From the Guidelines
For a 33-year-old who received both HPV vaccines as a teen, no additional HPV vaccination is needed at this time. The HPV vaccines you received during adolescence provide long-lasting protection against the most common cancer-causing HPV types. Current evidence suggests that protection from the HPV vaccine remains strong for at least 10-12 years after vaccination, with no evidence of waning immunity over time 1. The vaccines you received likely included Gardasil (quadrivalent) and possibly Gardasil 9 (nonavalent), which protect against HPV types responsible for most cervical cancers and genital warts. Even though you're now 33, the protection from your adolescent vaccination series continues. However, you should still follow recommended cervical cancer screening guidelines, typically including Pap tests every 3 years or HPV/Pap co-testing every 5 years between ages 30-65, as the vaccine doesn't protect against all HPV types that can cause cancer. The vaccine works best when given before exposure to HPV through sexual contact, which is why you received it as a teenager, and your early vaccination likely provided optimal protection.
Some key points to consider:
- The American Cancer Society endorses the ACIP recommendations for HPV vaccination, with a focus on routine vaccination at ages 11-12 years 1.
- Vaccination at older ages is less effective in lowering cancer risk, with reduced efficacy and effectiveness for preventing precancerous lesions in individuals older than 21 years 1.
- The 9-valent HPV vaccine (Gardasil 9) provides protection against additional HPV types and can prevent an estimated 3,800 more cases of cancer in the US annually 1.
- Recent updates to the ACS guideline recommend routine age for HPV vaccination to be between ages 9 and 12 years, with catch-up vaccination for all individuals through age 26 years 1.
- The ACS does not endorse shared clinical decision making for vaccination at ages 27 to 45 years due to the minimal cancer prevention benefit expected from vaccination in this age range 1.
From the Research
HPV Vaccine Effectiveness
- The HPV vaccine is most effective when administered before sexual debut, preventing HPV infections, precancers, and cancers 2, 3.
- Vaccination of sexually active populations does not prevent cancer, emphasizing the importance of screening to detect HPV infections during adulthood 2.
Screening Recommendations
- Screening with HPV testing is the most effective method of detecting precancers and cancers between ages 25 and 65 2.
- Ensuring adequate screening around the age of menopause may be key to preventing cervical cancer among elderly women 2.
Vaccine Schedule
- The current recommendation for HPV vaccination in the United States is for 3 doses to be administered over a 6-month period, but a 2-dose schedule is recommended for teens who begin the series before age 15 4, 5.
- Three doses remain recommended for persons who initiate the vaccination series at ages 15 through 26 years and for immunocompromised persons 5.