HPV Vaccine Gaining Ground for Use in Pregnancy


'There is not [yet] enough information to recommend HPV vaccination in pregnancy.' DR. LAWRENCE

LA JOLLA, CALIF. — The human papillomavirus vaccine, although still not recommended for use in pregnancy, was no longer listed as contraindicated by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices as of early last year.

“This may lessen the concern when a woman inadvertently receives a dose before learning she is pregnant,” Dr. Hal Lawrence said at Perspectives in Women's Health sponsored by FAMILY PRACTICE NEWS, OB.GYN. NEWS, and INTERNAL MEDICINE NEWS.

“Given time and more data, multiple doses of the vaccine may prove to be safe during pregnancy, offering clinicians an opportunity to initiate or complete the three-dose series during a period of routine office visits,” added Dr. Lawrence, vice president for practice activities, American College of Obstetricians and Gynecologists, and a member of the editorial advisory board of OB.GYN. NEWS.

For now, however, neither intentional initiation of the vaccine series nor delivery of doses two and three during pregnancy is recommended, according to updated vaccine information from the CDC's Guidelines for Vaccinating Pregnant Women, available online at

The HPV vaccine contains neither live nor attenuated viral particles; instead, it contains viruslike particles engineered to resemble the L1 protein on the outer capsule of the virus.

Although it provokes a robust immune response, “it does not have any actual viral activity,” said Dr. Lawrence. This mechanism is reassuring, and to date no adverse events related to mothers or developing fetuses have been associated with administering the HPV vaccine during pregnancy.

In an interview following the meeting, however, Dr. Lawrence emphasized that the data are limited. “What we are really saying is that while no adverse events have been reported, there is not enough information to recommend HPV vaccination in pregnancy,” he said.

Dr. Lawrence said that clinicians with patients who received the HPV vaccine during pregnancy are encouraged to call the HPV Vaccine Pregnancy Registry at 800-986-8999 to add to the information base. As HPV vaccinations during pregnancy are identified and pregnancy outcomes are tracked, the CDC and other organizations may reevaluate use of the vaccine during pregnancy.

In other news regarding HPV vaccines, Dr. Lawrence cited recent data showing partial blocking of 10 additional HPV strains, in addition to HPV 6, 11, 16, and 18, the four covered by the quadrivalent vaccine. “This may boost protection [against cervical cancer] to 90%,” he said at the meeting.

HPV is also responsible for the majority of anal and vulvar cancers in young women and for head, neck, and oral cancers as well, any of which could potentially be prevented with the HPV vaccine, according to Dr. Lawrence. For additional information, see ACOG Committee Opinion No. 344 and ACOG Practice Bulletin No. 61.

OB.GYN. NEWS, FAMILY PRACTICE NEWS, and INTERNAL MEDICINE NEWS are published by the International Medical News Group, a division of Elsevier.

Next Article: