Only Two Doses of HPV Vaccine Needed for Younger Adolescents

Human papillomavirus vaccination series completion will now require only two doses of vaccine for adolescents younger than 15 years. The Advisory Committee on Immunization Practices approved this recommendation at their biannual meeting in Atlanta yesterday. The new schedule for <15 year olds calls for the second dose to be given between 6 and 12 months after the first dose. Adolescents receiving the first dose of HPV vaccine at age 15 or older will continue to be recommended three doses of vaccine, given at 0, 1-2, and 6 months.

This recommendation follows practices already in place in other parts of the world and is based on evidence of non-inferior protection with two doses at younger ages. The change has the potential to save insurers, individual payers, and the federal government millions of dollars a year. The retail price of one dose of HPV vaccine is $130-$160, and administration costs add even more to each dose. Multiply this by the pool of approximately 4 million US births a year, and that’s a potential $640 million dollars a year saved in retail costs. Of course, HPV vaccine one-dose uptake and three-dose completion rates are much lower than 100%, but, still, the potential savings are great.

Some commenters at the ACIP meeting speculated that the complicated three-dose schedule was a deterrent not just to completion of the series, but to its initiation as well. That question will be interesting to try to answer in the next several years as providers enact these new recommendations.

The ACIP additionally voted to change the recommended dosing schedule for Pfizer’s meningococcal group B vaccine (Trumenba). Most adolescents and young adults recommended to take the vaccine will now be able to complete the series with two doses of vaccine, rather than three. The three-dose recommendation remains in place for individuals age 10-18 at high risk of disease.