The key role of obstetricians/gynecologists and other health care providers is to provide patients and their parents with information about the benefits and safety aspects of the papillomavirus (HPV) vaccine to encourage adolescents to receive HPV vaccination, according to updated recommendations published online June 26 by the American College of Obstetrics and Gynecology (ACOG). Current vaccination rates are low,” wrote the ACOG committee of the Adolescent Health Preparedness Expert Working Group. Research suggests that physician recommendations play a key role in patient and patient parent uptake of HPV vaccination.” The committee updated its March 2014 recommendations to include the 9-valent HPV vaccine. Meanwhile, the Centers for Disease Control and Prevention (CDC) recommends vaccination for boys and girls aged 11 to 12 years. Those who do not receive HPV vaccine in the target age range should receive additional vaccinations up to age 26. A new formulation, Gardasil 9, was approved by the U.S. Food and Drug Administration in December 2014. the new vaccine protects against the original four strains of the quadrivalent vaccine, as well as five other strains that can cause cervical, vulvar, vaginal, penile and anal cancers. Another early bivalent vaccine fights strains 16 and 18, which cause most cervical cancers. 9-strain vaccine is more than 99% effective in reducing disease caused by strains 6, 11, 16, and 18 of HPV infection, and 96.7% effective in reducing disease caused by strains 31, 33, 45, 52, and 58. Despite the existence of recommendations for HPV vaccination in adolescents, only about 50% of U.S. girls aged 13 and 17 years have received at least one dose of the vaccine, and 33% have received all three doses. the CDC estimates that an immunization rate of more than 80% would prevent 53,000 cases of cervical cancer in the lifetime of girls currently younger than 12 years of age. If a man or woman has previously received all three doses of the vaccine, neither the CDC’s Advisory Committee on Immunization Practices nor the ACOG generally recommends receiving the 9-strain vaccine again. However, the 9-strain vaccine can continue to be offered to men or women who have previously received only one or two doses of the earlier vaccine. The safety of the 9-strain vaccine is similar to that of the quadrivalent vaccine, except for greater abnormal redness and swelling at the injection site of the new vaccine. After more than 60 million doses of HPV vaccine have been administered, the committee wrote, “there are no data indicating any serious adverse effects or adverse reactions associated with vaccination. Obstetricians and gynecologists or other providers should inform patients of discomfort after vaccination and that such discomfort need not be a cause for concern.” However, those who have had a history of life-threatening reactions to HPV vaccine or its components, including yeast, should not receive the vaccine. The committee does not recommend routine pregnancy testing or routine HPV testing until patients receive the vaccine. People in the target age group who may test positive for HPV DNA should still be vaccinated. Although data on HPV vaccination during pregnancy suggest that it is reassuringly safe, the ACOG recommends that women who are pregnant not receive the vaccine. Women who are breastfeeding may be vaccinated.