Gardasil 9 Dosing Schedule for Adults
For adults aged 15-26 years, Gardasil 9 should be administered as a 3-dose schedule with injections at 0,1-2, and 6 months. 1
Dosing Schedule Based on Age
The recommended dosing schedule for Gardasil 9 varies by age:
- Ages 9-14 years: 2-dose schedule (0,6-12 months)
- Ages 15-26 years: 3-dose schedule (0,1-2,6 months)
- Ages 27-45 years: 3-dose schedule (0,1-2,6 months) - with shared clinical decision-making
Special Populations
- Immunocompromised individuals: 3-dose schedule regardless of age
- Men who have sex with men: Recommended through age 26 years (3-dose schedule if ≥15 years)
Administration Details
Gardasil 9 is administered as a 0.5 mL intramuscular injection. Each dose contains HPV L1 proteins for types 6,11,16,18,31,33,45,52, and 58 adsorbed on amorphous aluminum hydroxyphosphate sulfate adjuvant 2.
Important Considerations
Catch-up vaccination: The CDC recommends catch-up HPV vaccination for all persons through age 26 years who are not adequately vaccinated 1.
Adults 27-45 years: Vaccination is not routinely recommended for all adults aged >26 years, but shared clinical decision-making is recommended for those aged 27-45 years 1.
Older adults: HPV vaccination is not licensed for use in adults >45 years 1.
Completion of series: If vaccination is interrupted, the series does not need to be restarted. Simply continue with the remaining doses.
Previous vaccination: There is no recommendation for revaccination for those who previously completed a full series with other HPV vaccine formulations 3.
Clinical Pearls
- HPV vaccines are prophylactic (prevent new infections) but do not treat existing HPV infections or HPV-related disease 1.
- The highest antibody responses occur in ages 9-15 years, with protection lasting at least 5 years without evidence of waning 1.
- HPV vaccination does not eliminate the need for cervical cancer screening, and vaccinated individuals should continue screening per guidelines 1.
Common Pitfalls to Avoid
- Incorrect dosing interval: Ensure proper spacing between doses for maximum efficacy.
- Assuming therapeutic effect: Remember that HPV vaccines prevent new infections but do not treat existing HPV infections or associated diseases 4.
- Neglecting special populations: Immunocompromised individuals require a 3-dose schedule regardless of age 1.
- Overlooking contraindications: Do not administer to individuals with severe allergic reactions to a previous dose or to yeast 1.
By following these guidelines, you can ensure appropriate administration of Gardasil 9 for adult patients, maximizing protection against HPV-related diseases.