Recommendation C2b
➤ The interval between the doses should be at least 6 months and may be
up to 12–15 months (6 months: Strong Recommendation; EB-H, 12–15
months: Moderate Recommendation; EB-L).
Recommendation C3
➤ High coverage of priority populations should be emphasized. Where
coverage of the primary targeted group of females is high (≥50%) and
resources allow, the age group may be expanded upward in catch-up
efforts (Strong Recommendation; EB-H).
Recommendation C4
b
➤ For prevention of cervical cancer in basic resource settings where
vaccine coverage of girls is ≥50%, vaccination of boys is NOT
recommended.
• For prevention of cervical cancer, if there is low vaccine coverage of the priority
female target population (<50%) in basic resource settings, then vaccination may be
extended to boys (Moderate Recommendation; EB-I).
In All Resource Settings
Recommendation D
➤ Females who are HIV positive or immunosuppressed for other reasons
should follow the same age recommendations but should receive three
doses (Weak Recommendation; EB-Ins).
Recommendation E
➤ HPV vaccination is not recommended for pregnant women (Weak
Recommendation; EB-Ins).
Recommendation F
➤ No vaccination strategy is recommended for women receiving treatment
for cervical cancer precursor lesions (CIN2+; eg, conization, loop
electrosurgical excision process, cryotherapy) (Ins).
a
Qualifying Statement for A4 and B4: Extending vaccination to boys to prevent cervical cancer is
not cost-effective unless there is low vaccine coverage of the priority female target population (<50%).
Vaccination may be extended to boys for other reasons, such as to prevent other noncervical HPV-
related cancers and diseases (eg, genital warts) and/or to reduce circulating HPVs more rapidly.
b
Qualifying Statement for C4: Extending vaccination to boys to prevent cervical cancer is not
cost-effective unless there is low vaccine coverage of the priority female target population (<50%).
However, if resources allow for efforts to reduce noncervical cancers and diseases and/or reduce
circulating HPVs more rapidly, then vaccination may be extended to boys.
Additional Qualifying Statements: If boys are vaccinated, use the same age-related
recommendations as for girls, according to resource settings. Recommendations regarding boys do
not apply to men who have sex with men (MSM). Readers are referred to US CDC, Australian and
other guidelines.