[MCOH-EH] Gardasil-9 for Surgeons/OR Staff

[Swift, Melanie D., M.D., M.P.H.]

My opinions only:

FDA approved it up to age 45 based on the available studies in ages 27 - 45. The new ACIP recommendation in this age group is tepid. "For adults aged 27 through 45 years, public health benefit of HPV vaccination in this age range is minimal; shared clinical decision-making is recommended because some persons who are not adequately vaccinated might benefit."

My read on this is that they don't want to say never offer it to someone age 40 who is perhaps immune suppressed (post-transplant, for example) and thus at high risk for HPV, especially if that person was not ever vaccinated. Also you could customize based on sexual history, so if someone did not get vaccinated in adolescence and is just initiating sexual activity in their 30s, they may never have been expose to HPV and could still benefit.

I would not see this as a justification for a mandatory occupational program. In healthcare, exposure would be through the respiratory route, and we just have no data about risk and impact of vaccination from this exposure type. (Those of you in Nevada may have other occupational population considerations...)

Offering the vaccine to people who may be exposed to HPV aerosols at work, with appropriate counseling, may be reasonable, but would need to be an individual decision. From an occupational standpoint I think programs should evaluate their respiratory protection program first!


Melanie

Melanie Swift, MD, MPH
Medical Director, Mayo Clinic Physician Health Center
Associate Medical Director, Occupational Health Service
Senior Associate Consultant
Assistant Professor of Medicine
Division of Preventive, Occupational, and Aerospace Medicine
Phone 507.284.2560
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org<http://www.mayoclinic.org/>



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Tara Dockery
Sent: Tuesday, October 08, 2019 2:24 PM
To: MCOH-EH
Subject: [EXTERNAL] Re: [MCOH-EH] Gardasil-9 for Surgeons/OR Staff

I have not heard of this being given to staff, but I had also not heard it can be given up to the age of 45 now. I wonder why not older?

Tara

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Sumeet Batra
Sent: Tuesday, October 8, 2019 12:04 PM
To: mcoh-eh at mylist.net
Subject: [MCOH-EH] Gardasil-9 for Surgeons/OR Staff


CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.
Hello,

I know this has been discussed here in the past but I am curious whether any of your organizations is providing Gardasil-9 to any of your surgeons or OR staff, especially now that the FDA and ACIP have cleared it for use up to age 45.  If so, are you making it mandatory or voluntary?  Have you encountered any issues or barriers administering this vaccine to staff?  Thank you,

Sumeet Batra, MD, MPH
Medical Director, Occupational Health Services
Cook Children's Health Care System
801 7th Avenue
Fort Worth, TX 76104
(682) 885-3837
(682) 885-6717 (fax)


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