1. Learning Collaborative #4 November 2015
National Immunization Partnership with the Academic Pediatric Association (NIPA)
CDC Grant # 1H23IP000950

2. Agenda Take attendance (5 min) HPV9 (5 min)
Review of site questions/concerns with HPV9 (10 min)
Review of site progress with their strategies (30 min)
Questions (8 min)
Next month – reminder (2 min)

3. 9 -Valent HPV Vaccine
9-valent HPV vaccine targets HPV 16, 18, 31, 33, 45, 52, 58 plus 6, 11
These types account for 66% (16,18)+ 15% of cervical cancers (total 81%) and 90% of genital warts
14% of cancers in females, 4% in males caused by the additional 5 types
CIN 2+ lesions
50% attributable to HPV 16/18
25% attributable to 5 additional types

4. 9-valent HPV vaccine Efficacy: 97% vs. CIN2, VIN2/3
Higher antibody titers in 9-15 compared to yr olds
Safe to use concomitantly with MenACWY and Tdap
Slightly higher injection site reaction than HPV4

5. Recommendations 3-dose schedule 0, 1-2 months, 6 months
No need to restart if interrupted
Can use any HPV vaccine product to complete the series
No recommendation for those who previously completed the series
HPV9 vaccine recommendations are the SAME as for HPV4 vaccine and these vaccines can and should be used interchangeably

6. HPV9 vaccine vs HPV4 vaccine
Should you target HPV9 vaccine to females (added cancer benefit) and use up HPV4 in males?
There is increased HPV oncogenic strain protection for females.
The key is effective delivery of HPV vaccine to all adolescents.
Be careful if you contemplate this. Do not disrupt your delivery system for all adolescents with added complexity of decision rules for administration.

7. Questions?
How is 9-valent HPV vaccine delivery going in your practice?
Any issues with transitioning?

8. Site Progress on QI Strategies
How is each site progressing with their strategies?
(Prompts, Standing Orders, Reminder-Recall)
Any questions?

9. Learning Collaborative #5 December 2015 *holiday schedule
Tues 8am ET/ 7am CT/ 6am MT/ 5am PT
Tues Noon ET/ 11am CT/ 10am MT/ 9am PT
Wed 3pm ET/ 2pm CT/ 1pm MT/ Noon PT

10. Contact Information
Please contact:
Nui Dhepyasuwan, MEd
Phone: 703/ x103 I Fax: 703/
Holly Tyrrell, MSSW
Phone: 703/ x113 I Fax: 703/