Can I receive Gardasil (Human Papillomavirus vaccine) when I am HPV (Human Papillomavirus) positive?

Gardasil Vaccination in HPV-Positive Individuals

Individuals who are HPV-positive can receive Gardasil vaccination, as it will still provide protection against HPV types they have not yet been exposed to, though the vaccine will not treat or clear existing HPV infections.

Understanding Gardasil and Its Efficacy in HPV-Positive Individuals

What is Gardasil?

• Gardasil is a quadrivalent vaccine that protects against HPV types 6,11,16, and 18, and is FDA-approved for use in both males and females 1
• The vaccine is made of virus-like proteins based on the L1 capsid protein structure, which cannot cause infection even in immunocompromised individuals 1
• Gardasil-9, the newer version, protects against nine HPV types (6,11,16,18,31,33,45,52, and 58) 2

Efficacy in HPV-Positive Individuals

• The vaccine is most effective when administered before exposure to HPV through sexual activity 1
• For individuals already infected with one or more vaccine HPV types, the vaccine will still protect against the remaining HPV types included in the vaccine 3
• Clinical trials showed no clear evidence of protection from disease caused by HPV types for which participants were already PCR-positive or seropositive 1
• The vaccine has no therapeutic effect on existing HPV infections or HPV-related lesions 1, 2

Official Recommendations for HPV-Positive Individuals

FDA and Advisory Committee Guidelines

• Gardasil is not contraindicated for individuals who are HPV-positive 2
• The vaccine is indicated for individuals aged 9-45 years regardless of HPV status 2
• HPV testing before vaccination is not recommended as there are no good measures of past exposure, and current testing only reflects current viral shedding 1

Special Considerations

• Women with abnormal Pap tests or positive HPV tests can receive the vaccine, though they may have diminished benefit depending on which HPV types they already have 1
• Individuals with genital warts (typically caused by HPV 6 or 11) can still benefit from vaccination against other HPV types 1
• The vaccine is safe for HPV-positive individuals, with equivalent safety demonstrated in clinical trials 1

Benefits of Vaccination Despite HPV-Positive Status

Protection Against Other HPV Types

• Even if infected with one HPV type, vaccination can protect against other vaccine-covered types not yet acquired 1, 3
• The vaccine prevents reinfection with the same HPV type after clearance of an existing infection 3
• Given that there are multiple oncogenic HPV types, protection against additional types remains valuable 4

Long-term Protection

• The vaccine induces high levels of neutralizing antibodies that provide long-term protection 3, 5
• Vaccination produces a strong immune response even in those previously exposed to HPV 3

Practical Considerations

Vaccination Approach for HPV-Positive Individuals

• No special dosing or administration changes are needed for HPV-positive individuals 2
• Standard dosing schedule applies: 3 doses at 0,2, and 6 months for individuals 15-45 years of age; 2 doses for those 9-14 years of age 2
• Continued cervical cancer screening is essential for women regardless of vaccination status 1, 2

Common Misconceptions

• Being HPV-positive is not a contraindication for receiving the vaccine 1, 2
• The vaccine will not worsen existing HPV infections 2
• The vaccine is not a treatment for existing HPV infections or related conditions 2

Important Caveats

• The potential benefit of vaccination decreases with increasing likelihood of previous HPV exposure 1
• Individuals with multiple sexual partners have higher likelihood of exposure to multiple HPV types 1
• Regular cervical cancer screening must continue even after vaccination 2