Human Papillomavirus Bivalent Vaccine, Recombinant
Pronunciation: PAP-i-LO-ma-VYE-rus
Class: Vaccine, viral
Trade Names
Cervarix
- Injection, suspension Each 0.5 mL dose contains: 20 mcg of HPV type 16 L1 protein and 20 mcg of HPV type 18 L1 protein
Pharmacology
Induces development of humoral immune responses against human papillomavirus (HPV).
Indications and Usage
Prevention in girls and women 10 through 25 yr of age of diseases caused by HPV types 16 and 18, including cervical cancer, cervical intraepithelial neoplasia (CIN) (grade 2 or worse) and adenocarcinoma in situ, and CIN grade 1.
Contraindications
Severe allergic reactions (eg, anaphylaxis) to any component of the vaccine.
Dosage and Administration
Women and Girls 10 to 25 yr of ageIM 3 separate 0.5 mL doses, with the second dose given 1 mo after the first dose and the third dose given 6 mo after the first dose.
General Advice
- Administer IM in the deltoid region of the upper arm; do not inject IV, subcutaneously, or intradermally.
- The vials and prefilled syringes are for single use only.
- Do not dilute or mix with other vaccines.
- Shake well immediately before using, which will yield a white, cloudy liquid.
- Prior to administration, inspect visually for particulate matter and discoloration. Do not use if product has particulates or appears discolored.
Storage/Stability
Store in refrigerator at 36° to 46°F. Do not freeze. Discard if vaccine has been frozen.
Drug Interactions
Immunosuppressive therapies (eg, alkylating agents, antimetabolites, corticosteroids, cytotoxic drugs, irradiation)Immune responses to vaccines may be reduced.
Adverse Reactions
Cardiovascular
Syncope (postmarketing).
CNS
Fatigue (55%); headache (53%); dizziness (2%); vasovagal reactions sometimes accompanied by tonic-clonic movements (postmarketing).
Dermatologic
Rash (10%); urticaria (7%).
EENT
Nasopharyngitis (4%); pharyngolaryngeal pain (3%); pharyngitis (2%).
GI
GI symptoms including nausea, vomiting, diarrhea, and/or abdominal pain (28%).
Genitourinary
Dysmenorrhea (2%); UTI, vaginal infection (1%).
Hypersensitivity
Anaphylactic/anaphylactoid reactions, angioedema, erythema multiform (postmarketing).
Local
Pain (92%); erythema (48%); swelling (44%); bruising, pruritus (1%).
Musculoskeletal
Myalgia (49%); arthralgia (21%); back pain (1%).
Respiratory
Upper respiratory tract infection (2%).
Miscellaneous
Pyrexia (13%); influenza (3%); chlamydia infection (2%).
Precautions
MonitorBecause syncope may occur following vaccination, observe patients for 15 min after administration. |
Pregnancy
Category B .
Lactation
Undetermined.
Children
Safety and efficacy not established in children younger than 10 yr of age.
Syncope
Syncope, sometimes associated with tonic-clonic movements and other seizure-like activity, has been reported.
Impaired immune responsiveness
Reduced antibody response to active immunization may occur.
Latex allergy
The tip cap and rubber plunger of the needleless prefilled syringe contain dry natural latex rubber that cause allergic reactions in latex-sensitive persons. The vial stopper does not contain latex.
Limitations
Does not provide protection against disease from vaccine and nonvaccine HPV types to which patient has previous exposure through sexual activity; does not protect against diseases due to HPV types not contained in the vaccine; protects only against those cervical cancers caused by HPV 16 and 18; does not protect against genital diseases not caused by HPV; may not result in protection in all vaccine recipients.
Overdosage
Symptoms
None well documented.
Patient Information
- Inform patient, parent, or guardian that vaccination is not a substitute for routine cervical cancer screening.
- Provide patient, parent, or guardian with required vaccine information with each vaccination.
- Inform patient, parent, or guardian of the benefits and risks associated with vaccination.
- Inform patient, parent, or guardian that use is not recommended during pregnancy.
- Advise patient, parent, or guardian of the importance of completing the immunization series.
- Instruct patient, parent, or guardian to report any adverse reactions to health care provider.
- Inform patients that syncope has been reported following vaccination in young women, sometimes resulting in falling with injury; observation for 15 min after administration is recommended.
- Instruct patients to inform their health care provider if they have an allergy to latex. The needleless prefilled syringe contains dry natural latex rubber.
Copyright © 2009 Wolters Kluwer Health.
