From the Guidelines
The HPV vaccine is recommended for all female adults through age 26, even if they've already been sexually active or had HPV infections. For women aged 27-45, vaccination might still be beneficial and should be discussed with a healthcare provider based on individual risk factors 1. The vaccine, available as Gardasil 9, protects against HPV types that cause most cervical cancers and genital warts.
Key Points
- The standard regimen consists of two doses given 6-12 months apart for those who start vaccination before age 15, or three doses (at 0,1-2, and 6 months) for those who start at age 15 or older 1.
- The vaccine is most effective when given before any exposure to HPV through sexual contact, but it can still provide protection against HPV types not yet acquired.
- Side effects are generally mild and may include pain at the injection site, fever, headache, and fatigue.
- The vaccine works by stimulating the immune system to produce antibodies against HPV, preventing infection with the virus types covered by the vaccine and thereby reducing the risk of cervical cancer, other HPV-related cancers, and genital warts 1.
Special Considerations
- HPV vaccination is also recommended for females aged 13 to 18 years to catch up missed vaccine or complete the vaccination series 1.
- There are currently insufficient data to recommend for or against universal vaccination of females aged 19 to 26 years in the general population, and a decision about whether a woman in this age group should receive the vaccine should be based on an informed discussion between the woman and her health care provider regarding her risk of previous HPV exposure and potential benefit from vaccination 1.
From the FDA Drug Label
GARDASIL 9 is a vaccine indicated in girls and women 9 through 45 years of age for the prevention of the following diseases: Cervical, vulvar, vaginal, anal, oropharyngeal and other head and neck cancers caused by Human Papillomavirus (HPV) types 16,18,31,33,45,52, and 58. GARDASIL 9 is indicated in girls and women 9 through 45 years of age for the prevention of the following diseases: ... Genital warts (condyloma acuminata) caused by HPV types 6 and 11. The HPV vaccine recommendation for female adults is to administer GARDASIL 9 to girls and women 9 through 45 years of age.
- The recommended dosage is a 3-dose regimen at 0,2, and 6 months for females 15 through 45 years of age. The vaccine is for the prevention of diseases caused by HPV types 6,11,16,18,31,33,45,52, and 58 2.
From the Research
HPV Vaccine Recommendation for Female Adults
- The HPV vaccine is recommended for female adults up to age 45, with the strongest predictor of vaccine uptake being practitioner recommendation 3.
- Young adulthood is a critical period for HPV vaccination, with many individuals citing their parents' views and recommendations from medical providers as influential on their decision-making process 4.
- The HPV vaccine is a safe and highly effective way to prevent cervical cancer, with two FDA-approved vaccines (Gardasil and Cervarix) available 5.
- Provider and patient factors play a significant role in HPV vaccination and Pap smear uptake among young women, with vaccinated women more likely to receive a provider's recommendation for Pap testing and initiate Pap testing themselves 6.
- Age at initial HPV vaccination may impact cervical cancer screening participation, with women vaccinated at ages 9-12 less likely to participate in screening compared to those vaccinated at ages 13-23 7.
- Key factors influencing HPV vaccination among female adults include:
- Perceived risk of HPV infection
- Benefits of the HPV vaccine
- Motivations for and barriers to HPV vaccination
- Logistical barriers, such as uncertainty over vaccination status and insurance coverage
- Provider and patient factors, including recommendations and communication
- Strategies to promote HPV vaccination and cervical cancer screening among female adults may include:
- Improving the timing and messaging of outreach efforts
- Bolstering clinical infrastructure and processes for recommending and documenting vaccination
- Addressing logistical and system-level barriers to vaccination
- Encouraging provider-patient communication and recommendations for Pap testing and HPV vaccination 4, 6, 7