The terms “women” and "girls" are used in this article to refer to people who identify as female and have the typical reproductive organs of a cisgender female. We recognize that some people who identify as female do not have the same anatomy as that depicted in this article.
The human papillomavirus (HPV) is a group of 200 related viruses that are most commonly spread by skin-to-skin contact through sexual activity. HPV is so prevalent that the Centers for Disease Control and Prevention (CDC) estimates 85% of all people will get an HPV infection in their lifetime, and 13 million adults and teenagers will be infected with HPV each year.
HPV infections usually go undetected because they don't always present symptoms and tend to go away on their own. Some types of HPV can cause genital warts, while others can become more serious and lead to cancer of the cervix, vulva, vagina, penis, anus, or back of the throat.
This article discusses the HPV vaccine schedule by age, benefits and side effects of the vaccine, and screening recommendations for early detection of infections and related cancers.
HPV Vaccine Schedule
There are three different HPV vaccine types currently licensed in the United States:
- Gardasil 9
Currently, Gardasil 9 is the only one available for use.
When to Get Vaccinated
According to the CDC, the ideal age range to receive the HPV vaccine is between 11 and 12 years old. However, adolescents as young as 9 years old and adults up to age 45 may be candidates for the vaccine.
A person's age and immune status may determine how many doses of the vaccine they receive.
Age Range for Two Doses
A two-dose regimen is recommended for people ages 9 to 14. The first dose must be initiated before a person turns 15 to fall under the two-dose schedule.
Research shows that children in the 9-14 age range who receive two doses of the vaccine at least six months apart have equal or greater protection than people over the age of 15 who receive three doses.
Two Dose Schedule
- Dose 1: Administered sometime between the ages of 9 to 14
- Dose 2: Administered six to 12 months after the first dose
Age Range for Three Doses
People who get the first dose of the HPV vaccine after their 15th birthday require three doses. The three dose regimen is recommended for people ages 15 to 26 and for individuals ages 9 to 14 who have a compromised immune system.
Three Dose Schedule
- Dose 1: Administered sometime between the ages of 15 to 26
- Dose 2: Administered one to two months after the first dose
- Dose 3: Administered six months after the first dose
Benefits of HPV Vaccine Protection
HPV can lead to cervical cancer and other cancers of the vagina, vulva, penis, anus, and throat. Vaccination is one of the best tools available to help protect against these cancers.
The HPV vaccine has been available since 2006, and ongoing monitoring has shown the vaccine to be safe and effective.
Since its introduction in the United States, HPV infections that cause genital warts and certain cancers have decreased by 88% in teen girls and 81% in women.
HPV Vaccination in Boys
Historically, HPV vaccination efforts have been focused on young women and girls since their risk for developing HPV-related cancers is 10 times higher than males. Men relied on herd immunity from women being vaccinated against HPV as their primary method of prevention. Those efforts have shifted as HPV vaccines among both men and women continue to provide long-lasting protection in both sexes. As of 2011, the CDC recommends administration of the HPV vaccine to young men and boys according to a similar schedule as that for women.
Most vaccines do come with side effects, and the HPV vaccine is no exception.
However, side effects of the Gardasil-9 shot are typically mild and the incidence of serious adverse reactions is uncommon. In fact, a study of nearly 1 million girls who had received their HPV vaccine found no serious adverse effects such as neurological or autoimmune responses.
Possible Side Effects
Possible side effects of the HPV vaccine include:
- Pain, redness, or swelling at the injection site
- Dizziness or fainting
- Muscle or joint pain
These side effects usually resolve a day or two after the injection.
Parental education and engagement with the HPV vaccine for their children is crucial, yet knowledge of HPV and its relationship to cancer isn't widely known.
A 2017 survey distributed by the National Cancer Institute aimed at determining public knowledge of HPV found that 70% of U.S. adults, regardless of age or sex, didn't know that HPV causes oral, anal, and penile cancers.
A separate 2020 survey that evaluated parents' intentions to start and complete the HPV vaccination series found that parents of 58% of unvaccinated adolescents in the U.S. had no plans to initiate the series.
A total of 22.8% of respondents listed safety concerns as the most common reason why they did not intend to initiate the vaccine series. Of the survey respondents who were not planning to complete the series, 22.2% noted the lack of receiving a healthcare provider recommendation for subsequent doses.
Talking about your child's sexual health can be uncomfortable, but having the discussion with their healthcare provider could determine the possibility of a cancer diagnosis later in your child's life.
HPV Vaccine Ingredients
The ingredients in Gardasil 9 include:
- Proteins of nine HPV types
- Amorphous aluminum hydroxyphosphate sulfate
- Yeast protein
- Sodium chloride
- Polysorbate 80
- Sodium borate
- Water (for injection)
Is There an HPV Vaccine for Adults?
The HPV vaccine is not recommended for people over the age of 26. This is because the vaccine is more likely to benefit younger people, before they have already been exposed to HPV.
However, adults between the ages of 27 and 45 can talk to their healthcare provider to learn if they could benefit from receiving the vaccine.
If it's determined that an adult over the age of 26 could benefit from the HPV vaccine, they should follow the three-dose regimen.
Ongoing Screening for HPV
Pap smears and HPV tests are the two available ongoing screening methods for HPV in women. Both tests are performed the same way by a healthcare provider.
The provider uses a tool called a speculum to collect cells from the cervix for testing. Pap tests look to see if the collected cells are normal, whereas HPV tests specifically look for HPV cells in the sample.
Regular inspection for genital warts is another way to screen for HPV. If you think you may have genital warts, talk to your healthcare provider about treatment options.
Initiating the HPV vaccine series during adolescence is the most effective way to prevent HPV-related cancers later in life. The CDC recommends that young people receive the two-dose vaccine at age 11 or 12, though anytime between the ages of 9 to 14 is acceptable.
If a person hasn't been vaccinated before they turn 15, it's recommended that they receive the three-dose vaccine series sometime between the ages of 15 and 26. People older than 26 can still receive the vaccine if their healthcare provider determines it is appropriate for them.
Ongoing monitoring over time has shown that HPV vaccine is safe, effective, and unlikely to cause side effects.
A Word From Verywell
The HPV vaccine is an effective tool to help prevent HPV-related cancers. Getting your child vaccinated during adolescence is the best way to protect them from the risks of HPV before they are even exposed. Talk to your healthcare provider about the benefits of HPV vaccination.
Frequently Asked Questions
Are Gardasil shots effective?
Yes. Since their introduction in 2006, Gardasil shots have shown to decrease HPV infections by 88%.
Learn More:What to Know About HPV Vaccines
Why was the first round of Gardasil recalled?
The first round of Gardasil was recalled out of an abundance of caution after it was found that a select number of vials may have contained small glass particles.(Video) HPV Vaccinations: 9 Benefits of Starting at Age 9
Can you get HPV after being vaccinated?
The HPV vaccine protects against the types of HPV that cause cancer. It is possible to get other types of HPV after being vaccinated, but the risk for serious illness as a result of that infection is significantly reduced.
Are all three HPV shots necessary?
Yes, to ensure adequate protection against HPV, three doses of the HPV vaccine are necessary in people who begin the regimen after they turn 15.
When is it too late to schedule the HPV vaccine?
The ideal timeframe for HPV vaccine administration is before a person becomes sexually active. By age 26, most people have been exposed to HPV and therefore do not benefit from the vaccine. Every person is different, so talk to your healthcare provider if you feel that you could benefit from the HPV vaccine.