Human papillomavirus vaccination update: Nonavalent vaccine and the two-dose schedule.

ABSTRACT

BACKGROUND: Australia has included quadrivalent human papillomavirus (HPV) vaccination in its national program since 2007. Significant declines have been observed in the incidence of HPV infection, genital warts and high-grade cervical lesions. In 2018, the program changed to a nonavalent HPV vaccine administered over a routine two-dose schedule for the target cohort of adolescents aged 12-13 years. OBJECTIVE: The aim of this article is to provide an overview of the nonavalent HPV vaccine, the rationale for its use and expected outcomes, and to review the updated dose scheduling requirements for HPV vaccines. DISCUSSION: The nonavalent HPV vaccine will broaden the impact of HPV vaccination, primarily against cervical cancer and pre-cancer. A two-dose schedule with an interval of 6-12 months between doses is appropriate for those aged ≤14 years at the time of first dose. Older individuals and those who are immunocompromised should continue to receive the three-dose schedule at zero, two and six months.