccination?
“While HPV vaccination is highly effective when given at the recommended age of 11-12, most adults will have minimal benefit,” said Debbie Saslow, PhD, manager director of HPV & GYN cancers. “The recommendation is to talk with your health care provider about whether to get vaccinated if you are 27 years old or older. Three doses are recommended for those who choose to get vaccinated in this age range.”
Most HPV-related cancers are thought to have been caused by HPV infections acquired at younger ages. While a small number of people will benefit from vaccination at older ages, little evidence is available on who those people are or what the benefit would be.
“If you haven’t been vaccinated against HPV before and are within ages 27-45, getting vaccinated now may have no benefit at all, or it might prevent an HPV infection that could lead to genital warts, or—for women—a cervical precancer (that would likely be detected during routine screening, but which might require invasive follow-up procedures), or possibly an HPV cancer” said Dr. Saslow.
It has been suggested that adults more likely to benefit from vaccination are those who have had limited exposure to HPV in the past and who plan to have new sex partners, such as men and women who are newly divorced or widowed. Adults who are least likely to benefit from vaccination are those who are in a long-term monogamous relationship or who are not (and don’t plan to be) sexually active.
If you have already been diagnosed with an HPV-related cancer or precancer, then HPV vaccination will not help to treat any existing infection. HPV vaccination only prevents new HPV infections.
Insurance coverage might also be a determining factor in deciding whether to get the vaccine at age 27-45. “Some insurers pay for any vaccine recommended by ACIP, including those with shared decision making, as soon as the vote is taken,” said Dr. Saslow. “Other insurers do not currently pay for adult HPV vaccination but will once the CDC publishes the recommendation, usually within a few months, or at the end of the year.”
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