90649 Human Papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vHPV), 3 dose schedule, for intramuscular use

Name of the Procedure:

Human Papillomavirus (HPV) Vaccine, Types 6, 11, 16, 18, Quadrivalent (4vHPV), 3 Dose Schedule, for Intramuscular Use

Summary

The HPV vaccine, specifically the quadrivalent version, protects against four major types of HPV: 6, 11, 16, and 18. Administered in three doses, this vaccine is given as an intramuscular injection and aims to prevent infections that can lead to cervical cancer, genital warts, and other HPV-related diseases.

Purpose

The HPV vaccine is designed to prevent infections caused by the human papillomavirus types 6, 11, 16, and 18. The primary goal is to reduce the incidence of cervical cancer, genital warts, and other diseases associated with these HPV types.

Indications

• Prevention of HPV-related diseases in individuals, primarily before they become sexually active.
• Recommended for males and females, typically starting at ages 11-12.
• Can be administered up to age 26, and sometimes beyond, depending on individual risk factors and healthcare provider recommendations.

Preparation

• No specific preparation such as fasting is required.
• Inform the healthcare provider of any allergies, medical conditions, and current medications.
• An assessment of the patient's vaccination history and overall health status may be conducted.

Procedure Description

1. The patient is seated comfortably, and the healthcare provider will explain the procedure.
2. The injection site is typically the upper arm (deltoid muscle).
3. The skin is cleaned with an antiseptic wipe.
4. The vaccine is administered as an intramuscular injection.
5. The procedure is repeated after 1-2 months for the second dose and again at 6 months for the final dose.

Tools, Equipment, and Technology Used:

• Sterile syringe and needle
• Antiseptic wipes

Anesthesia or Sedation:

• Not applicable, as the injection is quick and generally causes only minor discomfort.

Duration

Each injection takes only a few minutes. Post-injection monitoring for adverse reactions usually lasts about 15 minutes.

Setting

The procedure is performed in a healthcare provider's office, outpatient clinic, or a public health setting.

Personnel

• Nurse or medical assistant (administers the vaccine)
• Physician or nurse practitioner (may oversee and provide patient education)

Risks and Complications

Common Risks:

• Mild pain, redness, or swelling at the injection site
• Low-grade fever
• Headache

Rare Risks:

• Severe allergic reactions (anaphylaxis)
• Fainting

Management:

• Observation period post-vaccination
• Prompt treatment of any adverse reactions with appropriate medical measures

Benefits

• Significantly reduces the risk of developing cervical cancer, genital warts, and other HPV-related diseases.
• Provides long-term immunity with completion of the three-dose series.
• Benefits of vaccination are typically realized shortly after the series is completed and persist for many years.

Recovery

• Minimal to no downtime required after each injection.
• Patients are advised to monitor the injection site for any unusual reactions.
• Routine activities can typically be resumed immediately.

Alternatives

Other Treatment Options:

• Bivalent HPV vaccine (types 16 and 18)
• Nonavalent HPV vaccine (covers additional HPV types)
• Abstinence or practicing safe sex to reduce HPV transmission (though not as effective as vaccination for long-term prevention)

Pros and Cons of Alternatives:

• Broader vaccines offer protection against more HPV types but may still follow similar administration schedules.
• Non-vaccine preventive measures do not provide the same level of targeted protection.

Patient Experience

During the procedure, patients might feel a brief sting or pinch from the injection. Post-procedure, there may be mild soreness or swelling at the injection site. Discomfort is generally minimal and manageable with over-the-counter pain relief if necessary. Most patients report feeling fine shortly after each dose and can return immediately to their usual activities.