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Am Fam Physician. 2006;74(3):512

Girls 11 to 12 years of age should be routinely vaccinated against human papillomavirus (HPV), according to new recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP). The committee noted that the HPV vaccination series can be started as early as nine years of age (at the discretion of the physician), and may be given as late as 13 to 26 years of age. The quadravalent HPV vaccine ideally should be administered before the onset of sexual activity, but females who are sexually active still should be vaccinated.

ACIP also recommended that a second dose of varicella vaccine be given to children four to six years of age to provide further protection against the disease. The first dose of varicella vaccine is recommended at 12 to 15 months of age. However, ACIP noted that 15 to 20 percent of children who have received one dose of varicella vaccine are not fully protected and may develop chickenpox after coming in contact with varicella zoster virus. Additionally, one dose of the vaccine may not continue to provide protection into adulthood, when chickenpox can be more severe.

ACIP also recommended that children, adolescents, and adults who have already received one dose of varicella vaccine should receive a second dose. Additional information about the new recommendations is available at

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