Recommended HPV Vaccine Schedule and Dosing

Medically reviewed by Soma Mandal, MD

The HPV vaccine protects against the human papillomavirus virus (HPV), which is a common sexually transmitted infection—especially among teenagers and young adults. The infections usually go away on their own within a couple years and don't cause any symptoms. But sometimes HPV infections can persist over the course of several decades and cause cervical, oral, vaginal, penile, and anal cancer. This is why HPV vaccine is recommended for teens and young adults.

The HPV vaccine is the most effective way to prevent HPV infections and protect against oral and genital cancers caused by HPV. Numerous clinical trials have found the current vaccine to be roughly 90% effective at preventing cancers caused by HPV infections.

The HPV vaccine was first licensed by the U.S. Food and Drug Administration (FDA) in 2006. Although the dosing and vaccine types have changed over the years, major medical organizations such as the FDA, Centers for Disease Control and Prevention (CDC), and Academy of American Pediatrics recommend the HPV vaccine for use in young people, as well as in some older individuals who are vulnerable to HPV infections.

Editor's Note: There have been three HPV vaccines approved for use in the U.S. since 2006. But since late 2016, only one has been available: The 9-valent HPV vaccine (9vHPV), manufactured by Gardasil9 (Merck & Co). While all the previously used vaccines protect against the most common types of HPV, the 9vHPV vaccine can protect against even more high-risk types as well as types that cause anogenital warts.

Recommended HPV Vaccine Schedule

The CDC recommends the HPV vaccine be administered to children and adults between the ages of 9-26 years. Ideally, the vaccine is given when a child is 11 or 12. But vaccination can start as early as 9 years old. And if you weren't vaccinated in your tween years, you can play “catch up” through the age of 26.

Because the HPV vaccination schedule and dosing depends in large part on the age of the person being vaccinated, it’s simplest to look at the HPV vaccine schedule by age groups:

Recommendations for Children, Aged 9-14

The CDC recommends most children aged 9-14 years receive two doses of the HPV vaccine, with the two doses spaced 6-12 months apart. If the doses were administered closer together—five months apart or less—a third dose is required. Three doses are also recommended for children who are immunocompromised, such as those with HIV.

Most children in this age group are not yet sexually active, but early protection is most effective against HPV. That's why experts recommend getting vaccinated well before children even come in contact with the virus.

Recommendations for Teens and Young Adults, Aged 15-26

If someone begins receiving the HPV vaccine on or after their 15th birthday, three doses are required over the course of six months. The second dose can be given one or two months after the first, and the third dose should be given six months after the first.

Recommendations for Adults, Aged 27-45

HPV vaccines aren’t routinely recommended for adults aged 27-45 since most people in this age range have already been exposed to HPV. However, people at high risk of a new HPV infection or with other risk factors may benefit from HPV vaccination. If you are 27 or older and have not gotten vaccinated against HPV, it's recommended that the decision to get vaccinated be made after a conversation with your healthcare provider.

Editor's Note: Whether or not you already have had HPV doesn't impact your ability to get the HPV vaccine, and testing for HPV before vaccination isn't recommended. The vaccine can protect against other types of HPV that you don't have but to which you might be exposed in the future. And since the vaccine doesn't protect against all HPVs, it's important to get regular cervical cancer via pap smears even if you are fully vaccinated.

What If You Don't Stick to the HPV Vaccine Series?

Depending on how old you are when you receive your first dose, you will need either two or three doses. That means two or three trips to the healthcare provider's office to complete your HPV vaccination series. While finishing your series and spacing out the doses at their appropriate amount is recommended for the most effective protection, sometimes scheduling conflicts or transportation barriers makes it so that you might not be able to stick to the exact dosing schedule.

If for some reason you don't get your second or third dose within the recommended window, all you need to do is get your next dose as soon as possible. There is no maximum interval between doses; that means you don't have to re-start your vaccine series or get any extra doses if you go a little longer than you should between doses.

Getting the doses too close together is a different story. While the interval for a two-dose HPV vaccine series is 6-12 months, the minimum interval is five months. If you get your second dose earlier than five months, you will have to repeat the dose.

If you are receiving a three-dose series, the minimum interval is four weeks between dose one and two, 12 weeks between dose two to three, and five months between dose one to three. If you receive any of the doses sooner than the minimum interval, you'll have to repeat the dose.

What To Expect

HPV vaccines are administered through an injection in the upper arm. When the needle enters, you will feel like a pinch or quick prick. The vaccine doses can be given with other routine child or adult vaccinations, without interfering with either vaccine’s effectiveness. It’s just usually recommended that the vaccines be given in different arms.

Because fainting is a potential side effect particularly among adolescents, children will likely be told to sit or lie down during the vaccination and for 15 minutes after its administration.

At the time of your initial dose, ask about making an appointment for your second dose to ensure you complete your full series. Same goes for making an appointment for your third dose, if needed, after getting your second dose.

Is the HPV Vaccine Safe?

Like all vaccines approved for use, the HPV vaccines has gone through multiple trials with thousands of participants. From those studies, researchers have concluded that the vaccine is safe. Notably, the vaccine has a low rate of serious side effects, and no deaths have been linked to the HPV vaccine.

The most common side effects after an HPV vaccine are similar to the side effects of most vaccines, including pain, swelling, and redness at the injection site within the first few days after vaccination. Some people have also reported headache, nausea, exhaustion, and fever after HPV vaccination.

The HPV vaccine is one of the most common adolescent vaccines to be associated with fainting. However, researchers think it is the vaccine process rather than the vaccine itself that causes adolescents to faint since other adolescent vaccines have also been tied to fainting.

Who Shouldn't Get the HPV Vaccine?

It is safe for most people to get the HPV vaccine. However, there are some populations who should not get it or who should consult with a healthcare provider before getting the vaccine. You should take caution about getting the HPV vaccine if:

• You've had a prior serious allergic reaction to any ingredient in the HPV vaccine, including yeast

• You've had a severe reaction to a HPV vaccine dose

• You are pregnant
  

Quick Review

The HPV vaccine schedule recommends that children get the HPV vaccine when they are 11 or 12. But you can get the vaccine as young as 9 and as old as 26. If you get the vaccine between ages 9-14, you will receive two doses, 6-12 months apart. Children who are immunocompromised might need three doses. If you receive the vaccine when you are 15-26, you will receive three doses over the span of six months. If you miss one of your doses, you simply need to get your next dose as soon as possible.

It's not recommended that people 27-45 years old get the HPV vaccine, though you and your healthcare provider can discuss whether it's right for you. The HPV vaccine is safe and highly effective at preventing types of HPV that cause certain cancers. Early protection is the best protection.

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