HUMAN PAPILLOMAVIRUS (HPV)

SCHOOL BASED VACCINATION

 GUIDELINES

• Department Memorandum No. 2015-0146

– Guidelines on the Implementation School Based
Immunization

• Department Memorandum No. 2015-0146-A

– Amendment to DM No. 2015-0146
 Rationale
• Human Papillovirus (HPV)
– Most common viral infection of reproductive
tract (females and males)
– Cause precancerous lesions
– Majority do not cause symptoms/disease and
resolve spontaneously
– Persistent infection with HPV types 16 & 18 lead
to precancerous lesions. If untreated can
progress to cervical cancer.
 Rationale
• Human Papillovirus (HPV)
– Responsible for vast majority of cervical cancer
– Most sexually active women and men are
infected (young adults: 15-24 years of age)
– Genital infection with HPV is the most common
STI
– Genital warts is highest among 16-24 years of
age
 Rationale
• Human Papillovirus (HPV) Vaccination
– Primary prevention tool
– Does not eliminate the need for screening later
in life (vaccine do not protect against all high
risk HPV types)
– WHO recommends early vaccination prior to
becoming sexually active.
– HPV vaccines are most efficacious to not
previously exposed to virus
 Scope and Coverage
A. Vaccine Information
1. Types of Vaccine
- 3 types of HPV vaccine (quadrivalent,
bivalent, and nonavalent vaccine)
- directed against oncogenic genotypes
- do not contain live /viral DNA (non-
infectious)
- do not contain antibiotics/preservative
agents
 Scope and Coverage
1.1 Quadrivalent HPV Vaccine (Gardasil)
- Suspension for IM injection containing purified
proteins for 4 HPV types (6, 11, 16 & 18).
- 1-dose vial
- Indicated for female and males from 9 years of age
- For prevention of premalignant genital lesions
(cervical, vulvar and vaginal), premalignant anal
lesions, cervical cancers and anal cancers causally
r/t oncogenic types and anogenital warts causally
r/t to HPV types
 Scope and Coverage
2. HPV vaccine can be given to the ff:
- Lactating women
- With minor acute illnesses (diarrhea, mild URTI,
low grade fever)
- Women with equivocal / abnormal Pap test, + HPV
test or genital warts. Advise that vaccine do not
have therapeutic effect on existing Pap test
abnormalities, HPV infection or genital warts
- Immunocompromised (efficacy might be less)
 Scope and Coverage
3. HPV vaccine cannot be given to the ff:
- Moderate to severe illness. Wait until illness
improves before immunization
- Pregnant women (data on vaccination in
pregnancy are limited)
- With severe allergic reaction to the vaccine or
component of the vaccine
- With history of immediate hypersensitivity to yeast
 Specific Guidelines

All female school children enrolled in Grade 4 Public

Schools, aged 9-14 years old shall be vaccinated with
two (2) doses of HPV Quadrivalent vaccine, 0.5ml,
Intramuscular (IM), LEFT deltoid arm.
 Specific Guidelines
First At the time of visit with January 2023
Dose the health worker at age
between 9-14 years old
Second 6 months after the first July 2023
Dose dose

Note: Health workers must ensure that those who

received the HPV 1st dose shall be given the 2nd dose
of HPV vaccine after 6 months
 Specific Guidelines
- The DOH shall procure the single dose,
quadrivalent HPV vaccines

- HPV vaccine can be co-administered with other

vaccines and different injection sites (eg
diphtheria, tetanus, acellular pertussis w/ or w/o
poliomyelitis, Hepatitis A and Hepatitis B vaccines)
 Specific Guidelines
- Adolescents should be seated during vaccination.

- Carefully observe the vaccinees for 15 minutes

after administration of vaccine

- To reduce fainting, ensure that vacinees have eaten

before vaccination, provided w/ comfortable room
and privacy during waiting/observation period
 Specific Guidelines
- Epinephrine kit must always be readily available

- Transport vehicle must be on stand by

- Referral hospitals must be informed on the

vaccination.
 Specific Guidelines
F. Immunization Safety and Adverse Events Following
Immunization (AEFI)
1. Vaccines should be stored at 20C to 80C. Do not
freeze the vaccine
2. Safe immunization practice must be observed
- Always use AD syringe
- Do not pre-fill syringes
- Do not re-cap needles
- Do not use aspirating needle
- Dispose used syringes and needles into SCB
- Proper disposal of infectious wastes
 Specific Guidelines
3. AEFI following HPV are generally non-serious and
of short duration of HPV Quadrivalent
ADVERSE REACTION FREQUENCY RATE FREQUENCY CATEGORY
Headache 26% Very common
GI disorders 17% Very Common
Fever 13% Very common
Injection site pain 5.7% Common
Redness 5.7% Common
Swelling 5.7% Common
Urticaria 3% Common
Myalgia 2% Common
Arhtralgia 1% Common
Anaphylaxis 1.7*2.6 per 106 Very Rare
 Specific Guidelines
• Reporting will be monthly and
submitted along with routine
accomplishment to the program
FORMS
FORMS
 FORMS

Reporting Template
 ROLES AND FUNCTIONS
• DOH – shall provide the necessary vaccines and other
immunization logistics
• DepEd – shall assist and facilitate for the implementation
of the immunization in school and issue memorandum
about the activity, inform
students/parents/teachers/school clinic staff
• LGUs – health personnel shall lead the vaccination in
collaboration with schools, hospitals, and other partners
within the catchment areas
THANK YOU