Quadrivalent human papillomavirus vaccine against the viral types most likely to cause cervical cancer (types 16 and 18) and genital warts (types 6 and 11) has been licensed in the United States. The vaccine is 95% to 100% efficacious against cervical intraepithelial neoplasia and adenocarcinoma in situ and 99% efficacious against genital warts caused by serotypes in the vaccine. Local pain injection site pain and swelling are the main adverse reactions. Routine vaccination of females at 11 to 12 years of age is recommended. Catch-up vaccination is recommended for females age 13 to 26 years who have not yet been vaccinated, and vaccination of girls 9 and 10 years of age is permitted at the discretion of the physician.
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