Human Papilloma virus Bivalent (Types 16 and 18) Vaccine, Recombinant
Indications
Human Papilloma virus Bivalent (Types 16 and 18) Vaccine, Recombinant is used for:
Human Papillomavirus infection, Premalignant cervical lesions and cervical cancer, Adenocarcinoma in situ, Cervical intraepithelial neoplasia
Adult Dose
Intramuscular
Cervical Cancer Prevention
Indicated for prevention of cervical precancers and cervical cancer associated with oncogenic HPV types 16 and 18
Girls and women (9-25 years old): 0.5 mL IM x3 doses at 0, 1, and 6 months (FDA approved labeled dose)
CDC recommendations
Girls and women aged 9-26 years: 0.5 mL IM for 3 doses administered at schedule of 0, 2, and 6 mo
Child Dose
Child: Not recommended for use in girls below 9 yr of age.
Intramuscular
Cervical Cancer Prevention
Indicated for prevention of cervical precancers and cervical cancer associated with oncogenic HPV types 16 and 18
Girls and women (9-25 years old): 0.5 mL IM x3 doses at 0, 1, and 6 months (FDA approved labeled dose)
CDC recommendations
Girls and women aged 9-26 years: 0.5 mL IM for 3 doses administered at schedule of 0, 2, and 6 mo
Renal Dose
Administration
Inject IM in deltoid region of upper arm
Contra Indications
Known hypersensitivity to any component. Postpone admin in patient suffering from an acute febrile illness.
Precautions
Observe patient for 15 min after admin as syncope, sometimes accompanied by transient tonic clonic movements and other seizure-like activity may occur during recovery. Caution in patients with thrombocytopenia or other coagulation disorders as IM admin can cause bleeding. Not to be administered by IV, SC, or intradermal route. Immunocompromised individuals may have diminished immune response to the vaccine. As vaccination will not provide protection against every HPV infection or existing HPV infections, routine cervical screening should still be performed. Not recommended for use during pregnancy; caution in lactation.
Lactation: Unknown whether distributed in breast milk; use with caution
Pregnancy-Lactation
Pregnancy category: B; Not recommended for use in pregnant women
Women who become pregnant after initiating the vaccination series, no intervention is needed; delay the remaining doses until completion of pregnancy
Interactions
Immunosuppressive therapies e.g. irradiation, cytotoxic drugs and corticorsteroids may reduce a patient's immune response to the vaccine.
Adverse Effects
Side effects of Human Papilloma virus Bivalent (Types 16 and 18) Vaccine, Recombinant :
>10%
Injection site pain, erythema, and inflammation
Fatigue, Headache, Myalgia, GI symptoms, Arthralgia
Mechanism of Action
Human Papillomavirus (HPV) type 16 and 18 cause about 70% of cervical cancer. HPV bivalent (types 16 and 18) vaccine is a non-infectious vaccine produced by recombinant technology, which contains virus-like particles (VLP) of the major capsid L1 protein of oncogenic HPV types 16 and 18. Efficacy of vaccine may be mediated by the production of IgG neutralizing antibodies against the HPV-L1 capsid proteins.