What is the recommended number of Human Papillomavirus (HPV) vaccine doses for a 38-year-old man?

HPV Vaccination Schedule for a 38-Year-Old Man

A 38-year-old man should receive a 3-dose series of HPV vaccine at 0,1-2, and 6 months if he and his healthcare provider decide vaccination is appropriate through shared clinical decision-making. 1

Vaccination Recommendations by Age

For Adults Aged 27-45 Years

• HPV vaccination is not routinely recommended for all adults over age 26
• Instead, the Advisory Committee on Immunization Practices (ACIP) recommends shared clinical decision-making for adults aged 27-45 years 1
• For a 38-year-old man, this means discussing with a healthcare provider whether vaccination would be beneficial based on individual risk factors

Dosing Schedule for Adults

• Adults aged 27-45 years who decide to get vaccinated should receive the standard 3-dose schedule:
  • First dose: At initial visit (0 months)
  • Second dose: 1-2 months after first dose
  • Third dose: 6 months after first dose 1, 2

Factors to Consider in Shared Decision-Making

When discussing HPV vaccination with a 38-year-old man, healthcare providers should consider:

• New sex partners are a risk factor for acquiring new HPV infections at any age 1
• Persons in long-term, mutually monogamous relationships are less likely to acquire new HPV infections 1
• Most sexually active adults have already been exposed to some HPV types, though not necessarily all vaccine-targeted types 1
• Vaccine effectiveness may be lower in persons with multiple lifetime sexual partners due to likely previous exposure to vaccine-type HPV 1
• HPV vaccines are prophylactic and cannot treat existing HPV infections or HPV-related disease 1

Important Considerations

• No prevaccination testing (such as HPV testing) is recommended to determine appropriateness of vaccination 1
• If the vaccination schedule is interrupted, it does not need to be restarted - simply continue where left off 2
• Minimum intervals between doses should be observed:
  • At least 4 weeks between first and second doses
  • At least 12 weeks between second and third doses 2

Vaccine Type

• The 9-valent HPV vaccine (9vHPV) is currently the only HPV vaccine available in the United States
• It protects against HPV types 6,11,16,18,31,33,45,52, and 58, which are responsible for approximately 90% of cervical cancers and most HPV-related diseases 1

Common Pitfalls to Avoid

1. Assuming vaccination is unnecessary in adults over 26 years - while not routinely recommended, it may still provide protection against HPV types not yet encountered 2

2. Administering doses too close together (less than 4 weeks between doses 1 and 2 or less than 12 weeks between doses 2 and 3), which may result in suboptimal immune response 2

3. Giving only 2 doses instead of the required 3 doses for adults, which may result in inadequate protection 2

4. Forgetting follow-up doses - all three doses are necessary for optimal protection in adults 2