The Australian Immunisation Handbook 10th Edition 2013

Cervical screening detects histopathological changes. It is not recommended to
test for the presence of HPV virus or antibody routinely as a way of determining
whether HPV vaccination is indicated.
For women who have recently been diagnosed with cervical dysplasia, or have
been treated for this in the past, HPV vaccine will have no impact on current
disease, but may prevent future dysplasia due to different HPV types included in
the vaccine.
4.6.8 Pregnancy and breastfeeding
HPV vaccines are not recommended for pregnant women.
Women who become pregnant after starting the HPV vaccination course should
withhold getting further doses of the HPV vaccine while pregnant, and receive
the remaining doses of the course after pregnancy.
Females who inadvertently receive a dose of HPV vaccine around the time of
conception or during pregnancy should be informed of the body of evidence
supporting lack of harm from vaccine administration in this setting. Among
women who became pregnant during the course of 4vHPV vaccine clinical trials
(despite recommendations for participants to avoid pregnancy), the overall
proportions of pregnancies that resulted in an adverse outcome (spontaneous
abortion, late fetal death, infant with congenital anomalies) were similar among
4vHPV vaccine recipients and placebo or control vaccine recipients. Although
one clinical trial raised the possibility of an association between 4vHPV vaccine
administered within 30 days following the estimated date of conception and an
increased incidence of congenital anomalies in the infant, those conditions were
relatively common and unrelated. 72 Pooled analyses from multiple clinical trials
have not confirmed such an association. 95
Pooled analysis of women who became pregnant during clinical trials showed
that, overall, there were no differences in pregnancy outcomes between 2vHPV
vaccine and control vaccine recipients. 96,97
HPV vaccines can be given to breastfeeding women. Among breastfeeding
mothers in the clinical studies of 4vHPV vaccine, the rates of adverse events
in the mother and the breastfeeding infant were comparable between 4vHPV
vaccine and control vaccination groups. 98 The effect on breastfed infants of
the administration of 2vHPV vaccine to their mothers has not been evaluated
directly in clinical studies, but breastfeeding is not considered a contraindication
for receiving the 2vHPV vaccine.
Refer to 3.3 Groups with special vaccination requirements, Table 3.3.1
Recommendations for vaccination in pregnancy for more information.
240 The Australian Immunisation Handbook 10th edition