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Introduction to the HPV Vaccines Work Group
Oliver Brooks, MD
Chair, HPV Vaccines Work Group
Advisory Committee on Immunization Practices
April 15, 2025
National Center for Immunization & Respiratory Diseases
•HPV can cause cancer of the cervix, vagina, vulva, penis, anus, and oropharynx
•HPV vaccination provides lasting protection against the HPV types that most
commonly cause cancer
•In the 19 years since HPV vaccine licensure, we have seen:
-High vaccine efficacy in clinical trials
-High population impact in real -world settings
-Strong herd effects of vaccination programsHPV vaccine is a critical public health tool
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•An ACIP HPV Vaccines Work Group met previously for many years, but
had been inactive since 2019
•Re-formed ACIP HPV Vaccines Work Group was announced during June
2024 ACIP meeting and began meeting monthly in July 2024
•First presentation by new Work Group during October 2024 ACIP meetingBackground
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•Routine vaccination
-Age 11 or 12 years
-Can be started at age 9 years
•Catch -up vaccination
-Through age 26 years
•Shared clinical decision -making
-Age 27 –45 yearsCurrent HPV vaccination recommendations,
United States
Recommendations of the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices
https://www.cdc.gov/vaccines/hcp/acip -recs/vacc -specific/hpv.html Number of doses
2 doses (0, 6 -12 months)
if starting series before 15th birthday
3 doses (0,1-2, 6 months)
if starting series on or after 15th birthday or if
immunocompromising condition
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•Wording of the age for routine HPV vaccination
-Some stakeholders interested in starting vaccination at age 9 years
-Current ACIP recommendations are consistent with vaccination at age 9 years
-Work Group is considering m odification of wording to “ HPV vaccination is routinely
recommended at age 9 to 12 years” to allow more flexibility Work Group Terms of Reference
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•Number of doses in the recommended HPV vaccination series
-Accumulating evidence on efficacy of HPV vaccination with fewer doses
-Work Group is reviewing data to inform policy for:
•two doses for persons aged 15 years and older
•one dose for persons aged 9 years and olderWork Group Terms of Reference
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•2022: WHO recommended a 2 -dose schedule for ages 9 and older, with an option for a 1 -dose
schedule in girls and boys aged 9 –20 years
•Some of the first countries to change to a routine 1-dose recommendation
–UK and Australia
•Some countries did not change to a 1 -dose schedule, but changed from a 3-dose to a 2 -dose schedule
for persons ages >14 years
–e.g., Netherlands and Sweden
•1-dose recommendations have been made by regional advisory groups
–PAHO in 2023 and AFRO in 2024
•As of April 2025: in some age groups, 67 countries have adopted 1 -dose and 77 countries have
adopted 2 -dose HPV vaccination schedulesGlobal HPV vaccine policy recommendations
7Pan American Health Organization (PAHO): https://www.paho.org/fr/node/92810
WHO African Region (AFRO): https://www.afro.who.int/news/africa -immunization -advisory -group -urges -single -dose -hpv -vaccine -adoption -advance -vaccination
•Introduction to reduced number of HPV vaccine doses
-Summary of evidence on 1 -dose HPV vaccination
•Introduction to wording of age for routine HPV vaccination
-Interest in vaccination at age 9 years
•Systematic review and narrative summary of literature about HPV
vaccination at ages 9 –10 years to increase coverageSummary of October 2024 presentation
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Today’s agenda
Reduced number of doses for HPV vaccination:
Work Group progress and literature updateDr. Carla DeSisto
CDC/NCIRD
KEN SHE trial Dr. Ruanne Barnabas
Harvard University
HPV vaccination coverage Ms. Cassandra Pingali
CDC/NCIRD
Modeling of reduced number of doses for HPV
vaccinationDr. Jane Kim
Harvard University
Modified EtR: Wording of the age for routine HPV
vaccinationDr. Ruth Stefanos
CDC/NCIRD
Next steps and Work Group considerations Dr. Lauri Markowitz
CDC/NCIRD
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ACIP HPV Vaccines Work Group
ACIP voting members
Oliver Brooks (chair)
Noel Brewer
Sybil Cineas
Robert Schechter
CDC Co -Leads
Carla DeSisto
Lauri MarkowitzLiaison members
Robin O'Meara (AAFP)
Angela Myers (AAP)
Linda Eckert (ACOG)
Alfonso Iorio (ACP)
Jamilia Sherls (AIM)
Sandra Fryhofer (AMA)
Sean O'Leary (IDSA)
Nicole Forbes (NACI)
Kevin Ault (NFID)
Alexandra Yonts (PIDS)
Nneka Holder (SAHM)
10Ex-Officio members
Sixun Yang (FDA)
Aimée R. Kreimer (NIH)
Eleanore Chuang (NIH)
Consultant members
Deana Baptiste (ACS)
Peter Szilagyi
Rachel Winer
Elizabeth Moore (consumer rep)
Julia Gargano (DVD)
Ruth Stefanos (DVD)
Virginia Senkomago (DCPC)
Patrick Clay (DSTDP)
Harrell Chesson (DSTDP)
Shannon Stokley (ISD)
Cassandra Pingali (ISD)ACIP HPV Vaccines Work Group - CDC Staff
Elizabeth R. Unger (DHCPP)
Gitika Panicker (DHCPP)
Christine Olson (ISO)
Julianne Gee (ISO)
Hannah Rosenblum (ACIP Secretariat)
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