HPV Vaccine Schedule for Individuals Starting at Age 15 or Older
For individuals starting the HPV vaccination series at age 15 or older, a 3-dose schedule is recommended. 1
Recommended Schedule for Ages 15+
- Individuals initiating HPV vaccination at ages 15 through 26 years should receive three doses of HPV vaccine 1
- The recommended 3-dose schedule is:
- First dose: at elected date
- Second dose: 1-2 months after the first dose
- Third dose: 6 months after the first dose 1
- The minimum interval between the first and second doses is 4 weeks 1
- The minimum interval between the second and third doses is 12 weeks 1
Why Three Doses for Ages 15+?
- Immune response to HPV vaccination is age-dependent, with stronger responses seen in younger individuals 1
- Studies show that individuals who start vaccination after age 15 require three doses to achieve adequate protection against HPV infection 1, 2
- Two-dose schedules are only recommended for those initiating vaccination before their 15th birthday 1, 2
Special Populations
- Immunocompromised individuals (including those with HIV) should receive the 3-dose schedule regardless of age at initiation 1
- Men who have sex with men should receive HPV vaccination through age 26 if not previously vaccinated 1
- For adults aged 27-45 years, shared clinical decision-making is recommended regarding HPV vaccination, but the 3-dose schedule would still apply if vaccination is chosen 1
Interrupted Schedules
- If the vaccination schedule is interrupted, it does not need to be restarted 1
- If interrupted after the first dose, administer the second dose as soon as possible 1
- Doses received after shorter-than-recommended intervals should be readministered 1
Effectiveness Considerations
- HPV vaccination is most effective when administered before potential exposure to HPV through sexual contact 1
- Providers should inform individuals aged 22-26 years who have not been previously vaccinated that vaccination at older ages may be less effective in lowering cancer risk 1
- Despite potentially lower effectiveness in older age groups, vaccination can still provide protection against HPV types to which an individual has not yet been exposed 1, 3
Vaccine Type
- As of January 2017, the 9-valent HPV vaccine (9vHPV, Gardasil-9) is the only HPV vaccine available in the United States 1
- The 9vHPV vaccine protects against HPV types 6,11,16,18,31,33,45,52, and 58 1
- HPV types 16 and 18 are responsible for approximately 70% of HPV-related cancers 1
Important Reminders
- No prevaccination testing (e.g., Pap or HPV testing) is recommended to establish the appropriateness of HPV vaccination 1
- All women, regardless of vaccination status, should continue to follow cervical cancer screening guidelines 1
- Vaccination can be administered to individuals who may have already been exposed to HPV, as they may still benefit from protection against HPV types they have not yet encountered 1