What is the recommended schedule for Human Papillomavirus (HPV) vaccination?

HPV Vaccination Schedule Recommendations

The Centers for Disease Control and Prevention recommends routine HPV vaccination at age 11 or 12 years, with a 2-dose schedule for those starting before age 15 (doses at 0 and 6-12 months) and a 3-dose schedule for those starting at age 15 or older (doses at 0,1-2, and 6 months). 1

Age-Based Recommendations

• Routine vaccination is recommended at age 11 or 12 years, but can be started as early as age 9 years 1
• The American Academy of Pediatrics recommends starting the HPV vaccine series between ages 9 and 12 years, at an age the provider deems optimal for acceptance and completion of the vaccination series 2
• Catch-up vaccination is recommended for all persons through age 26 years who are not adequately vaccinated 1

Dosing Schedule Based on Age

• For individuals initiating vaccination before their 15th birthday:

  • 2-dose schedule is recommended 1, 3
  • Doses should be administered at 0 and 6-12 months 1
  • The minimum interval between doses should be at least 6 months 4

• For individuals initiating vaccination at age 15 years or older:

  • 3-dose schedule is recommended 1, 3
  • Doses should be administered at 0,1-2, and 6 months 1
  • Minimum intervals are 4 weeks between first and second doses, and 12 weeks between second and third doses 1

Special Populations

• A 3-dose schedule is recommended for individuals with certain immunocompromising conditions, regardless of age at initiation 1, 5
• Earlier initiation at age 9 may help reduce health disparities in vaccination coverage and HPV-associated cancers 6
• Starting vaccination earlier may disentangle HPV recommendations from discussions of sexuality and might alleviate vaccine hesitancy 2

Clinical Considerations

• HPV vaccine can be administered at the same visit as other age-appropriate vaccines, using a separate syringe at a different anatomic site 1
• No prevaccination testing is recommended before vaccination 1
• Vaccination is most effective when given before exposure to HPV through sexual activity 1, 5
• Cervical cancer screening recommendations remain unchanged for vaccinated individuals 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

Potential Benefits of Earlier Vaccination

• Initiating the vaccine at age 9 or 10 may be preferable for parents or adolescents who do not want to receive multiple concomitant vaccines at age 11 or 12 2
• The immune response is robust at younger ages with no evidence of waning protection 2
• Earlier initiation may improve overall vaccination rates and reduce disparities in coverage 6