IM Administer as 3 separate 0.5 mL doses in the deltoid region of the upper arm or in the higher anterolateral area of the thigh, according to the following schedule: 1st dose: at elected date; 2nd dose: 2 mth after 1st dose; 3rd dose: 6 mth after 1st dose. Completion of the vaccination course w/ Gardasil 9 is recommended for individuals who received Gardasil 9 as 1st dose. Individual 9-14 yr Alternatively, a 2-dose schedule may be administered. Administer 2nd dose between 5-13 mth after 1st dose. Administer 3rd dose if 2nd dose is administered earlier than 5 mth after 1st dose.
Appropriate medical treatment should always be readily available in case of rare anaphylactic reactions following vaccination. Not for intravascular use. Not recommended for SC or intradermal administration. May not result in protection in all vaccine recipients. Not intended for active external genital lesions; cervical, vulvar, vag or anal cancer or intraepithelial neoplasia. No protection against diseases that are not caused by HPV. Does not substitute for routine cervical cancer screening. Syncope, sometimes associated w/ tonic-clonic movements & other seizure-like activity, following HPV vaccination. Current or recent febrile illness. Individuals w/ impaired immune responsiveness may have reduced Ab response to active immunization. Individuals w/ thrombocytopenia or any coagulation disorder. Immunologic response to Gardasil 9 may be diminished in immunocompromised individuals. Women who receive Gardasil 9 should continue to undergo cervical cancer screening per standard of care. Pregnancy & lactation. Childn <9 yr. Elderly ≥65 yr.
Immunosuppressive therapies including irradiation, antimetabolites, alkylating agents, cytotoxic drugs & corticosteroids (used in greater than physiologic doses) may reduce the immune responses to vaccines.
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