Is administration of the HPV vaccine during pregnancy feasible in the future?

Abstract

Despite the strong evidence supporting the efficacy of the HPV vaccine, the uptake rate remains low. One reason for this is that young females do not interact frequently with the healthcare system. In fact, pregnancy is often the first time young women experience multiple scheduled visits to a health provider. We review the data regarding safety of administering the HPV vaccine during pregnancy and consider the possibility of incorporating vaccination into prenatal care. Although the optimal time for vaccination is prior to sexual debut, this does not always occur, and as such, a broader approach to HPV vaccination may be necessary. Increasing the vaccine uptake rate among young women who did not initiate or complete the series earlier may significantly contribute to the decline in HPV-associated diseases.

Keywords::

• HPV vaccine
• pregnancy
• vaccine administration
• young women

Financial & competing interests disclosure

AB Berenson receives support from a Midcareer Investigator Award In Patient-Oriented Research (K24HD043659, principal investigator: Berenson), from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), a research career development award Building Interdisciplinary Research Careers in Women’s Health Program (K12HD052023, principal investigator: Berenson) from the Office of Research on Women’s Health (ORWH), the Office of the Director (OD), the National Institute of Allergy and Infectious Diseases (NIAID) and NICHD at the NIH. She is also supported by a prevention grant (PP120150, principal investigator: Berenson) from the Cancer Prevention Research Institute of Texas (CPRIT). PR Patel receives support as a Scholar in the Women’s Reproductive Health Research Career Development Program (K12HD001269, principal investigator: Hankins), sponsored by the NICHD and the ORWH at the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the NIH or the Cancer Prevention Research Institute of Texas. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Vaccinations for tetanus toxoid, reduced diphtheria and acellular pertussis, influenza, hepatitis A and B, meningitis and pneumonia are administered routinely to pregnant women.

• The prenatal care period provides an excellent opportunity to begin or to ‘catch-up’ the HPV vaccination series in young women who did not initiate or complete the regime during adolescence.

• Administration of the HPV vaccine during pregnancy demonstrated pregnancy outcomes (birth defects, miscarriages, stillbirths) similar to expected ranges in the general population.

• Recent studies indicate possibility of vertical transmission of HPV antibodies to infants of mothers who received the HPV vaccine.