HPV Vaccine Recommendations
For the full text of CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations, see the Human Papillomavirus (HPV) ACIP Vaccine Recommendations.
- HPV vaccine is recommended for routine vaccination at age 11 or 12 years. (Vaccination can be started at age 9.)
- ACIP also recommends vaccination for everyone through age 26 years if not adequately vaccinated previously. HPV vaccination is given as a series of either two or three doses, depending on age at initial vaccination.
- Vaccination is not recommended for everyone older than age 26 years. However, some adults ages 27 through 45 years may decide to get the HPV vaccine based on discussion with their clinician, if they did not get adequately vaccinated when they were younger. HPV vaccination of people in this age range provides less benefit, for several reasons, including that more people in this age range have already been exposed to HPV.
- For adults ages 27 through 45 years, clinicians can consider discussing HPV vaccination with people who are most likely to benefit. HPV vaccination does not need to be discussed with most adults over age 26 years. See ACIP’s shared clinical decision-making FAQs.
Keep in mind that HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases. HPV vaccine works best when given before any exposure to HPV.
Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination. At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.
Two doses of HPV vaccine are recommended for most persons starting the series before their 15th birthday.
- The second dose of HPV vaccine should be given 6 to 12 months after the first dose.
- Adolescents who receive two doses less than 5 months apart will require a third dose of HPV vaccine.
Three doses of HPV vaccine are recommended for teens and young adults who start the series at ages 15 through 26 years, and for immunocompromised persons.
- The recommended three-dose schedule is 0, 1–2 and 6 months.
- Three doses are recommended for immunocompromised persons (including those with HIV infection) aged 9 through 26 years.
A severe allergic reaction (e.g., anaphylaxis) to a vaccine component or following a prior dose of HPV vaccine is a contraindication to receipt of HPV vaccine.
- Anaphylactic allergy to latex is a contraindication to bivalent HPV vaccine in a prefilled syringe since the tip cap might contain natural rubber latex.
- Quadrivalent and 9-valent HPV vaccines are produced in Saccharomyces cerevisiae (baker’s yeast) and are contraindicated for persons with a history of immediate hypersensitivity to yeast.
- A moderate or severe acute illness is a precaution to vaccination, and vaccination should be deferred until symptoms of the acute illness improve.
- A minor acute illness (e.g., diarrhea or mild upper respiratory tract infection, with or without fever) is not a reason to defer vaccination.
HPV vaccine is not recommended for use during pregnancy. Women known to be pregnant should delay initiation of the vaccination series until after the pregnancy. However, pregnancy testing before vaccination is not needed.
Although HPV vaccines have not been linked to causing adverse pregnancy outcomes or side effects (adverse events) to the developing fetus among pregnant women vaccinated inadvertently, HPV vaccines have not been studied in pregnant women in clinical trials.
- If a woman is found to be pregnant after starting the HPV vaccine series, second and/or third doses should be delayed until she is no longer pregnant.
- If a woman receives HPV vaccine and later learns that she is pregnant, there is no reason to be alarmed.
- Any woman who learns she was pregnant when she received an HPV vaccine is encouraged to contact the manufacturer.
- Toll-free phone number for 9vHPV is 1-800-986-8999 or http://merckpregnancyregistries.com/external icon
HPV vaccines are very safe. Scientific research shows the benefits of HPV vaccination far outweigh the potential risks. Like all medical interventions, vaccines can have some side effects.
All vaccines used in the United States, including HPV vaccines, are required to go through years of extensive safety testing before they are licensed by the U.S. Food and Drug Administration (FDA). During clinical trials conducted before they were licensed:
- 9-valent HPV vaccine was studied in more than 15,000 males and females
- Quadrivalent HPV vaccine was studied in more than 29,000 males and females
- Bivalent HPV vaccine was studied in more than 30,000 females
- Each HPV vaccine was found to be safe and effective.
Gardasil® 9 was studied in clinical trials with more than 15,000 females and males.
Gardasil® was studied in clinical trials with more than 29,000 females and males.
Cervarix® was studied in clinical trials with more than 30,000 females.
- The most common adverse reactions reported during clinical trials of HPV vaccines were local reactions at the site of injection.
- In prelicensure clinical trials, local reactions such as pain, redness, or swelling were reported by 20% to 90% of recipients.
- A temperature of 100°F during the 15 days after vaccination was reported in 10% to 13% of HPV vaccine recipients. A similar proportion of placebo recipients reported an elevated temperature.
- A variety of systemic adverse reactions have been reported by vaccine recipients, including nausea, dizziness, myalgia, and malaise. However, these symptoms occurred with equal frequency among both HPV vaccine and placebo recipients.
- Local reactions generally increased in frequency with increasing doses. However, reports of fever did not increase significantly with increasing doses.
- No serious adverse events have been associated with any HPV vaccine. Ongoing monitoring is conducted by CDC and the Food and Drug Administration.
Syncope (fainting) can occur after any medical procedure, including vaccination. Adolescents should be seated or lying down during vaccination and remain in that position for 15 minutes after vaccination. This is to prevent any injuries that could occur from a fall during a syncopal event.