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FOR CERVICAL CANCER VACCINATION
11 th OCTOBER 2008
DR. JYOTI BHASKAR
Director Lifecare IVF
Pushpanjali Crosslay Hospital
VACCINATION TARGET GROUP
Bivalent 10-45 YRS Quadrivalent 9-45 yrs
Most convenient and optimal age (12-16 years old) –
before first sexual exposure
Offered to all upto 45 years, regardless of sexual
activity but less effective if sexually active.
Informed discussion between the woman and her
health care provider
Not recommended in males
Full explanation of the role, action and
usefulness of the vaccine
the role of HPV in cervical carcinogenesis (in
particular HPV-16 and HPV-18); It is NOT
trial results and expectations;
safety and efficacy;
as well as answer queries on issues
• 0, 1, 6 months
• 0, 2, 6 months
Minimum Intervals between doses
• 4 weeks between 1st & 2nd dose
• 12 weeks between 2nd and 3rd dose
1. Intramuscularly in deltoid Muscle
2. In lying down position and observe for 15 mts
• Before Vaccination not recommended
• Vaccinated women should be screened as per
the standard guideline
• Screen positive women may be vaccinated
Sexually Active Women
• Sexually active women and women with
previous abnormal cervical cytology can
receive the HPV vaccine
• Benefits may be limited to the protection
against infection of HPV genotypes with which
they have not been infected
• Should be Vaccinated
• Counselled - the benefits may be limited to the
protection against infection of HPV genotypes (and
related CIN) with which they have not been infected.
• Cervical screening and corresponding management
• Not a contraindication to vaccination.
• Immune response to the HPV vaccine may be
PREGNANCY AND LACTATION
• The use of the vaccine in pregnancy is not
recommended, although no teratogenic effect
caused by the vaccine has been reported.
• There is no evidence to show that the HPV vaccine
adversely affects fertility, pregnancy or infant
• Women who are planning to conceive are advised to
defer vaccination until after delivery.
PREGNANCY AND LACTATION
• Women who become pregnant before completion of
vaccination are advised to postpone the remaining
dose until after the pregnancy.
• Termination of pregnancy is not indicated for women
who become inadvertently pregnant during the
course of vaccination.
• Lactating women can receive the HPV vaccine and still
continue breastfeeding because it is a vaccine
without live viral DNA.
Use of CIN grade 2 or 3 (CIN2–3) and AIS
as clinical end-points in vaccine efficacy trials
instead of invasive cervical cancer
Contraindications and Precautions
• History of hypersensitivity to any vaccine
• Women with moderate or severe acute
illnesses should be deferred until after the
• If administered concomitantly with any other
vaccine, it should be at a separate site, with a
"There are challenges for countries in
terms of cost and so on, but this vaccine
is unique and offers tremendous
Dr Teresa Aguado, WHO’s coordinator for the
Initiative for Vaccine Research, Product Research and