Materiały źródłowe

• #1 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  To prevent lower anogenital tract HPV infection by the most common high-risk and low-risk subtypes, the CDC recommends that boys and girls be vaccinated for HPV starting at ages 11 to 12. It is further recommended that women get vaccinated through the age of 26 and men through the age of 21. […] The 9 valent HPV vaccine is available to prevent certain cancerous lesions in males and females. The HPV vaccine covers HPV subtypes 6,11,16,18,31,33,45,52 and 58. The effectiveness of the vaccine has been inferred from several studies. It has been shown to prevent anal cancer, genital warts, cervical intraepithelial neoplasia, vulvar intraepithelial neoplasia, and anal intraepithelial neoplasia. The vaccine is most effective when administered before initiating sexual activity at ages 9-12. […] Educate patient about the HPV vaccine. […] The pharmacists should also encourage the patients to be vaccinated against HPV.

• #2 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  In December 2014, Gardasil 9 was approved by the FDA. This vaccine helps prevent cervical, vaginal, vulvar and anal cancers and genital warts caused by five additional HPV types 31, 33, 45, 52, and 58 which case approximately 20% of cervical cancers that were not previously covered by the previously-approved Gardasil vaccine. Gardasil 9 could thus potentially help prevent up to 90% of these cancers. Similar to quadrivalent Gardasil, Gardasil 9 is given in a series of three injections over a six month period. […] In October 2016, the CDC updated dosing recommendations for the HPV vaccine. Scientific studies have shown that 2 doses of HPV vaccine given to 9-14 year olds at least 6 months apart were as good as or better than 3 doses given to adolescents and young adults. […] The vaccine works best in people who have not yet come in contact with these viruses. It is recommended for all 11 and 12 year old boys and girls as a routine vaccination and for all young women and men 13-26 years of age who have not yet received the vaccine.

• #3 HPV Vaccination for Appropriate Patients

  https://www.merckvaccines.com/gardasil9/resources/patient-a-recommend/

  GARDASIL 9 is a vaccine indicated in females 9 through 45 years of age for the prevention of cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by human papillomavirus (HPV) Types 16, 18, 31, 33, 45, 52, and 58; cervical, vulvar, vaginal, and anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11. […] GARDASIL 9 is indicated in males 9 through 45 years of age for the prevention of anal, oropharyngeal and other head and neck cancers caused by HPV Types 16, 18, 31, 33, 45, 52, and 58; anal precancerous or dysplastic lesions caused by HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58; and genital warts caused by HPV Types 6 and 11. […] GARDASIL 9 does not eliminate the necessity for vaccine recipients to undergo screening for cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers as recommended by a health care provider.

• #4 GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) | Official Site

  https://www.gardasil9.com/

  GARDASIL 9 helps protect individuals ages 9 to 45 against the following diseases caused by 9 types of HPV: cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females. […] Vaccination does not remove the need for recommended cancer screenings, and its important to get routine cervical cancer screenings. GARDASIL 9 does not treat HPV infection, cancer, or genital warts. […] The appropriate dosing schedule will be determined by a health care professional. […] Only a doctor or health care professional can decide if GARDASIL 9 is right for you or your child.

• #5 Human papillomavirus (HPV) Vaccine – Mother To Baby | Fact Sheets – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582527/

  This sheet is about exposure to the HPV vaccine during pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider. […] The HPV vaccine protects against infection with some types of HPV that cause cancer and genital warts. Gardasil9, which protects against 9 of the HPV virus types, is the brand name of the HPV vaccine currently available in the United States. […] The vaccine is approved for people between the ages of 9 and 45 years of age but provides the most protection when given before becoming sexually active. […] The CDC notes that the HPV vaccine can be given to a person who is breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions. […] There is no evidence to suggest that getting the HPV vaccine would make it harder to get pregnant in the future.

• #6 HPV Vaccines | Preventing Human Papillomavirus Infection | American Cancer Society

  https://www.cancer.org/cancer/risk-prevention/hpv/hpv-vaccines.html

  HPV (human papillomavirus) vaccination is cancer prevention. This is why it is important that all children get vaccinated against HPV. […] HPV vaccines can help protect children and young adults from some HPV infections. These vaccines are used to prevent some types of cancer that can result from an HPV infection. They will not treat an HPV infection. And they will not protect against cancer if a person already has an HPV infection. […] The HPV vaccine is strongly recommended for all boys and girls. Since vaccines are used to help prevent diseases, children are vaccinated for diseases before being exposed to the infection that causes the disease. […] The HPV vaccine works best in children and pre-teens. Vaccination at the recommended ages of 9 to 12 will prevent more cancers than vaccination at older ages, with cancer prevention decreasing as age at vaccination increases.

• #7 Understanding the HPV Vaccine: Protecting Your Health | Riverside Healthcare

  https://www.riversidehealthcare.org/blog/understanding-hpv-vaccine-protecting-your-health

  The HPV vaccine works by stimulating the body’s immune system to produce antibodies against specific strains of the virus. By receiving the vaccine, individuals develop immunity to these strains, reducing their risk of HPV-related complications, including cervical, anal, penile, and oropharyngeal cancers, says Riverside Medical Group Primary Care Provider, Katie Van Hoveln, NP-C. […] The HPV vaccine is a vital tool in preventing HPV-related cancers and promoting overall health. At Riverside Healthcare, we encourage open dialogue between patients and healthcare providers to address any concerns or questions regarding vaccination, says Katie. […] Talk with your primary care provider today about scheduling your HPV vaccine. If you don’t have a primary care provider, visit RiversideHealthcare.org/primary care to find the provider that fits your needs.

• #8 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.) […] ACIP also recommends vaccination for everyone through age 26 years if not adequately vaccinated when younger. HPV vaccination is given as a series of either two or three doses, depending on age at initial vaccination. […] For adults ages 27 through 45 years, clinicians can consider discussing HPV vaccination with people who are most likely to benefit. HPV vaccination does not need to be discussed with most adults over age 26 years. […] Keep in mind that HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases. HPV vaccine works best when given before any exposure to HPV. […] Two doses of HPV vaccine are recommended for most persons starting the series before their 15th birthday.

• #9 The Human Papillomavirus (HPV) Vaccine

  https://www.health.ny.gov/diseases/communicable/human_papillomavirus/

  The New York State Department of Health endorses the National Human Papillomavirus (HPV) Vaccination Roundtable’s „Start at 9” campaign to urge vaccination with HPV vaccine begin at age 9 years as routine practice. […] When the HPV vaccine is administered between the ages of 9 and 14 years, only two doses, given at least 6 months apart are needed to complete the series. […] The HPV vaccine protects preteens, teens, and young adults from human papillomavirus (HPV). […] Research shows that when boys and girls are vaccinated early – prior to 9 to 14 years – they are better protected from serious health problems that HPV can cause, including certain cancers and genital warts. […] Two (2) doses of HPV vaccine given at least six (6) months apart are recommended for those 9- to 14-year-olds to protect them from HPV cancers and genital warts.

• #10 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine. […] Obstetriciangynecologists should assess and vaccinate adolescent girls and young women with the HPV vaccine during the catch-up period (ages 1326 years), regardless of sexual activity, prior exposure to HPV, or sexual orientation, if they were not vaccinated in the target age of 1112 years. […] For some women aged 2745 years who are previously unvaccinated, obstetriciangynecologists and other health care professionals may use shared clinical decision making regarding the HPV vaccination, considering the patients risk for acquisition of a new HPV infection and whether the HPV vaccine may provide benefit. […] Obstetriciangynecologists are encouraged to stock and administer HPV vaccine in their offices when feasible.

• #11 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine. […] Obstetriciangynecologists should assess and vaccinate adolescent girls and young women with the HPV vaccine during the catch-up period (ages 1326 years), regardless of sexual activity, prior exposure to HPV, or sexual orientation, if they were not vaccinated in the target age of 1112 years. […] For some women aged 2745 years who are previously unvaccinated, obstetriciangynecologists and other health care professionals may use shared clinical decision making regarding the HPV vaccination, considering the patients risk for acquisition of a new HPV infection and whether the HPV vaccine may provide benefit. […] Obstetriciangynecologists are encouraged to stock and administer HPV vaccine in their offices when feasible.

• #12 The HPV Vaccine: Access and Use in the U.S. | KFF

  https://www.kff.org/womens-health-policy/fact-sheet/the-hpv-vaccine-access-and-use-in-the-u-s/

  While the FDA expanded its approval of the HPV vaccine to include adults ages 27 to 45, ACIP does not recommend routine catch-up vaccinations for all adults in this age group. […] Current global research suggests Gardasil9 protection is long-lasting: more than 10 years of follow-up data in both boys and girls indicate the vaccines are still effective and there is no evidence of waning protection, although it is still unknown if recipients will need a booster in the future. […] The Centers for Disease Control and Prevention (CDC) suggest that additional outreach focused on populations that experienced declines in vaccination is needed to further understand the impact of the COVID-19 pandemic on access to and initiation of recommended vaccines. […] The HPV vaccine has been available in the U.S. for nearly two decades and uptake has risen over that time, though more recently since the COVID-19 pandemic there have been notable declines in vaccination rates.

• #13 HPV Vaccine: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hpv-vaccine-care-instructions.abn0347

  The HPV (human papillomavirus) vaccine protects against HPV. […] Experts recommend that children age 11 or 12 get the HPV vaccine, but the vaccine can be given from age 9 to 26. […] Children ages 9 to 14 get the vaccine in a series of two shots. Some children may need a third dose. Anyone age 15 and older gets the vaccine as a three-dose series. For the vaccine to work best, all shots in the series must be given. […] The best time to get the vaccine is before a person becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. […] Having the HPV vaccine does not change the need for Pap tests. If you’ve had the HPV vaccine, follow the same Pap test schedule as those who haven’t had the vaccine. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems.

• #14 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  The CDC now recommends that young people under the age of 15 require only 2 doses. The first dose before the age of 15 and the second one within 6-12 months later. All others who are 15 or older should continue to receive a series of 3 injections over a 6 month period. The first vaccine injection can be given at any time. The second injection should be given two months after the first one, and the third injection should be given six months after the initial one. It is preferred that the same HPV vaccine be used for the entire 3 shot series. If a patient is late to receive the next vaccine in the series, the vaccine doses should not be repeated. […] Yes, there are some points to consider when counseling young women about the HPV vaccine. […] Avoid administering the vaccine to pregnant females. If a girl has already had one or two shots before she became pregnant, delay the other shots until she completes her pregnancy.

• #15 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  The CDC now recommends that young people under the age of 15 require only 2 doses. The first dose before the age of 15 and the second one within 6-12 months later. All others who are 15 or older should continue to receive a series of 3 injections over a 6 month period. The first vaccine injection can be given at any time. The second injection should be given two months after the first one, and the third injection should be given six months after the initial one. It is preferred that the same HPV vaccine be used for the entire 3 shot series. If a patient is late to receive the next vaccine in the series, the vaccine doses should not be repeated. […] Yes, there are some points to consider when counseling young women about the HPV vaccine. […] Avoid administering the vaccine to pregnant females. If a girl has already had one or two shots before she became pregnant, delay the other shots until she completes her pregnancy.

• #16 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons. […] A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine. […] HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. […] HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. […] The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection. […] No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.

• #17 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  Be sure to emphasize the vaccine will not be completely effective unless all shots are scheduled and administered as directed.(For 15 yrs old 2 doses; for 15 and older, 3 doses with the first one at an elected time, the second one 2 months later, then the third injection 6 months after the first one.) […] Tell young women that the HPV vaccine does not take the place of routine gynecological care and Pap tests. They should still make their appointments for Pap tests. […] Similar to other vaccines, not all recipients of the HPV vaccine will be protected. […] Explain to young women that condoms offer some protection against HPV, but that avoiding sexual contact is the only way to completely protect oneself from HPV.

• #18 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  The CDC now recommends that young people under the age of 15 require only 2 doses. The first dose before the age of 15 and the second one within 6-12 months later. All others who are 15 or older should continue to receive a series of 3 injections over a 6 month period. The first vaccine injection can be given at any time. The second injection should be given two months after the first one, and the third injection should be given six months after the initial one. It is preferred that the same HPV vaccine be used for the entire 3 shot series. If a patient is late to receive the next vaccine in the series, the vaccine doses should not be repeated. […] Yes, there are some points to consider when counseling young women about the HPV vaccine. […] Avoid administering the vaccine to pregnant females. If a girl has already had one or two shots before she became pregnant, delay the other shots until she completes her pregnancy.

• #19 Human Papillomavirus Vaccine (HPV) | AAFP

  https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/disease-pop-immunization/human-papillomavirus-vaccine-hpv.html

  It is recommended by the Advisory Committee on Immunization Practices (ACIP) and the AAFP that children with a history of sexual abuse or assault get routine HPV vaccination beginning at age 9. […] More than 205 million doses of the HPV vaccine have been distributed worldwide and nearly 90 million doses of HPV vaccines have been distributed in the United States from June 2006 through March 2016. […] Each vaccine continues to be monitored for any safety problems. […] Among women who have not been previously infected with a targeted HPV type, 2vHPV, and 4vHPV have over 95% efficacy in preventing cervical pre-cancers caused by HPV16 and HPV18.

• #20 HPV vaccine — what you should know | News & articles | UnitedHealthcare

  https://www.uhc.com/news-articles/healthy-living/hpv-vaccine-what-you-should-know

  HPV (human papillomavirus) is one of the most common sexually transmitted diseases. But the HPV vaccine can help protect teens and young adults. […] A recent study showed it reduced the risk of developing cervical cancer by almost 90% among girls vaccinated before age 17. […] The vaccine helps prevent you from getting infected with HPV. While there are currently several vaccines that can help prevent HPV infection, the only one available for use in the U.S. is Gardasil-9. […] The vaccine we have here protects against many types of HPV, including strains 16 and 18, which are the types most commonly linked to cervical cancer. […] Generally, its recommended that boys and girls get the vaccine when theyre 11 or 12, to protect them before they become sexually active. […] The HPV vaccine itself is given as a series of shots. Children ages 9 through 14 get two doses, 6 to 12 months apart. People between the ages of 15 and 45 or those who are immunocompromised get three doses, given over 6 months.

• #21 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  Megan Wysong, MPH, senior research associate with the International Vaccine Access Center (IVAC), says the HPV vaccine is nearly 100% effective at preventing persistent infections caused by HPV vaccine types. […] Since 2006, when HPV vaccines were first distributed in the U.S., the number of HPV infections and cervical precancers dropped drastically, per CDC data: Infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teenage girls and 81% among young adult women. […] Cervical precancers caused by the HPV types most often linked to cervical cancer dropped by 40% among vaccinated women. […] All HPV vaccines protect against HPV strains that cause 90% of cervical and anal cancers, and many cancers that can affect the throat and genitals. […] Research has demonstrated that HPV vaccines provide long-lasting protection against both HPV infections and diseases resulting from these infections, says Wysong.

• #22 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  Megan Wysong, MPH, senior research associate with the International Vaccine Access Center (IVAC), says the HPV vaccine is nearly 100% effective at preventing persistent infections caused by HPV vaccine types. […] Since 2006, when HPV vaccines were first distributed in the U.S., the number of HPV infections and cervical precancers dropped drastically, per CDC data: Infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teenage girls and 81% among young adult women. […] Cervical precancers caused by the HPV types most often linked to cervical cancer dropped by 40% among vaccinated women. […] All HPV vaccines protect against HPV strains that cause 90% of cervical and anal cancers, and many cancers that can affect the throat and genitals. […] Research has demonstrated that HPV vaccines provide long-lasting protection against both HPV infections and diseases resulting from these infections, says Wysong.

• #23 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  Teens and young adults should be vaccinated too. Everyone through age 26 years should get HPV vaccine if they were not fully vaccinated already. […] Some adults age 27 through 45 years who were not already vaccinated might choose to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them. […] HPV vaccination works extremely well. […] Since HPV vaccination was first recommended in 2006, infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women. […] HPV vaccination has also reduced the number of cases of precancers of the cervix in young women. […] The protection provided by HPV vaccines lasts a long time. People who received HPV vaccines were followed for at least about 12 years, and their protection against HPV has remained high with no evidence of decreasing over time.

• #24 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] The findings from the current study indicate that nurses could play a significant role in providing quantitative and randomized controlled trials that focus on HPV vaccine education interventions to enhance vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] The HPV vaccination education content focused on how well the vaccine works, the safety of the vaccine, and the benefits of the vaccine. […] The current study described the efficacy of an intervention to improve vaccination confidence, attitudes, and beliefs toward HPV vaccination among non-Hispanic Black mothers. […] Nurses can play a significant role in providing more HPV vaccination education intervention studies to reduce racial and ethnic disparities in cervical cancer.

• #25 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  The vaccine can be given as early as age 9 and up through age 26, but Gypsyamber DSouza, PhD 07, MPH, MS, professor in Epidemiology, says it is most effective when given at the recommended ages of 1112. […] There is a stronger immune response when vaccinated at a young age, she says, and it is important to have that immune protection before exposure to HPV. […] But kids older than 12 who have not been vaccinated can and should still be vaccinated, say both DSouza and Wysong. […] While younger is ideal, the vaccine is still effective if given later. […] The short answer is no. Studies have shown that receiving the vaccine at the recommended age doesnt increase sexual behavior or cause people to become sexually active earlier. […] The CDC recommends that everyone under age 26 should get the HPV vaccine even if they are already sexually active, Wysong says.

• #26 HPV vaccine: Who needs it, how it works

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292

  Most people catch HPV soon after they become sexually active. But even if you have one strain of HPV, you might still benefit from the vaccine. It can protect you from other strains that you don’t yet have. […] The HPV vaccine has been found to be safe in many studies. […] Overall, the effects tend to be mild. The most common side effects of HPV vaccines include soreness, swelling or redness at the injection site. […] The HPV vaccine is part of the routine childhood vaccines schedule. Each state in the U.S. decides which vaccines from that schedule are needed for school attendance. […] Yes. The HPV vaccine doesn’t replace Pap tests. Screening for cervical cancer with regular Pap tests starting at age 21 is an essential part of preventive healthcare.

• #27 Human Papillomavirus Vaccine (HPV) | AAFP

  https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/disease-pop-immunization/human-papillomavirus-vaccine-hpv.html

  It is recommended by the Advisory Committee on Immunization Practices (ACIP) and the AAFP that children with a history of sexual abuse or assault get routine HPV vaccination beginning at age 9. […] More than 205 million doses of the HPV vaccine have been distributed worldwide and nearly 90 million doses of HPV vaccines have been distributed in the United States from June 2006 through March 2016. […] Each vaccine continues to be monitored for any safety problems. […] Among women who have not been previously infected with a targeted HPV type, 2vHPV, and 4vHPV have over 95% efficacy in preventing cervical pre-cancers caused by HPV16 and HPV18.

• #28 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  HPV Vaccine is very safe. Over 15 years of monitoring have shown that HPV Vaccines are very safe and effective. Like all vaccines, scientists continue to monitor vaccines to ensure they are safe and effective. […] HPV Vaccine is available in many doctor’s offices and clinics, especially those that take care of children and young adults. Many pharmacies also vaccinate children and adults for HPV. In addition, all of ADH’s Local Health Units (LHUs) give HPV vaccinations to all children and some adults. […] Most health insurance plans cover routine vaccinations like HPV vaccine. The Vaccines For Children (VFC) program also provides vaccines for children 18 years and younger who are uninsured, underinsured, Medicaid-eligible, American Indian, or Alaska Native. In AR many clinics that care for children, as well as some pharmacies, are VFC providers. In addition, all of ADH’s Local Health Units (LHUs) are VFC providers.

• #29 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons. […] A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine. […] HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. […] HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. […] The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection. […] No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.

• #30 HPV Vaccine: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hpv-vaccine-care-instructions.abn0347

  Common side effects of getting the vaccine include headache, fever, and redness or swelling at the site of the shot. […] If you are a parent of a child who’s getting the shot, talk to your child about HPV and the vaccine. […] Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

• #31 HPV vaccine: Who needs it, how it works

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292

  Most people catch HPV soon after they become sexually active. But even if you have one strain of HPV, you might still benefit from the vaccine. It can protect you from other strains that you don’t yet have. […] The HPV vaccine has been found to be safe in many studies. […] Overall, the effects tend to be mild. The most common side effects of HPV vaccines include soreness, swelling or redness at the injection site. […] The HPV vaccine is part of the routine childhood vaccines schedule. Each state in the U.S. decides which vaccines from that schedule are needed for school attendance. […] Yes. The HPV vaccine doesn’t replace Pap tests. Screening for cervical cancer with regular Pap tests starting at age 21 is an essential part of preventive healthcare.

• #32 The Human Papillomavirus (HPV) Vaccine

  https://www.health.ny.gov/diseases/communicable/human_papillomavirus/

  Common, mild side effects include redness and pain at the injection site, low-grade fever, dizziness, and nausea. […] Anyone who has ever had a life-threatening allergic reaction to any component of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine. […] HPV vaccine is not recommended for pregnant women. […] All private insurance plans regulated by New York State are required to cover the cost of all ACIP-recommended vaccines, including HPV vaccine, for patients through the age of 18. […] A federal program called the Vaccines for Children (VFC) Program can help pay for your child’s vaccines if he or she is 18 years if age or younger and is not insured, underinsured, eligible for Medicaid, an American Indian or an Alaska Native.

• #33 GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) Dosing Schedule

  https://www.gardasil9.com/patient-pd/what-is-gardasil-9/gardasil9-schedule/

  HPV, human papillomavirus. […] The CDC notes that HPV vaccination may begin at age 9, and recommends it routinely for the 11- to 12-year-old age group. […] Make sure your child completes their recommended vaccine schedule. […] If your child is 9- to 14-years-old, your child’s doctor will determine whether your child needs a 2-dose or 3-dose schedule of GARDASIL 9. […] Fainting can happen after getting an HPV vaccine. […] For this reason, your child’s doctor may ask your child to sit or lie down for 15 minutes after he or she gets GARDASIL 9. […] If your child misses a dose of GARDASIL 9, make sure that your child gets all doses recommended by your health care professional so that your child gets the best protection. […] GARDASIL 9 helps protect individuals ages 9 to 45 against the following diseases caused by 9 types of HPV: cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females.

• #34 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons. […] A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine. […] HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. […] HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. […] The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection. […] No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.

• #35 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons. […] A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine. […] HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. […] HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. […] The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection. […] No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.

• #36 HPV (Human Papillomavirus) Vaccine: What You Need to Know | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hpv-human-papillomavirus-vaccine-what-you-need-to-know.cdc30

  In some cases, your health care provider may decide to postpone HPV vaccination until a future visit. […] People with minor illnesses, such as a cold, may be vaccinated. People who are moderately or severely ill should usually wait until they recover before getting HPV vaccine. […] Your health care provider can give you more information.

• #37 Human Papillomavirus Vaccine (HPV) | AAFP

  https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/disease-pop-immunization/human-papillomavirus-vaccine-hpv.html

  Despite overwhelming evidence of the safety and effectiveness of the human papillomavirus (HPV) vaccine, vaccination rates remain low. The American Academy of Family Physicians (AAFP) urges physicians to strongly recommend the HPV vaccine to their patients. […] Physicians give consistent, strong recommendations for the HPV vaccine. A physicians recommendation is the single best predictor of vaccination. […] The currently available HPV vaccine is the 9-valent human papillomavirus (9vHPV) vaccine. This vaccine protects against the most common HPV types, which cause 90% of cervical, vaginal, vulvar, anal, and penile cancers. Additionally, this vaccine prevents HPV types that cause genital warts in both males and females. […] The 9vHPV vaccine is routinely recommended for both males and females, routinely given at age 11 or 12. Specifically, the 9vHPV vaccine is recommended from ages 9 through 26 for females and ages 9 through 21 for males.

• #38 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Testing for HPV DNA is not recommended before vaccination. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. […] Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine.

• #39 Strategies for Discussing HPV Vaccine Adherence in Your Practice

  https://www.chesshealthsolutions.com/2024/04/09/strategies-for-discussing-hpv-vaccine-adherence-in-your-practice/

  Talking to patients about the HPV vaccine requires a blend of empathy, clear communication, and factual education. […] The goal is to educate patients and guardians about the vaccines benefits, address any concerns, and encourage vaccinations to prevent HPV-related cancers. […] Emphasize that vaccination can prevent more than 90% of HPV-attributable cancers. […] Emphasize that the HPV vaccine is highly effective in preventing infections with the types of HPV most commonly associated with cancer and genital warts. […] Present the HPV vaccine as a normal part of the adolescent vaccine schedule, similar to vaccines for tetanus or meningitis. […] Engage in conversations about the HPV vaccine with patients and their guardians as early as possible, ideally during preteen years (ages 9-12).

• #40 Strategies for Discussing HPV Vaccine Adherence in Your Practice

  https://www.chesshealthsolutions.com/2024/04/09/strategies-for-discussing-hpv-vaccine-adherence-in-your-practice/

  Tailor the conversation to the patients age, sex, cultural background, and potential concerns about the vaccine. […] Practice assertive communication by strongly recommending the HPV vaccine as a safe and effective way to prevent cancer. […] Acknowledge and address any fears or misconceptions patients may have about the vaccine. […] Counter myths and misinformation with facts and research to reinforce the vaccines safety and efficacy. […] For patients or guardians who are hesitant, offer additional resources and suggest a follow-up conversation. […] Provide educational materials that patients and guardians can review at home. […] Ensure that everyone in the practice, from receptionists to nurses and doctors, can provide consistent information about HPV and the vaccine. […] Make educational materials readily available and ensure the clinic atmosphere supports vaccination discussions.

• #41 Strategies for Discussing HPV Vaccine Adherence in Your Practice

  https://www.chesshealthsolutions.com/2024/04/09/strategies-for-discussing-hpv-vaccine-adherence-in-your-practice/

  Talking to patients about the HPV vaccine requires a blend of empathy, clear communication, and factual education. […] The goal is to educate patients and guardians about the vaccines benefits, address any concerns, and encourage vaccinations to prevent HPV-related cancers. […] Emphasize that vaccination can prevent more than 90% of HPV-attributable cancers. […] Emphasize that the HPV vaccine is highly effective in preventing infections with the types of HPV most commonly associated with cancer and genital warts. […] Present the HPV vaccine as a normal part of the adolescent vaccine schedule, similar to vaccines for tetanus or meningitis. […] Engage in conversations about the HPV vaccine with patients and their guardians as early as possible, ideally during preteen years (ages 9-12).

• #42 School nurses play critical role in HPV vaccination promotion and compliance | School of Nursing

  https://nursing.gmu.edu/news/2024-02/school-nurses-play-critical-role-hpv-vaccination-promotion-and-compliance

  Each year, an estimated 13 million Americans are infected with human papillomavirus (HPV). The Centers for Disease Control and Prevention (CDC) estimates that the HPV vaccine can prevent over 90% of cancers caused by HPV. […] School nurses are uniquely situated to be at the forefront of preventing HPV-related cancers through promoting timely vaccination among children and adolescents. […] Given their proximity to adolescents, school nurses are in the prime position to administer vaccinations and ensure proper adherence to vaccine series schedules, including the HPV vaccine. […] Improving awareness and supporting our efforts can have a significant impact on increasing vaccination rates, said McNally. […] There are several complex factors that impact nursing practice. Nurses have good vaccine knowledge and positive attitudes, but poor workflow processes, competing demands, and difficulties communicating about vaccines challenge school nurses’ ability to do their job fully, McNally said.

• #43 School nurses play critical role in HPV vaccination promotion and compliance | School of Nursing

  https://nursing.gmu.edu/news/2024-02/school-nurses-play-critical-role-hpv-vaccination-promotion-and-compliance

  McNally recommends training nurses on vaccine safety and efficacy, teaching strategies to engage with parents and guardians, providing schools with the necessary resources to administer vaccines, and advocating for policies that support accessible vaccinations as actionable steps to support nurses and increase HPV vaccination.

• #44 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] The findings from the current study indicate that nurses could play a significant role in providing quantitative and randomized controlled trials that focus on HPV vaccine education interventions to enhance vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] The HPV vaccination education content focused on how well the vaccine works, the safety of the vaccine, and the benefits of the vaccine. […] The current study described the efficacy of an intervention to improve vaccination confidence, attitudes, and beliefs toward HPV vaccination among non-Hispanic Black mothers. […] Nurses can play a significant role in providing more HPV vaccination education intervention studies to reduce racial and ethnic disparities in cervical cancer.

• #45 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] The findings from the current study indicate that nurses could play a significant role in providing quantitative and randomized controlled trials that focus on HPV vaccine education interventions to enhance vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] The HPV vaccination education content focused on how well the vaccine works, the safety of the vaccine, and the benefits of the vaccine. […] The current study described the efficacy of an intervention to improve vaccination confidence, attitudes, and beliefs toward HPV vaccination among non-Hispanic Black mothers. […] Nurses can play a significant role in providing more HPV vaccination education intervention studies to reduce racial and ethnic disparities in cervical cancer.

• #46 Strategies for Discussing HPV Vaccine Adherence in Your Practice

  https://www.chesshealthsolutions.com/2024/04/09/strategies-for-discussing-hpv-vaccine-adherence-in-your-practice/

  Tailor the conversation to the patients age, sex, cultural background, and potential concerns about the vaccine. […] Practice assertive communication by strongly recommending the HPV vaccine as a safe and effective way to prevent cancer. […] Acknowledge and address any fears or misconceptions patients may have about the vaccine. […] Counter myths and misinformation with facts and research to reinforce the vaccines safety and efficacy. […] For patients or guardians who are hesitant, offer additional resources and suggest a follow-up conversation. […] Provide educational materials that patients and guardians can review at home. […] Ensure that everyone in the practice, from receptionists to nurses and doctors, can provide consistent information about HPV and the vaccine. […] Make educational materials readily available and ensure the clinic atmosphere supports vaccination discussions.

• #47 Strategies for Discussing HPV Vaccine Adherence in Your Practice

  https://www.chesshealthsolutions.com/2024/04/09/strategies-for-discussing-hpv-vaccine-adherence-in-your-practice/

  Work with schools, religious groups, and local health departments to promote HPV vaccination awareness and education. […] Keep records of patient vaccinations to monitor progress and identify those who need follow-up reminders. […] Remind patients and parents about the necessity of completing the entire vaccine series for full protection.

• #48 GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) Dosing Schedule

  https://www.gardasil9.com/patient-pd/what-is-gardasil-9/gardasil9-schedule/

  HPV, human papillomavirus. […] The CDC notes that HPV vaccination may begin at age 9, and recommends it routinely for the 11- to 12-year-old age group. […] Make sure your child completes their recommended vaccine schedule. […] If your child is 9- to 14-years-old, your child’s doctor will determine whether your child needs a 2-dose or 3-dose schedule of GARDASIL 9. […] Fainting can happen after getting an HPV vaccine. […] For this reason, your child’s doctor may ask your child to sit or lie down for 15 minutes after he or she gets GARDASIL 9. […] If your child misses a dose of GARDASIL 9, make sure that your child gets all doses recommended by your health care professional so that your child gets the best protection. […] GARDASIL 9 helps protect individuals ages 9 to 45 against the following diseases caused by 9 types of HPV: cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females.

• #49 Your Child’s Vaccines: Human Papillomavirus (HPV) Vaccine (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/hpv-vaccine.html

  The HPV vaccine protects against human papillomavirus (HPV), a virus that can cause different types of cancer (such as cancer of the cervix, penis, anus, vagina, vulva, and throat) as well as genital warts. […] The vaccine is recommended for girls and boys 11-12 years old (though kids as young as 9 also can get it) and for older kids who aren’t yet vaccinated. […] The vaccine is an important way to prevent infection and the spread of HPV. It works best when given before someone might be exposed to the virus. […] Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever, and to find out the right dose. […] A warm, damp cloth or a heating pad on the site of the shot may help reduce soreness, as can moving or using the arm.

• #50 Your Child’s Vaccines: Human Papillomavirus (HPV) Vaccine (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/hpv-vaccine.html

  The HPV vaccine protects against human papillomavirus (HPV), a virus that can cause different types of cancer (such as cancer of the cervix, penis, anus, vagina, vulva, and throat) as well as genital warts. […] The vaccine is recommended for girls and boys 11-12 years old (though kids as young as 9 also can get it) and for older kids who aren’t yet vaccinated. […] The vaccine is an important way to prevent infection and the spread of HPV. It works best when given before someone might be exposed to the virus. […] Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever, and to find out the right dose. […] A warm, damp cloth or a heating pad on the site of the shot may help reduce soreness, as can moving or using the arm.

• #51 Your Child’s Vaccines: Human Papillomavirus (HPV) Vaccine (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/hpv-vaccine.html

  The HPV vaccine protects against human papillomavirus (HPV), a virus that can cause different types of cancer (such as cancer of the cervix, penis, anus, vagina, vulva, and throat) as well as genital warts. […] The vaccine is recommended for girls and boys 11-12 years old (though kids as young as 9 also can get it) and for older kids who aren’t yet vaccinated. […] The vaccine is an important way to prevent infection and the spread of HPV. It works best when given before someone might be exposed to the virus. […] Check with your doctor to see if you can give either acetaminophen or ibuprofen for pain or fever, and to find out the right dose. […] A warm, damp cloth or a heating pad on the site of the shot may help reduce soreness, as can moving or using the arm.

• #52 Schedule HPV Vaccine (Human Papillomavirus) | Walgreens

  https://www.walgreens.com/topic/pharmacy/scheduler/human-papillomavirus-hpv-vaccine_36.jsp

  HPV vaccine is routinely recommended for children ages 11-12 to ensure they’re protected before they’re exposed to the virus. […] The HPV vaccine may be given beginning at age 9 years and vaccination is recommended for everyone through age 26. […] The HPV vaccine may be given to adults ages 27-45, based on discussions between the patient and their healthcare provider. […] Contact your doctor or pharmacist if you have any unexpected or worsening reactions after receiving a vaccine.

• #53 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  Be sure to emphasize the vaccine will not be completely effective unless all shots are scheduled and administered as directed.(For 15 yrs old 2 doses; for 15 and older, 3 doses with the first one at an elected time, the second one 2 months later, then the third injection 6 months after the first one.) […] Tell young women that the HPV vaccine does not take the place of routine gynecological care and Pap tests. They should still make their appointments for Pap tests. […] Similar to other vaccines, not all recipients of the HPV vaccine will be protected. […] Explain to young women that condoms offer some protection against HPV, but that avoiding sexual contact is the only way to completely protect oneself from HPV.

• #54 GARDASIL®9 (Human Papillomavirus 9-valent Vaccine, Recombinant) | Official Site

  https://www.gardasil9.com/

  GARDASIL 9 helps protect individuals ages 9 to 45 against the following diseases caused by 9 types of HPV: cervical, vaginal, and vulvar cancers in females, anal cancer, certain head and neck cancers, such as throat and back of mouth cancers and genital warts in both males and females. […] Vaccination does not remove the need for recommended cancer screenings, and its important to get routine cervical cancer screenings. GARDASIL 9 does not treat HPV infection, cancer, or genital warts. […] The appropriate dosing schedule will be determined by a health care professional. […] Only a doctor or health care professional can decide if GARDASIL 9 is right for you or your child.

• #55 Human Papillomavirus (HPV): Infection and Vaccination | ACOG

  https://www.acog.org/womens-health/faqs/hpv-vaccination

  You can protect yourself against HPV infection by getting the HPV vaccine. The vaccine is safe and effective and protects against the HPV types that are the most common cause of genital warts and cancer. […] Yes, the HPV vaccine is a safe and effective way to protect yourself against HPV-related diseases. […] The HPV vaccine is highly effective when given before a person has sex. The vaccine can reduce the risk of HPV-related genital warts and cancer by up to 99 percent when all recommended shots have been given. […] The HPV vaccine is given as a series of shots: For those age 9 to 14, two shots of vaccine are recommended. The second shot should be given 6 to 12 months after the first one. […] For those age 15 through 26, three shots of vaccine are recommended. The second shot should be given 1 to 2 months after the first one. The third shot should be given 6 months after the first shot.

• #56 HPV Vaccination Recommendations | CDC

  https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html

  Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons. […] A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine. […] HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. […] HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. […] The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection. […] No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.

• #57 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  The CDC now recommends that young people under the age of 15 require only 2 doses. The first dose before the age of 15 and the second one within 6-12 months later. All others who are 15 or older should continue to receive a series of 3 injections over a 6 month period. The first vaccine injection can be given at any time. The second injection should be given two months after the first one, and the third injection should be given six months after the initial one. It is preferred that the same HPV vaccine be used for the entire 3 shot series. If a patient is late to receive the next vaccine in the series, the vaccine doses should not be repeated. […] Yes, there are some points to consider when counseling young women about the HPV vaccine. […] Avoid administering the vaccine to pregnant females. If a girl has already had one or two shots before she became pregnant, delay the other shots until she completes her pregnancy.

• #58 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Testing for HPV DNA is not recommended before vaccination. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. […] Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine.

• #59 Human papillomavirus (HPV) Vaccine – Mother To Baby | Fact Sheets – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK582527/

  This sheet is about exposure to the HPV vaccine during pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider. […] The HPV vaccine protects against infection with some types of HPV that cause cancer and genital warts. Gardasil9, which protects against 9 of the HPV virus types, is the brand name of the HPV vaccine currently available in the United States. […] The vaccine is approved for people between the ages of 9 and 45 years of age but provides the most protection when given before becoming sexually active. […] The CDC notes that the HPV vaccine can be given to a person who is breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions. […] There is no evidence to suggest that getting the HPV vaccine would make it harder to get pregnant in the future.

• #60 The Human Papillomavirus (HPV) Vaccine

  https://www.health.ny.gov/diseases/communicable/human_papillomavirus/

  Older teens and young adults can still benefit from the HPV vaccine – even if they are sexually active. […] The vaccine will protect them from the most common types of HPV. […] Individuals with weak immune systems (including people living with HIV/AIDS) ages nine (9) through 26, should get the three (3) dose vaccine series at 1, 1-2, and 6 months. […] The HPV vaccine is recommended for preteen boys and girls aged 9 to 12 years so they are protected before ever being exposed to the virus. […] The HPV vaccine is a safe and effective way to protect against the serious health problems that HPV can cause. […] The vaccine is given as a series of two (2) or three (3) shots, depending on when it is started. […] If your child has started, but not completed the HPV vaccine series, talk with your doctor about completing the series so he or she will have full protection.

• #61 Human papillomavirus (HPV) vaccines: Canadian Immunization Guide – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-9-human-papillomavirus-vaccine.html

  Individuals 9 to 20 years of age, unless immunocompromised, should receive 1 dose of HPV vaccine. […] Individuals 21 to 26 years of age, unless immunocompromised, should receive 2 doses of HPV vaccine. […] Individuals 27 years of age and older, unless immunocompromised, may receive a 2-dose schedule of the HPV vaccine with shared decision making and discussion with a healthcare provider. […] HPV vaccine can be offered in pregnancy. Routine questioning about last menstrual period and/or pregnancy is not required or recommended before offering HPV vaccine. […] HPV vaccine prevents abnormal Pap smears and HPV-associated cancers, including cervical and anal cancers. […] When recommended to receive HPV vaccine, individuals who are considered immunocompromised and/or living with HIV should receive a 3-dose schedule of 9vHPV vaccine.

• #62 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Testing for HPV DNA is not recommended before vaccination. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. […] Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine.

• #63 Human Papillomavirus Vaccine (HPV) | AAFP

  https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/disease-pop-immunization/human-papillomavirus-vaccine-hpv.html

  It is recommended by the Advisory Committee on Immunization Practices (ACIP) and the AAFP that children with a history of sexual abuse or assault get routine HPV vaccination beginning at age 9. […] More than 205 million doses of the HPV vaccine have been distributed worldwide and nearly 90 million doses of HPV vaccines have been distributed in the United States from June 2006 through March 2016. […] Each vaccine continues to be monitored for any safety problems. […] Among women who have not been previously infected with a targeted HPV type, 2vHPV, and 4vHPV have over 95% efficacy in preventing cervical pre-cancers caused by HPV16 and HPV18.

• #64 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Further, obstetriciangynecologists are encouraged to stock and administer HPV vaccines in their offices when feasible. […] Obstetriciangynecologists play a critical role and should assess and vaccinate adolescent girls age 1112 years and previously unvaccinated young women during the catch-up period (ages 1326 years). […] Health care professionals should use shared clinical decision making with previously unvaccinated women aged 2745 years to assess the benefit of HPV vaccination.

• #65 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  Teens and young adults should be vaccinated too. Everyone through age 26 years should get HPV vaccine if they were not fully vaccinated already. […] Some adults age 27 through 45 years who were not already vaccinated might choose to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them. […] HPV vaccination works extremely well. […] Since HPV vaccination was first recommended in 2006, infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women. […] HPV vaccination has also reduced the number of cases of precancers of the cervix in young women. […] The protection provided by HPV vaccines lasts a long time. People who received HPV vaccines were followed for at least about 12 years, and their protection against HPV has remained high with no evidence of decreasing over time.

• #66 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  Health care providers may recommend the vaccine past 26 years of age based on health status, Limaye says. […] Although Gardasil-9 is approved for use up to age 45, it is not always recommended. […] The vaccine is less effective in people already exposed to HPV, Wysong says, but it is still recommended to get the vaccine. […] Because the HPV protects against nine strains of the virus, Limaye explains, even if someone has been infected with one type, they can still benefit from protection against other strains. […] While the HPV vaccine prevents new HPV infections, Limaye adds, it does not treat existing HPV infections or diseases. […] Gardasil-9 is not recommended for use during pregnancy. […] Like all other vaccines, its not recommended to anyone who has ever had a life-threatening allergic reaction to any of its ingredients or to a previous dose of the vaccine.

• #67 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  HPV Vaccine is very safe. Over 15 years of monitoring have shown that HPV Vaccines are very safe and effective. Like all vaccines, scientists continue to monitor vaccines to ensure they are safe and effective. […] HPV Vaccine is available in many doctor’s offices and clinics, especially those that take care of children and young adults. Many pharmacies also vaccinate children and adults for HPV. In addition, all of ADH’s Local Health Units (LHUs) give HPV vaccinations to all children and some adults. […] Most health insurance plans cover routine vaccinations like HPV vaccine. The Vaccines For Children (VFC) program also provides vaccines for children 18 years and younger who are uninsured, underinsured, Medicaid-eligible, American Indian, or Alaska Native. In AR many clinics that care for children, as well as some pharmacies, are VFC providers. In addition, all of ADH’s Local Health Units (LHUs) are VFC providers.

• #68 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  Yes. Gardasil-9 was approved after robust clinical trials with more than 15,000 females and males. […] Studies have consistently demonstrated its safety and have shown that it has no effect on fertility. […] HPV vaccines are widely available, and most private health insurance plans cover the cost. […] You can get the vaccine from a variety of sources, including your private health care provider, pharmacy, community clinics, health departments, and Planned Parenthood, says Wysong.

• #69 The Human Papillomavirus (HPV) Vaccine

  https://www.health.ny.gov/diseases/communicable/human_papillomavirus/

  Common, mild side effects include redness and pain at the injection site, low-grade fever, dizziness, and nausea. […] Anyone who has ever had a life-threatening allergic reaction to any component of HPV vaccine, or to a previous dose of HPV vaccine, should not get the vaccine. […] HPV vaccine is not recommended for pregnant women. […] All private insurance plans regulated by New York State are required to cover the cost of all ACIP-recommended vaccines, including HPV vaccine, for patients through the age of 18. […] A federal program called the Vaccines for Children (VFC) Program can help pay for your child’s vaccines if he or she is 18 years if age or younger and is not insured, underinsured, eligible for Medicaid, an American Indian or an Alaska Native.

• #70 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  HPV Vaccine is very safe. Over 15 years of monitoring have shown that HPV Vaccines are very safe and effective. Like all vaccines, scientists continue to monitor vaccines to ensure they are safe and effective. […] HPV Vaccine is available in many doctor’s offices and clinics, especially those that take care of children and young adults. Many pharmacies also vaccinate children and adults for HPV. In addition, all of ADH’s Local Health Units (LHUs) give HPV vaccinations to all children and some adults. […] Most health insurance plans cover routine vaccinations like HPV vaccine. The Vaccines For Children (VFC) program also provides vaccines for children 18 years and younger who are uninsured, underinsured, Medicaid-eligible, American Indian, or Alaska Native. In AR many clinics that care for children, as well as some pharmacies, are VFC providers. In addition, all of ADH’s Local Health Units (LHUs) are VFC providers.

• #71 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  HPV Vaccine is Cancer Prevention […] HPV vaccine protects against infection with the Human Papillomavirus (HPV), which can cause several types of cancer in both men and women. The vaccine also prevents most genital warts and cervical precancers. Gardasil 9, which protects against 9 HPV types, is the only HPV vaccine currently in use in the United States. […] HPV can cause oropharyngeal (back of mouth and throat), cervical, penile, anal, and vulvar cancers. HPV is estimated to cause nearly 36,500 cases of cancer in men and women every year in the United States. HPV vaccination can prevent 33,700 of these cancers by preventing the infections that cause them. […] All children age 9-12 years, both boys and girls, should get two doses of HPV Vaccine, given 6-12 months apart. […] Early protection works best. That’s why HPV vaccine is recommended earlier rather than later, since it protects children best when given before they ever have contact with the virus.

• #72 HPV Vaccine – Arkansas Department of Health

  https://healthy.arkansas.gov/programs-services/diseases-conditions/infectious-disease/std-prevention/hpv/hpv-vaccine/

  Teens and young adults should be vaccinated too. Everyone through age 26 years should get HPV vaccine if they were not fully vaccinated already. […] Some adults age 27 through 45 years who were not already vaccinated might choose to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them. […] HPV vaccination works extremely well. […] Since HPV vaccination was first recommended in 2006, infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women. […] HPV vaccination has also reduced the number of cases of precancers of the cervix in young women. […] The protection provided by HPV vaccines lasts a long time. People who received HPV vaccines were followed for at least about 12 years, and their protection against HPV has remained high with no evidence of decreasing over time.

• #73 Do I Need an HPV Vaccine? | Johns Hopkins | Bloomberg School of Public Health

  https://publichealth.jhu.edu/2024/do-i-need-an-hpv-vaccine

  Megan Wysong, MPH, senior research associate with the International Vaccine Access Center (IVAC), says the HPV vaccine is nearly 100% effective at preventing persistent infections caused by HPV vaccine types. […] Since 2006, when HPV vaccines were first distributed in the U.S., the number of HPV infections and cervical precancers dropped drastically, per CDC data: Infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teenage girls and 81% among young adult women. […] Cervical precancers caused by the HPV types most often linked to cervical cancer dropped by 40% among vaccinated women. […] All HPV vaccines protect against HPV strains that cause 90% of cervical and anal cancers, and many cancers that can affect the throat and genitals. […] Research has demonstrated that HPV vaccines provide long-lasting protection against both HPV infections and diseases resulting from these infections, says Wysong.

• #74 Human Papillomavirus Vaccination | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/08/human-papillomavirus-vaccination

  Vaccination is recommended for women through age 26 years even if the patient is tested for HPV DNA and the results are positive. […] Testing for HPV DNA is not recommended before vaccination. […] Human papillomavirus vaccination is not recommended during pregnancy; however, routine pregnancy testing is not recommended before vaccination. […] The HPV vaccine can and should be given to breastfeeding women age 26 years and younger who have not previously been vaccinated. […] In children with a history of sexual abuse or assault, the HPV vaccine should be given as early as possible, starting at age 9 years. […] High rates of HPV vaccination will reduce the burden of HPV-related disease in the United States. Current vaccination rates are unacceptably low. […] Obstetriciangynecologists and other health care professionals should strongly recommend HPV vaccination to eligible patients and stress the benefits and safety of the HPV vaccine.

• #75

  https://www.accc-cancer.org/acccbuzz/blog-post-template/accc-buzz/2025/01/21/cervical-cancer-awareness-empowering-prevention-through-the-hpv-vaccine

  The HPV vaccine works by protecting against the HPV strains most commonly linked to cervical cancer. Gardasil 9, for example, covers 9 HPV types, including those responsible for the majority of cervical cancers. The vaccine has proven highly effective in preventing these high-risk HPV infections. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend routine vaccination for children aged 11 or 12, with the option to start as early as age 9. […] To overcome these barriers to HPV vaccination, a multifaceted approach is essential. Education and awareness campaigns are critical for dispelling myths and misinformation about the vaccine. Public health initiatives can play a significant role in educating communities about the safety and benefits of vaccination. Policy changes and access expansion, such as implementing school vaccination requirements and supporting programs like VFC, can ensure broader vaccine coverage.

• #76 HPV Vaccination Uptake Among Adolescents Varies by Health Care Facility Type

  https://www.infectiousdiseaseadvisor.com/news/hpv-vaccination-uptake-among-adolescents-varies-by-health-care-facility-type/

  A greater focus is needed on vaccination recommendation and uptake among adolescent patients at public health care facilities. […] To reduce disparities in access to HPV vaccination between private and public facilities, as well as increase awareness about HPV as a disease and its associated cancer risks and the HPV vaccine and its safety, urgent actions are needed to enhance clinician participation in the promotion of HPV vaccination, especially in public facilities. […] Additionally, clinician recommendations for HPV vaccination were also highest at hospital (86.3%) and private (83.5%) vs public (72.1%; P .001) facilities. […] Those who received recommended vaccines at public vs private facilities had lower odds of initiating (adjusted OR [aOR], 0.71; 95% CI, 0.58-0.88) and completing (aOR, 0.62; 95% CI, 0.51-0.76) the HPV vaccine series.

• #77

  https://www.accc-cancer.org/acccbuzz/blog-post-template/accc-buzz/2025/01/21/cervical-cancer-awareness-empowering-prevention-through-the-hpv-vaccine

  The HPV vaccine works by protecting against the HPV strains most commonly linked to cervical cancer. Gardasil 9, for example, covers 9 HPV types, including those responsible for the majority of cervical cancers. The vaccine has proven highly effective in preventing these high-risk HPV infections. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend routine vaccination for children aged 11 or 12, with the option to start as early as age 9. […] To overcome these barriers to HPV vaccination, a multifaceted approach is essential. Education and awareness campaigns are critical for dispelling myths and misinformation about the vaccine. Public health initiatives can play a significant role in educating communities about the safety and benefits of vaccination. Policy changes and access expansion, such as implementing school vaccination requirements and supporting programs like VFC, can ensure broader vaccine coverage.

• #78 Human Papillomavirus (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568814/

  To prevent lower anogenital tract HPV infection by the most common high-risk and low-risk subtypes, the CDC recommends that boys and girls be vaccinated for HPV starting at ages 11 to 12. It is further recommended that women get vaccinated through the age of 26 and men through the age of 21. […] The 9 valent HPV vaccine is available to prevent certain cancerous lesions in males and females. The HPV vaccine covers HPV subtypes 6,11,16,18,31,33,45,52 and 58. The effectiveness of the vaccine has been inferred from several studies. It has been shown to prevent anal cancer, genital warts, cervical intraepithelial neoplasia, vulvar intraepithelial neoplasia, and anal intraepithelial neoplasia. The vaccine is most effective when administered before initiating sexual activity at ages 9-12. […] Educate patient about the HPV vaccine. […] The pharmacists should also encourage the patients to be vaccinated against HPV.

• #79 HPV Vaccine: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hpv-vaccine-care-instructions.abn0347

  The HPV (human papillomavirus) vaccine protects against HPV. […] Experts recommend that children age 11 or 12 get the HPV vaccine, but the vaccine can be given from age 9 to 26. […] Children ages 9 to 14 get the vaccine in a series of two shots. Some children may need a third dose. Anyone age 15 and older gets the vaccine as a three-dose series. For the vaccine to work best, all shots in the series must be given. […] The best time to get the vaccine is before a person becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. […] Having the HPV vaccine does not change the need for Pap tests. If you’ve had the HPV vaccine, follow the same Pap test schedule as those who haven’t had the vaccine. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems.

• #80 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  The CDC now recommends that young people under the age of 15 require only 2 doses. The first dose before the age of 15 and the second one within 6-12 months later. All others who are 15 or older should continue to receive a series of 3 injections over a 6 month period. The first vaccine injection can be given at any time. The second injection should be given two months after the first one, and the third injection should be given six months after the initial one. It is preferred that the same HPV vaccine be used for the entire 3 shot series. If a patient is late to receive the next vaccine in the series, the vaccine doses should not be repeated. […] Yes, there are some points to consider when counseling young women about the HPV vaccine. […] Avoid administering the vaccine to pregnant females. If a girl has already had one or two shots before she became pregnant, delay the other shots until she completes her pregnancy.

• #81 HPV vaccine: Who needs it, how it works

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292

  Most people catch HPV soon after they become sexually active. But even if you have one strain of HPV, you might still benefit from the vaccine. It can protect you from other strains that you don’t yet have. […] The HPV vaccine has been found to be safe in many studies. […] Overall, the effects tend to be mild. The most common side effects of HPV vaccines include soreness, swelling or redness at the injection site. […] The HPV vaccine is part of the routine childhood vaccines schedule. Each state in the U.S. decides which vaccines from that schedule are needed for school attendance. […] Yes. The HPV vaccine doesn’t replace Pap tests. Screening for cervical cancer with regular Pap tests starting at age 21 is an essential part of preventive healthcare.

• #82 HPV Vaccine – Center for Young Women’s Health

  https://youngwomenshealth.org/clinicians/hpv-vaccine-nurses/

  Be sure to emphasize the vaccine will not be completely effective unless all shots are scheduled and administered as directed.(For 15 yrs old 2 doses; for 15 and older, 3 doses with the first one at an elected time, the second one 2 months later, then the third injection 6 months after the first one.) […] Tell young women that the HPV vaccine does not take the place of routine gynecological care and Pap tests. They should still make their appointments for Pap tests. […] Similar to other vaccines, not all recipients of the HPV vaccine will be protected. […] Explain to young women that condoms offer some protection against HPV, but that avoiding sexual contact is the only way to completely protect oneself from HPV.

• #83 HPV vaccine: Who needs it, how it works

  https://www.mayoclinic.org/diseases-conditions/hpv-infection/in-depth/hpv-vaccine/art-20047292

  Most people catch HPV soon after they become sexually active. But even if you have one strain of HPV, you might still benefit from the vaccine. It can protect you from other strains that you don’t yet have. […] The HPV vaccine has been found to be safe in many studies. […] Overall, the effects tend to be mild. The most common side effects of HPV vaccines include soreness, swelling or redness at the injection site. […] The HPV vaccine is part of the routine childhood vaccines schedule. Each state in the U.S. decides which vaccines from that schedule are needed for school attendance. […] Yes. The HPV vaccine doesn’t replace Pap tests. Screening for cervical cancer with regular Pap tests starting at age 21 is an essential part of preventive healthcare.

• #84 An Education Intervention to Increase Human Papillomavirus Vaccination Confidence and Acceptability: A Randomized Controlled Trial | Oncology Nursing Society

  https://www.ons.org/publications-research/onf/50/4/education-intervention-increase-human-papillomavirus-vaccination

  Objectives: To explore the effect of an intervention to improve human papillomavirus (HPV) vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] Implications for Nursing: Nurses can improve HPV vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers through HPV vaccination education. […] The findings from the current study indicate that nurses could play a significant role in providing quantitative and randomized controlled trials that focus on HPV vaccine education interventions to enhance vaccination confidence, attitudes, and beliefs among non-Hispanic Black mothers. […] The HPV vaccination education content focused on how well the vaccine works, the safety of the vaccine, and the benefits of the vaccine. […] The current study described the efficacy of an intervention to improve vaccination confidence, attitudes, and beliefs toward HPV vaccination among non-Hispanic Black mothers. […] Nurses can play a significant role in providing more HPV vaccination education intervention studies to reduce racial and ethnic disparities in cervical cancer.

• #85 School nurses play critical role in HPV vaccination promotion and compliance | School of Nursing

  https://nursing.gmu.edu/news/2024-02/school-nurses-play-critical-role-hpv-vaccination-promotion-and-compliance

  Each year, an estimated 13 million Americans are infected with human papillomavirus (HPV). The Centers for Disease Control and Prevention (CDC) estimates that the HPV vaccine can prevent over 90% of cancers caused by HPV. […] School nurses are uniquely situated to be at the forefront of preventing HPV-related cancers through promoting timely vaccination among children and adolescents. […] Given their proximity to adolescents, school nurses are in the prime position to administer vaccinations and ensure proper adherence to vaccine series schedules, including the HPV vaccine. […] Improving awareness and supporting our efforts can have a significant impact on increasing vaccination rates, said McNally. […] There are several complex factors that impact nursing practice. Nurses have good vaccine knowledge and positive attitudes, but poor workflow processes, competing demands, and difficulties communicating about vaccines challenge school nurses’ ability to do their job fully, McNally said.

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