The HPV vaccine, which protects against human papillomavirus, is an important vaccine recommended for preteens and teens. HPV is very common and can lead to certain cancers later in life. Understanding how often the HPV vaccine is needed can help ensure you or your child is fully protected.
What is HPV?
HPV stands for human papillomavirus. It is a very common virus. There are over 100 varieties of HPV. Some types of HPV can cause health problems like genital warts and cancer. Other types do not cause any problems and often go away on their own.
HPV is primarily spread through sexual contact. Nearly all sexually active adults will get HPV at some point. Most often HPV does not lead to any health issues and goes away on its own. But in some cases, HPV infections last longer and can cause cancers of the cervix, vulva, vagina, penis, anus, and throat.
The types of HPV that can cause cancer are considered high-risk. The types that can cause genital warts are considered low-risk. Vaccines can prevent infection from certain high-risk and low-risk HPV types.
Why is the HPV vaccine important?
The HPV vaccine is strongly recommended to protect against cancers and genital warts caused by HPV infection. The vaccine works best when given before any exposure to HPV. This is why it is recommended for preteens between ages 11-12.
The HPV vaccine provides protection against the types of HPV most likely to cause cancer. Getting vaccinated can prevent over 90% of HPV cancers. It also protects against 90% of genital warts. Overall, widespread HPV vaccination could prevent around 31,000 cases of cancer each year.
In addition to preventing cancer, the vaccine has other important benefits. It can reduce the need for HPV testing and invasive procedures like biopsies and cervical excision procedures to remove abnormal cells. Widespread vaccination could also reduce HPV transmission rates.
How many doses are needed?
The number of doses needed depends on age:
- Ages 9-14: 2 doses given 6-12 months apart
- Ages 15-26: 3 doses given over 6 months
- Ages 27-45: 3 doses over 6 months may be recommended if at high risk
For children younger than age 15, only two doses given at least six months apart are needed for full protection. Teens and young adults who start the series between ages 15-26 need three doses given over six months.
Catch-up vaccination is recommended for females up to age 26 and males up to age 21 if they did not already complete the series. Catch-up vaccination may be recommended until age 45 for some high risk groups, like men who have sex with men and immunocompromised people.
What are the current HPV vaccine recommendations?
The CDC currently recommends:
- Routine HPV vaccination at age 11-12 for both boys and girls
- Catch-up vaccination for all teens/young adults until age 26
- HPV vaccination until age 45 for adults at high risk
- Pregnant women can receive the HPV vaccine
HPV vaccination is recommended for preteens aged 11-12, before any exposure to the virus, for maximal protection. But the vaccine series can be started as early as age 9. Either 2 doses (under 15) or 3 doses (15+) are needed depending on age.
Routine catch-up vaccination is recommended for all females through age 26 and all males through age 21. For high risk groups, like men who have sex with men, catch-up vaccination is recommended through age 26. Some adults ages 27-45 may decide to get the HPV vaccine after a discussion with their doctor about their risk factors.
Pregnant women are able to get the HPV vaccine. Getting vaccinated during pregnancy is not recommended, but getting vaccinated before or after pregnancy can help protect the woman and infant.
At what ages is the HPV vaccine given?
|9-14 years||2 doses at 0, 6-12 months|
|15-26 years||3 doses at 0, 1-2, 6 months|
|27-45 years||3 doses at 0, 1-2, 6 months (for some high risk groups)|
The HPV vaccine is recommended at the following ages:
- Ages 11-12 – Routine vaccination recommended at this age
- Ages 9-14 – 2 doses 6-12 months apart
- Ages 15-26 – 3 doses over 6 months
- Ages 27-45 – May be recommended for some high risk groups until age 45
Ideally the vaccine series is finished before any sexual activity begins. But even if someone is sexually active, vaccination can still provide protection against HPV types not already acquired.
When are the doses given?
For children under age 15, the HPV vaccine is given as a series of 2 doses:
- Dose 1: At the initial visit
- Dose 2: Given 6-12 months after dose 1
For people ages 15-45, the series consists of 3 doses:
- Dose 1: At the initial visit
- Dose 2: 1 to 2 months after dose 1
- Dose 3: 6 months after dose 1
The vaccine doses are spaced out over several months to generate an optimal immune response. The second dose should be given no earlier than 24 weeks after the first dose. The recommended spacing provides the best protection.
If someone misses a dose, the series does not need to be restarted. The missed dose can be given at a later date to complete the series. However, longer intervals between doses may require additional doses.
How long does protection last?
Studies indicate that the HPV vaccine provides long-lasting protection, at least 10 years. Ongoing research continues to assess duration of protection and the potential need for additional booster doses later in life.
Clinical trials have followed vaccinated individuals for over 10 years. HPV antibody levels remain high for at least 10 years after vaccination, demonstrating ongoing protective effects. Real world data also shows the vaccine is effective at preventing HPV-related outcomes many years after vaccination.
More time is needed to determine if effectiveness might wane later in life. The CDC and FDA continue to monitor how long protection lasts. At this time, there are no recommendations for routine booster doses or revaccination later in life. But additional doses may potentially be recommended if duration of protection decreases as people age.
Who should get the HPV vaccine?
The CDC recommends routine HPV vaccination for girls and boys starting at age 11-12. Catch-up vaccination is also recommended for females through age 26 and males through age 21. Some adults ages 27-45 may also benefit based on shared decision-making with their doctor.
Those who should get the HPV vaccine include:
- Preteens ages 11-12 years
- Teens and young adults until age 26 who did not already complete the series
- Young men who have sex with men until age 26
- Transgender individuals until age 26
- Immunocompromised people until age 26
- Unvaccinated adults ages 27-45 after discussion with their doctor
Ideally the vaccine is given before any exposure to HPV. But even those who are sexually active can benefit, since it protects against HPV strains not already acquired.
Is HPV vaccination mandatory?
There is no federal vaccination mandate for HPV. Instead, each state determines vaccine requirements for school entry. As of 2022, only Virginia and the District of Columbia require the HPV vaccine for school attendance.
Over half of states have no HPV vaccine school requirements. Some have partial requirements, like only for girls or allow easy opt-outs. Despite not being mandatory, the CDC and major medical organizations strongly recommend routine HPV vaccination between ages 11-12.
How much does the HPV vaccine cost?
The HPV vaccine is covered under both private insurance plans and public programs:
- Private insurance: Plans must cover the vaccine at no out-of-pocket cost
- Medicaid: Fully covered for eligible children and adults
- CHIP: Fully covered for eligible children
- Uninsured: Available at no cost through the Vaccines for Children program
The Affordable Care Act requires private health plans to cover all recommended immunizations, including HPV, with no copays or deductibles when delivered by an in-network provider. Those with grandfathered plans may still have out-of-pocket costs.
Public programs like Medicaid, CHIP, and Vaccines for Children provide free HPV vaccination for eligible uninsured or underinsured individuals. Local health departments and community clinics often provide low-cost or free vaccination as well.
What are the side effects?
The HPV vaccine is very safe. Side effects are usually mild and go away quickly on their own. Common side effects include:
- Pain, redness, or swelling in the arm where the shot was given
Side effects are more common after the first dose and decrease with each subsequent dose. Severe side effects are very rare. Over 200 million doses have been distributed worldwide with an excellent safety record.
Some preteens and teens do faint after vaccination. Those with a history of fainting can receive the shot while lying down. The vaccine should still be given as recommended even if fainting occurs.
Is the HPV vaccine safe and effective?
Yes, HPV vaccines are very safe and effective:
- Over 200 million doses distributed worldwide since 2006
- Monitored extensively for side effects – determined to be very safe
- No evidence of any long term side effects
- Shown to significantly lower HPV infection and cancer rates
- Does not cause fertility or reproductive problems
Large clinical trials involving tens of thousands of people were conducted prior to FDA approval to determine safety and efficacy. Since introduction in 2006, HPV vaccines have been continuously monitored for side effects and effectiveness. Findings continue to support the excellent safety profile and ability to prevent HPV-associated cancers.
Despite misinformation circulating online, there is no scientific evidence that the HPV vaccine causes fertility or reproductive issues. Leading medical groups endorse its use. Vaccination provides protection against cancer without risks.
Does the HPV vaccine have side effects later in life?
There is no evidence that the HPV vaccine causes any long term or delayed side effects. No serious safety concerns have been identified in the years since it was introduced. Doctors and researchers continue monitoring vaccine safety data over time and have not detected any problems.
Online claims about long term side effects like autoimmune diseases, premature ovarian failure, or death are not supported by scientific evidence. Rates of these conditions are not higher in vaccinated individuals. Such claims have been widely debunked.
Those vaccinated are followed for many years through large databases to look for potential issues. None have been detected. The vaccine has an excellent safety record monitored closely by the CDC and FDA. Over 200 million doses have been given worldwide without cause for concern.
Why are multiple doses needed?
Multiple doses are needed to generate a strong and long-lasting immune response against HPV:
- The body takes time to produce antibodies after each dose
- Two doses are not enough in those ages 15 and older
- Spacing out doses over 6-12 months provides optimal immunity
- Antibody levels remain elevated for at least 10 years after vaccination
A single HPV vaccine dose produces an immune response in most people. However, antibody levels then decrease over time without further antigen exposure. Getting a second dose causes antibody concentrations to go up again. Additional doses trigger maturation of the antibody response.
The immune system needs time between exposure to the vaccine antigen to generate higher antibody concentrations after each subsequent dose. This is why spacing the doses over months provides optimal protection lasting many years.
The HPV vaccine is recommended for girls and boys starting at ages 11-12 to prevent HPV cancers and genital warts later in life. Two doses are recommended under age 15, while three doses are recommended between ages 15-26. Catch-up vaccination is advised for all young adults through age 26 who are unvaccinated. Vaccination provides long-lasting protection with minimal side effects.