HPV Vaccination Schedule Recommendations
HPV vaccination is routinely recommended at age 11 or 12 years, but can be started as early as age 9 years, with specific dosing schedules based on age at initiation: 2 doses for those starting before age 15, and 3 doses for those starting at age 15 or older. 1
Age-Based Recommendations
Children and Young Adolescents (9-14 years)
- Routine vaccination is recommended at age 11-12 years, though the series can be started as early as age 9 years 1
- For those initiating vaccination before their 15th birthday, a 2-dose schedule is recommended with doses administered at 0 and 6-12 months 1
- The American Academy of Pediatrics now recommends starting HPV vaccination between ages 9-12 years to improve vaccination rates and completion 2
Adolescents and Young Adults (15-26 years)
- For those initiating vaccination at age 15 years or older, a 3-dose schedule is recommended with doses administered at 0,1-2, and 6 months 1
- Catch-up vaccination is recommended for all persons through age 26 years who are not adequately vaccinated 1
Adults (27-45 years)
- Routine catch-up vaccination is not recommended for all adults over age 26 1
- Shared clinical decision-making is recommended for some adults aged 27-45 years who are not adequately vaccinated 1
- HPV vaccines are not licensed for use in adults over age 45 years 1
Dosing Intervals and Administration
Two-Dose Schedule (ages 9-14 years at initiation)
- First dose: At elected start date 1, 3
- Second dose: 6-12 months after first dose 1, 3
- Minimum interval between doses is 5 months for the schedule to be considered valid 3
Three-Dose Schedule (ages ≥15 years at initiation)
- First dose: At elected start date 1
- Second dose: 1-2 months after first dose 1
- Third dose: 6 months after first dose 1
- Minimum intervals: 4 weeks between first and second doses; 12 weeks between second and third doses 1
Special Considerations
Interrupted Schedules
- If the vaccine schedule is interrupted, the series does not need to be restarted 1
- If interrupted after the first dose, administer the second dose as soon as possible 1
- If only the third dose is delayed, administer it as soon as possible 1
Immunocompromised Individuals
- A 3-dose schedule (0,1-2,6 months) is recommended regardless of age at initiation for persons with certain immunocompromising conditions 1
Simultaneous Administration
- HPV vaccine can be administered at the same visit as other age-appropriate vaccines 1
- Each vaccine should be administered using a separate syringe at a different anatomic site 1
Important Clinical Considerations
- No prevaccination testing (e.g., Pap or HPV testing) is recommended before vaccination 1
- Cervical cancer screening recommendations have not changed for vaccinated individuals 1
- Vaccination is most effective when given before exposure to HPV through sexual activity 1
- Even if someone is sexually active, they should still be vaccinated as they may not have been exposed to all HPV types covered by the vaccine 1
Contraindications and Precautions
- The vaccine should not be given to people with a history of immediate hypersensitivity to yeast or any vaccine component 1
- Vaccination should be deferred for people with moderate or severe acute illness 1
- Consider having vaccine recipients sit or lie down for 15 minutes after administration due to risk of syncope in adolescents 1