HPV is associated with cancer of the cervix, vulva, vagina, anus, oropharynx, and penis. Fortunately, a vaccine is available which has the potential to markedly reduce, or even eliminate, these cancers. The CDC recommends that it be administered at age 11-12 years although it may be given as young as 9. For those not vaccinated at a younger age, it was originally recommended up to age 26. This was recently extended to age 45. The CDC estimates that 80% of those eligible need to be completely vaccinated to reach herd immunity. However, this goal remains out-of-reach as vaccine completion rates are extremely low in the US, especially among adults. One reason for this is that multiple doses are...

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HPV is associated with cancer of the cervix, vulva, vagina, anus, oropharynx, and penis. Fortunately, a vaccine is available which has the potential to markedly reduce, or even eliminate, these cancers. The CDC recommends that it be administered at age 11-12 years although it may be given as young as 9. For those not vaccinated at a younger age, it was originally recommended up to age 26. This was recently extended to age 45. The CDC estimates that 80% of those eligible need to be completely vaccinated to reach herd immunity. However, this goal remains out-of-reach as vaccine completion rates are extremely low in the US, especially among adults. One reason for this is that multiple doses are needed. Individuals who get the first dose on or after their fifteenth birthday need 3 doses in comparison to only 2 if initiated younger. Reducing the number of required doses after age 14 would make it easier for more individuals to complete the vaccine series. However, the CDC is unlikely to change this recommendation unless there are data from a randomized clinical trial showing that 2 doses are as effective as 3 in older individuals.

We are currently conducting a study examining whether 2 doses are as effective as 3 in individuals 15-26 years old. Since the age for vaccination has now been extended to 45, data are needed on older patients. This renewal will address this important question among women 27-45 years of age. We will recruit 318 participants of which half will be 27-35 and half will be 36-45 years old to determine if there are differences between these 2 age groups. Assays for antibody levels will be conducted by the CDC.

This study is critically needed as the US has struggled to increase HPV vaccination completion rates. Decreasing the number of doses needed could greatly increase these rates. Overall, this project has the potential to decrease HPV infections in the US, which in turn will substantially reduce the occurrence of HPV-related cancers.

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