HPV Vaccination for a 38-Year-Old Male
HPV vaccination is not routinely recommended for a 38-year-old male, but may be considered through shared clinical decision-making if the individual has risk factors for new HPV infection.
Current Recommendations by Age Group
Routine Recommendations
- HPV vaccination is routinely recommended at age 11 or 12 years (can start as early as age 9) 1, 2
- This timing maximizes effectiveness by ensuring vaccination occurs before potential exposure to HPV through sexual activity
Catch-up Vaccination
- Females: Recommended through age 26 years 1, 2
- Males: Recommended through age 21 years 1
- In 2019, ACIP harmonized recommendations to include catch-up vaccination for all persons through age 26 years 1
Adults Aged 27-45 Years
- Not routinely recommended for all adults in this age group 1
- Shared clinical decision-making is recommended for adults aged 27-45 years who are not adequately vaccinated 1, 2
Special Populations with Extended Recommendations
For certain high-risk groups, vaccination is specifically recommended through age 26 years:
- Men who have sex with men (MSM) 1, 2, 3
- Immunocompromised individuals, including those with HIV infection 1, 2
Factors to Consider for a 38-Year-Old Male
Efficacy Considerations
- Vaccination is most effective when administered before exposure to HPV 1, 4
- Most sexually active adults have already been exposed to HPV 1
- However, new infections can occur with new sex partners 1
- Vaccine efficacy is lower among adults compared to adolescents 4
Risk Assessment
When considering vaccination for a 38-year-old male, evaluate:
- New or multiple sex partners
- Men who have sex with men (higher risk of anal HPV infection and related cancers) 3
- Immunocompromised status
- History of HPV-related conditions
Clinical Decision-Making Process
- Discuss that vaccination at older ages is less effective in lowering cancer risk 1, 2
- Assess risk factors for new HPV infection
- Consider the individual's preferences after discussing potential benefits and limitations
Vaccine Information if Proceeding with Vaccination
- Currently, only the 9-valent HPV vaccine (9vHPV) is distributed in the United States 1
- For adults, a 3-dose schedule is recommended (0,1-2, and 6 months) 2
- Common side effects include local injection site reactions and headache 2
Common Pitfalls to Avoid
- Failing to assess sexual orientation when considering HPV vaccination for adult males 5
- Not discussing that vaccination at older ages has lower efficacy for cancer prevention 1
- Assuming all adults over age 26 are not candidates for vaccination without considering risk factors 1
Remember that while HPV vaccination is not routinely recommended for a 38-year-old male, individual risk factors may warrant consideration through shared clinical decision-making as recommended by the Advisory Committee on Immunization Practices.