{"id":17941,"date":"2022-12-14T18:03:26","date_gmt":"2022-12-14T18:03:26","guid":{"rendered":"https:\/\/msdconecta.co.cr\/es\/?page_id=17941"},"modified":"2023-02-08T02:22:22","modified_gmt":"2023-02-08T02:22:22","slug":"when-to-make-a-strong-recommendation-for-gardasil-9-vaccine","status":"publish","type":"page","link":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/","title":{"rendered":"When to make a strong recommendation for Gardasil 9 vaccine"},"content":{"rendered":"<div class=\"mhh-mcn-columns mhh-mcn-columns--align-center mhh-mcn-columns--vertical-alignment-center mhh-mcn-v1-columns--16bfa0f885c6a3459322b1cfe79676db mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--c55f2304030e9e2cad575a03d2cf5287 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-8\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--90d748f40c4125ed4a8a03dcb9a95712\">\n                    <img loading=\"lazy\" decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-17858\"\n        src=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/12\/1055-\u00bfCua\u0301ndo-recomendar-la-vacuna-de-Gardasil-9_-copia-01.png?quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"683\"\n                alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--ebc5a624fd265d72b21960c3c82fa445 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-12 mhh-mcn-column--l-4\">\n    \n\n<h1 class=\"has-teal-500-color has-text-color has-object-object-font-size wp-block-heading mhh-mcn-v1-heading--left mhh-mcn-v1-heading mhh-mcn-v1-heading--b70af2002b0cd45a68babf6b1e30b35a\">Take advantage of<br>every opportunity<br>to recommend\u00b9<\/h1>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--align-center mhh-mcn-v1-image--8fa09072af938a1057260d149ff73383\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-17887\"\n        src=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/12\/logo-gardasil9.png?quality=80&#038;lossy=1\"\n        width=\"490\"\n        height=\"235\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--6a93fba19092938cc6915e3f35ad0a8f\">\n                    <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-17859\"\n        src=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/12\/1055-\u00bfCua\u0301ndo-recomendar-la-vacuna-de-Gardasil-9_-copia-03.png?quality=80&#038;lossy=1\"\n        width=\"1024\"\n        height=\"128\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n            <\/figure>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--10cfb277a968c906453df40c4bf252bc mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--4df380135d04063fb702929b52bab5bd mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--20c211328505216420513dcb3e41154b\">When to recommend HPV vaccination for adults<\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--effec3922148c6c4041b9428e6164981 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--c5637706c38dd6931704b3fe65b87998 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--e189eb9ab0fce85e906aa7698441f2bc\"><em>&#8220;<\/em>Have your appropriate adult patients received their first dose of GARDASIL 9? Do they need to complete the series? <strong>For adults up to 26 years of age, catch-up HPV vaccination is recommended for those who are not adequately vaccinated. Shared clinical decision-making regarding HPV vaccination is recommended for adults ages 27 through 45 years.\u00b2<\/strong><em>&#8220;<\/em><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-teal-500-color has-alpha-channel-opacity has-teal-500-background-color has-background\" \/>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--bcef9868c7e12876b219a977b6151e3f mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--cc5a4318c724d0bb023abe06ad4655e5\">Their next visit could be your chance to talk about HPV vaccination.<sup>3,4,5<\/sup> Discuss GARDASIL 9 with your female patients during:<\/p>\n\n\n\n<ul class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--870d68b0acd6a1c99113aadb417d1994 mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-dot\" start=\"1\">\n    <li>Routine OB\/GYN visits\u00b3<\/li><li>Cervical cancer screenings\u2075<br><\/li><\/ul>\n\n\n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--bc8c5e7e17b143cdfdd046dceaa91b5b\">And with your male and female patients during:<\/p>\n\n\n\n<ul class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--98db71dc1d68d6bf0d0cbf8dc58609c6 mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-dot\" start=\"1\">\n    <li>Sexual health-related visits, including:<ul><li>STI prevention counselling and screenings\u2075<\/li><\/ul><ul><li>Contraception discussions\u2075<\/li><\/ul><\/li><li>Routine physicals\u2076<\/li><li>Adult vaccination appointments<ul><li>Consider using appointments for adult vaccinations (such as those required for travelling), as opportunities to recommend HPV vaccination.\u2074<\/li><\/ul><\/li><\/ul>\n\n    <\/div>\n<\/section>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-teal-500-color has-alpha-channel-opacity has-teal-500-background-color has-background\" \/>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--b11f06f0cba26b005a805b2f9d4b5f25 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--7376bc3ad46b3ec4696cc42ea6d3e5ad mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--039397480f0a3b900e5da67d82fc9f8e\">When to recommend HPV vaccination for adolescents<\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--309cf92f406140064074159b2a6ebcf8 mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--a772477e7902d1a92d350821f36ceddc mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<p class=\"has-text-color has-object-object-font-size mhh-mcn-v1-paragraph--center  mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--681925729a8d33e1a88f1eaa9d106866\" style=\"color:#676766\"><em>&#8220;Before every routine visit, check if your patient is old enough to receive their first dose of GARDASIL 9 or is up-to-date on their HPV vaccination.&#8221;<\/em><\/p>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--1a499bd20ca5d1d880b8c13e9c3f2bfa mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    <\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-teal-500-color has-alpha-channel-opacity has-teal-500-background-color has-background\" \/>\n\n\n\n<section class=\"mhh-mcn-v1-section mhh-mcn-v1-section--56c91512dace1dd20e3af43411533d82 mhh-mcn-section mhh-mcn-v1-section--align-full\">\n    <div class=\"mhh-mcn-container\">\n    \n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--32b62880f5164efba83b3d8fe726fbb7\">Considerations for every routine well-visit:<\/p>\n\n\n\n<ul class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--4e7228f983eaf321e2880160a6649ed4 mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-dot\" start=\"1\">\n    <li>The GARDASIL 9 series can be started in boys and girls at 9-years-old.<\/li><li>A good time to recommend HPV vaccination may be while the patient is scheduled to receive other vaccinations.\u2074<ul><li>GARDASIL 9 can be administered concomitantly at a separate injection site with meningococcal, TDap, and dTap-IPV vaccines.<sup>a,b<\/sup><\/li><\/ul><\/li><\/ul>\n\n    <\/div>\n<\/section>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-teal-500-color has-alpha-channel-opacity has-teal-500-background-color has-background\" \/>\n\n\n<div class=\"mhh-mcn-columns mhh-mcn-v1-columns--38727290e4c6f5c59d2087fec45b6faf mhh-mcn-v1-columns mhh-mcn-columns--gutter-m\">\n    <div class=\"mhh-mcn-columns-inner\">\n        \n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--6bc0b3691ae618b8834122b87516a4eb mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--49e9a2099b56614e09b3bab3e9533a58 with-aspect-ratio with-aspect-ratio--square\">\n    <div class=\"figure-outer\">\n    <div class=\"figure-inner\">\n                            <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-17877\"\n        src=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/12\/1055-\u00bfCua\u0301ndo-recomendar-la-vacuna-de-Gardasil-9_-copia-04.png?quality=80&#038;lossy=1\"\n        width=\"203\"\n        height=\"405\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n                <\/div>\n    <\/div>\n    <\/figure>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--815cc8873774a0e64c998ff24ea99d93 mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-8 mhh-mcn-column--l-8\">\n    \n\n<h2 class=\"has-teal-500-color has-text-color has-object-object-font-size wp-block-heading mhh-mcn-v1-heading--center mhh-mcn-v1-heading mhh-mcn-v1-heading--7e7af03518fafc3c7fa25580a1456974\"><strong>You play an important role in helping to<br>prevent certain HPV-related cancers.<sup>5,7,8<\/sup><\/strong><\/h2>\n\n<\/div>\n\n\n<div class=\"mhh-mcn-v1-column mhh-mcn-v1-column--a024525ee15577135ddb7c1ef460a5ff mhh-mcn-column mhh-mcn-column--12 mhh-mcn-column--m-2 mhh-mcn-column--l-2\">\n    \n<figure class=\"mhh-mcn-v1-image mhh-mcn-v1-image--6dd991b584060e8829874788411117ff with-aspect-ratio with-aspect-ratio--square\">\n    <div class=\"figure-outer\">\n    <div class=\"figure-inner\">\n                            <img decoding=\"async\"\n        class=\"mhh-mcn-image mhh-mcn-image--full wp-image-17878\"\n        src=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/12\/1055-\u00bfCua\u0301ndo-recomendar-la-vacuna-de-Gardasil-9_-copia-05.png?quality=80&#038;lossy=1\"\n        width=\"252\"\n        height=\"405\"\n        loading=\"lazy\"        alt=\"\"\n            \/>\n                <\/div>\n    <\/div>\n    <\/figure>\n\n<\/div>\n\n    <\/div>\n\n    <\/div>\n\n\n<div class=\"mhh-mcn-v1-links mhh-mcn-v1-links--align-center mhh-mcn-v1-links--justified-center mhh-mcn-v1-links--0245b4d85286fca1b12dce802309cae2\">\n    <a class=\"mhh-mcn-v1-link mhh-mcn-v1-link--center mhh-mcn-v1-link--vertical-alignment-center mhh-mcn-v1-link--197b68cef2fa55944adf243d126b08a2 mhh-mcn-v1-link--is-variation mhh-mcn-v1-link--button-custom\" href=\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2023\/01\/IP-GARDASIL-9-Caribbean-WP-0040.pdf?utm_source=WHATSAPP&#038;utm_medium=TEXT&#038;utm_campaign=CENCA_GARDASIL9_REGIONALHCP&#038;utm_id=FW-0165\" target=\"_self\">\n                    <span class=\"mhh-mcn-v1-link__label\">Learn more<\/span>\n                <\/a><\/div>\n\n\n\n<p class=\"has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--7e9c4083e2de338ca11b2e18831310ce\"><br><br>HPV=human papillomavirus<br><br><sup>a<\/sup>Results from clinical studies indicate that GARDASIL 9 may be administered concomitantly with Menactra [Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine], Adacel [Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed (Tdap)], and Repevax [Diphtheria, Tetanus, Pertussis (acellular, component) and Poliomyelitis (inactivated) Vaccine (adsorbed, reduced antigen(s) content)] (dTap-IPV).<br> <br><sup>b<\/sup>Menactra [Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine], Adacel [Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine Adsorbed (Tdap)], and Repevax [suspension for injection, in pre-filled syringe Diphtheria, Tetanus, Pertussis (acellular, component) and Poliomyelitis (inactivated) Vaccine (adsorbed, reduced antigen(s) content)] are the trademarks of their respective owners and are not trademarks of Merck Sharp &amp; Dohme Corp., a subsidiary of Merck &amp; Co., Inc.<br><br><\/p>\n\n\n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--859810b40a8ff7305adf064d231ce3c0\"><strong>References:<\/strong><\/p>\n\n\n\n<ol class=\"mhh-mcn-v1-clist mhh-mcn-v1-clist--b7d8b59a90477d1ce0cdaccc67c70978 mhh-mcn-v1-clist--order-starts-2-digits mhh-mcn-list list-style-type-line\" start=\"1\">\n    <li>World Health Organization (WHO). Human papillomavirus vaccines: WHO position paper, May 2017. Wkly Epidemiol Rec. 2017;19(92):241-268.<\/li><li>Meites E, Gee J, Unger E, Markowitz L. Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book). 14th edition. Chapter 11: Human Papillomavirus. Centers for Disease Control and Prevention (CDC). Updated October 2020. Accessed August 25, 2021. https:\/\/www.cdc.gov\/vaccines\/pubs\/pinkbook\/downloads\/hpv.pdf.<\/li><li>Guo F, Hirth JM, Berenson AB. Human papillomavirus vaccination and pap smear uptake among young women in the United States: Role of provider and patient. Journal of Women\u2019s Health. 2017:26(10)1114-1122.<\/li><li>World Health Organization. Vaccine-preventable diseases and vaccines (2019 update). In: World Health Organization. International Travel and Health. World Health Organization; 2019; 1-53.<\/li><li>Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(4)1-192.<\/li><li>Barrow RY, Ahmed F, Bolan GA, Workowski KA. Recommendations for provided quality sexually transmitted diseases clinical services, 2020. MMWR Morb Mortal Wkly Rep. 2020;68(5)1-20.<\/li><li>Gilkey MB, Calo WA, Moss JL, Shah PD, Marciniak MW, Brewer NT. Provider communication and HPV vaccination: the impact of recommendation quality. Vaccine. 2016;34(9):1187-1192. doi:10.1016\/j.vaccine.2016.01.023.<\/li><li>Wheldon CW, Garg A, Galvin AM, Moore JD, Thomson EL. Decision support needs for shared clinical decision-making regarding HPV vaccination among adults 27-45 years of age. Patient Educ Couns. 2021. doi.org\/10.1016\/j.pec.2021.04.016i.<br><br><\/li><\/ol>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-teal-500-color has-alpha-channel-opacity has-teal-500-background-color has-background\" \/>\n\n\n\n<p class=\"has-teal-500-color has-text-color has-object-object-font-size   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--0566ef5d60fd1d2416e7a566872a2e7a\"><strong>GARDASIL 9 &#8211; SELECTED SAFETY INFORMATION<\/strong><\/p>\n\n\n\n<p class=\"   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--706b94956460c1dc98e8844374b79bb4\"><strong>Therapeutic uses<br><\/strong>Gardasil 9 is indicated for active immunization of individuals from the age of 9 years against the following HPV diseases:<br>\u2022 Premalignant lesions and cancers affecting the cervix, vulva, vagina, and anus caused by vaccine HPV types.<br>\u2022 Genital warts (Condyloma acuminata) caused by specific HPV types.<br><br><strong>Dosage and administration<br><\/strong>GARDASIL 9 should be administered intramuscularly as 3 separate 0.5-mL doses according to the following schedule: Individuals 9 to and including 14 years of age at time of first injection Gardasil 9 can be administered according to a 2-dose (0, 6 \u2013 12 months) schedule. The second dose should be administered between 5 and 13 months after the first dose. If the second vaccine 2 dose is administered earlier than 5 months after the first dose, a third dose should always be administered. GARDASIL 9 can be administered according to a 3-dose (0, 2, 6 months) schedule. The second dose should be administered at least one month after the first dose and the third dose should be administered at least 3 months after the second dose. All three doses should be given within a 1-year period. <br>Individuals 15 years of age and older at time of first injection Gardasil 9 should be administered according to a 3-dose (0, 2, 6 months) schedule. The second dose should be administered at least one month after the first dose and the third dose should be administered at least 3 months after the second dose. All three doses should be given within a 1-year period. It is recommended that individuals who receive a first dose of GARDASIL 9 complete the vaccination course with GARDASIL 9<br><br><strong>Contraindications<br><\/strong>GARDASIL 9 is contraindicated in patients with hypersensitivity to either GARDASIL 9 or GARDASIL\u2122 or any of the inactive ingredients in either vaccine. Individuals who develop symptoms indicative of hypersensitivity after receiving a dose of GARDASIL 9 or GARDASIL should not receive further doses of GARDASIL 9.<br><br><strong>Warnings and precautions<br><\/strong>As for any vaccine, vaccination with GARDASIL 9 may not result in protection in all vaccine recipients. <br>The vaccine is for prophylactic use only and has no effect on active HPV infections or established clinical disease. The vaccine has not been shown to have a therapeutic effect. The vaccine is therefore not indicated for treatment of cervical, vulvar, vaginal, and anal cancer, high-grade cervical, vulvar, vaginal, and anal dysplastic lesions, or genital warts. It is also not intended to prevent progression of other established HPV-related lesions. As with all injectable vaccines, appropriate medical treatment should always be readily available in case of rare anaphylactic reactions following the administration of the vaccine.<br>Syncope (fainting) may follow any vaccination, especially in adolescents and young adults. Syncope, sometimes associated with falling, has occurred after HPV vaccination. Therefore, vaccinees should be carefully observed for approximately 15 minutes after administration of GARDASIL 9.<br>The decision to administer or delay vaccination because of a current or recent febrile illness depends largely on the severity of the symptoms and their etiology. Low-grade fever itself and mild upper respiratory infection are not generally contraindications to vaccination.<br>Individuals with impaired immune responsiveness, whether due to the use of immunosuppressive therapy, a genetic defect, Human Immunodeficiency Virus (HIV) infection, or other causes, may have reduced antibody response to active immunization.<br>This vaccine should be given with caution to individuals with thrombocytopenia or any coagulation disorder because bleeding may occur following an intramuscular administration in these individuals.<br><br><strong>Use in special populations<br><\/strong>Pregnancy should be avoided during the vaccination regimen for GARDASIL 9. Gardasil 9 can be used during breast-feeding. The safety and efficacy of GARDASIL 9 have not been evaluated in children younger than 9 years. The safety immunogenicity, and efficacy of GARDASIL 9 have not been fully evaluated in HIV-infected individuals.<br><br><strong>Adverse reactions<br><\/strong>The most common (&gt;10%) vaccine-related adverse experiences were observed among recipients of GARDASIL 9 were temperature and injection-site pain, swelling, erythema, headache. And common (&gt;1%) vaccine-related adverse experiences observed reported were pruritus, bruising, pyrexia, nausea, dizziness, pain in extremity, hematoma, and fatigue.<br><br><strong>Post-marketing reports:<br><\/strong>The following adverse experiences have been spontaneously reported during post-approval use of GARDASIL and may also be seen in post-marketing experience with GARDASIL9. Cellulitis, idiopathic thrombocytopenic purpura, lymphadenopathy, acute disseminated encephalomyelitis, dizziness, Guillain-Barr\u00e9 syndrome, headache, syncope sometimes accompanied by tonic-clonic movements; nausea, vomiting; arthralgia, myalgia; asthenia, chills, fatigue, malaise; hypersensitivity reactions including anaphylactic\/anaphylactoid reactions, bronchospasm, and urticaria. These experiences were reported voluntarily from a population of uncertain size. It is not possible to reliably estimate their frequency or to establish a causal relationship to vaccine exposure.<br><br><\/p>\n\n\n\n<p class=\"has-teal-500-color has-text-color   mhh-mcn-v1-paragraph mhh-mcn-v1-paragraph--754661683fd870a16f8eaf3e36704b75\"><strong>Before administering GARDASIL<sup>\u00ae<\/sup>9, please read the complete Prescribing Information.<\/strong><\/p>\n\n\n","protected":false},"excerpt":{"rendered":"<p>HPV=human papillomavirus aResults from clinical studies indicate that GARDASIL 9 may be administered concomitantly with Menactra [Meningococcal (Groups A, C, [&hellip;]<\/p>\n","protected":false},"author":46316,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_mhh_mcn_text_direction":"","_mhh_mcn_language":"","_mhh_mcn_left_sidebar_settings":{"entityId":0},"_mhh_mcn_sidebar_settings":{"entityId":0},"mhh_mcn_side_navigation_style":{"fontSize":{"l":"","m":"","s":""},"lineHeight":{"l":1.5,"m":1.5,"s":1.5},"itemColor":"","hoverItemColor":"","currentItemColor":"","borderItemColor":"","backgroundItemHoverColor":"","themeColor":""},"_mhh_mcn_child_page_navigation":{"isActive":false,"isSticky":false},"hide_header":false,"show_top_bar":false,"hide_footer":false,"full_width_layout":false,"icon":null,"job_code":"","primary_tag":0,"editor_notices":[],"mconnectHideShareThis":false,"footnotes":"","mconnectIsArchiveTemplate":false,"mconnectArchiveFiltersDisabled":false,"mconnectArchiveLockAllPresetFilters":false,"mconnectArchiveHidePageSubmenu":false,"mconnectArchiveShowParentPageOnly":false,"mconnectArchiveDefaultOrder":"DESC","mconnectArchiveDefaultOrderBy":"date","mconnectArchivePostsPerPage":12,"mconnectArchivePostTypes":[],"mconnectArchiveAllowFilterBy":["category","tx-content-type","tx-product","tx-pathology","tx-active-ingredient","tx-therapeutic-area"],"mconnectArchiveTaxonomyOrder":[],"mconnectArchiveFilterSorting":["is_keyword"],"mconnectArchiveContentItemStyle":{"showExcerpt":true,"showImage":true,"showIcon":false,"showPrimaryTag":true,"showBorder":false,"showDates":false,"showCta":true,"isCard":false,"hasBackground":false,"showMetadata":true},"mconnectArchiveLayout":{"type":"list","hasFeatured":false},"mconnectDynamicTaxonomyEntities":[],"mconnectArchiveTerms_category":[],"mconnectArchiveAllowTerms_category":[],"mconnectArchiveTerms_tx-content-type":[],"mconnectArchiveAllowTerms_tx-content-type":[],"mconnectArchiveTerms_tx-product":[],"mconnectArchiveAllowTerms_tx-product":[],"mconnectArchiveTerms_tx-pathology":[],"mconnectArchiveAllowTerms_tx-pathology":[],"mconnectArchiveTerms_tx-active-ingredient":[],"mconnectArchiveAllowTerms_tx-active-ingredient":[],"mconnectArchiveTerms_tx-therapeutic-area":[],"mconnectArchiveAllowTerms_tx-therapeutic-area":[],"mconnectArchiveAllowTerms_dynamic-taxonomy":[],"mconnectArchiveLegacyDefaultTermsApplied":false,"mconnectContentUpdatesPerPage":10,"mconnectContentUpdatesViewMoreUrl":"","mconnectContentUpdatesTerms_tx-content-type":[],"mconnectContentUpdatesTerms_tx-product":[],"mconnectContentUpdatesTerms_tx-pathology":[],"mconnectContentUpdatesTerms_tx-active-ingredient":[],"mconnectContentUpdatesTerms_tx-therapeutic-area":[],"sidebar_toogle":0,"sidebar_toogle_notification_warning":true,"sidebar_toogle_notification_alert":true,"content_expiration_sidebar_date":"","content_expiration_sidebar_expired_post_status":"","content_expiration_sidebar_redirection":""},"categories":[],"tags":[],"ga4_page_audience":[1187],"ga4_page_birn_id":[],"ga4_page_branding":[],"ga4_page_businessunit":[],"ga4_page_campaign":[],"ga4_page_content_purpose":[],"ga4_page_customer_journey_stage":[],"ga4_page_customer_specialty":[],"ga4_page_experience":[],"ga4_page_indication":[],"ga4_page_material_intent":[],"ga4_page_product":[],"ga4_page_region":[921],"ga4_page_therapeuticarea":[],"tx-therapeutic-area":[],"tx-product":[],"tx-pathology":[],"tx-content-type":[],"tx-active-ingredient":[],"mhh-area-of-interest":[],"access":[],"user_status":[],"user_role":[],"class_list":["post-17941","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish\" \/>\n<meta property=\"og:description\" content=\"HPV=human papillomavirus aResults from clinical studies indicate that GARDASIL 9 may be administered concomitantly with Menactra [Meningococcal (Groups A, C, [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/\" \/>\n<meta property=\"og:site_name\" content=\"MConnect Cenca Spanish\" \/>\n<meta property=\"article:modified_time\" content=\"2023-02-08T02:22:22+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/\",\"url\":\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/\",\"name\":\"When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish\",\"isPartOf\":{\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#website\"},\"datePublished\":\"2022-12-14T18:03:26+00:00\",\"dateModified\":\"2023-02-08T02:22:22+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/#breadcrumb\"},\"inLanguage\":\"es-CO\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/msdconecta.co.cr\/es\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"When to make a strong recommendation for Gardasil 9 vaccine\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#website\",\"url\":\"https:\/\/msdconecta.co.cr\/es\/\",\"name\":\"MConnect Cenca Spanish\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/msdconecta.co.cr\/es\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"es-CO\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#organization\",\"name\":\"MConnect Cenca Spanish\",\"url\":\"https:\/\/msdconecta.co.cr\/es\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es-CO\",\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/07\/logo_tcm2359-1256911.png\",\"contentUrl\":\"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/07\/logo_tcm2359-1256911.png\",\"width\":152,\"height\":48,\"caption\":\"MConnect Cenca Spanish\"},\"image\":{\"@id\":\"https:\/\/msdconecta.co.cr\/es\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/","og_locale":"es_ES","og_type":"article","og_title":"When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish","og_description":"HPV=human papillomavirus aResults from clinical studies indicate that GARDASIL 9 may be administered concomitantly with Menactra [Meningococcal (Groups A, C, [&hellip;]","og_url":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/","og_site_name":"MConnect Cenca Spanish","article_modified_time":"2023-02-08T02:22:22+00:00","twitter_card":"summary_large_image","twitter_misc":{"Tiempo de lectura":"5 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/","url":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/","name":"When to make a strong recommendation for Gardasil 9 vaccine - MConnect Cenca Spanish","isPartOf":{"@id":"https:\/\/msdconecta.co.cr\/es\/#website"},"datePublished":"2022-12-14T18:03:26+00:00","dateModified":"2023-02-08T02:22:22+00:00","breadcrumb":{"@id":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/#breadcrumb"},"inLanguage":"es-CO","potentialAction":[{"@type":"ReadAction","target":["https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/msdconecta.co.cr\/es\/when-to-make-a-strong-recommendation-for-gardasil-9-vaccine\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/msdconecta.co.cr\/es\/"},{"@type":"ListItem","position":2,"name":"When to make a strong recommendation for Gardasil 9 vaccine"}]},{"@type":"WebSite","@id":"https:\/\/msdconecta.co.cr\/es\/#website","url":"https:\/\/msdconecta.co.cr\/es\/","name":"MConnect Cenca Spanish","description":"","publisher":{"@id":"https:\/\/msdconecta.co.cr\/es\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/msdconecta.co.cr\/es\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"es-CO"},{"@type":"Organization","@id":"https:\/\/msdconecta.co.cr\/es\/#organization","name":"MConnect Cenca Spanish","url":"https:\/\/msdconecta.co.cr\/es\/","logo":{"@type":"ImageObject","inLanguage":"es-CO","@id":"https:\/\/msdconecta.co.cr\/es\/#\/schema\/logo\/image\/","url":"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/07\/logo_tcm2359-1256911.png","contentUrl":"https:\/\/msdconecta.co.cr\/es\/wp-content\/uploads\/sites\/77\/2022\/07\/logo_tcm2359-1256911.png","width":152,"height":48,"caption":"MConnect Cenca Spanish"},"image":{"@id":"https:\/\/msdconecta.co.cr\/es\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/pages\/17941","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/users\/46316"}],"replies":[{"embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/comments?post=17941"}],"version-history":[{"count":5,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/pages\/17941\/revisions"}],"predecessor-version":[{"id":19939,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/pages\/17941\/revisions\/19939"}],"wp:attachment":[{"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/media?parent=17941"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/categories?post=17941"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tags?post=17941"},{"taxonomy":"ga4_page_audience","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_audience?post=17941"},{"taxonomy":"ga4_page_birn_id","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_birn_id?post=17941"},{"taxonomy":"ga4_page_branding","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_branding?post=17941"},{"taxonomy":"ga4_page_businessunit","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_businessunit?post=17941"},{"taxonomy":"ga4_page_campaign","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_campaign?post=17941"},{"taxonomy":"ga4_page_content_purpose","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_content_purpose?post=17941"},{"taxonomy":"ga4_page_customer_journey_stage","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_customer_journey_stage?post=17941"},{"taxonomy":"ga4_page_customer_specialty","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_customer_specialty?post=17941"},{"taxonomy":"ga4_page_experience","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_experience?post=17941"},{"taxonomy":"ga4_page_indication","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_indication?post=17941"},{"taxonomy":"ga4_page_material_intent","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_material_intent?post=17941"},{"taxonomy":"ga4_page_product","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_product?post=17941"},{"taxonomy":"ga4_page_region","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_region?post=17941"},{"taxonomy":"ga4_page_therapeuticarea","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/ga4_page_therapeuticarea?post=17941"},{"taxonomy":"tx-therapeutic-area","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tx-therapeutic-area?post=17941"},{"taxonomy":"tx-product","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tx-product?post=17941"},{"taxonomy":"tx-pathology","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tx-pathology?post=17941"},{"taxonomy":"tx-content-type","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tx-content-type?post=17941"},{"taxonomy":"tx-active-ingredient","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/tx-active-ingredient?post=17941"},{"taxonomy":"mhh-area-of-interest","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/mhh-area-of-interest?post=17941"},{"taxonomy":"access","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/access?post=17941"},{"taxonomy":"user_status","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/user_status?post=17941"},{"taxonomy":"user_role","embeddable":true,"href":"https:\/\/msdconecta.co.cr\/es\/wp-json\/wp\/v2\/user_role?post=17941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}