HPV Vaccination at Age 31
Yes, a 31-year-old can and should receive the HPV vaccine if not previously adequately vaccinated, as catch-up vaccination is recommended for all persons through age 26 years, and you fall within the extended age range where vaccination remains beneficial. 1
Clear Recommendation for Your Age Group
Since you are 31 years old, you fall into a specific category in the current guidelines:
You are past the routine catch-up age of 26 years but well within the FDA-approved age range (9-45 years) for the 9-valent HPV vaccine (Gardasil 9). 1
The Advisory Committee on Immunization Practices (ACIP) does not routinely recommend catch-up vaccination for all adults aged 27-45 years, but explicitly recognizes that some persons who are not adequately vaccinated might be at risk for new HPV infection and might benefit from vaccination in this age range. 1
Shared clinical decision-making is recommended for adults aged 27-45 years, meaning you should discuss with your healthcare provider whether vaccination makes sense for your individual situation. 1, 2
Dosing Schedule
You will need a 3-dose schedule administered at 0,1-2, and 6 months, as you are over age 15. 2
Factors That Support Getting Vaccinated at Age 31
Your healthcare provider should consider these factors that would make vaccination more beneficial:
New or future sex partners: New sex partners at any age increase risk for acquiring new HPV infections, even if you've been sexually active before. 1, 2
Limited number of lifetime sex partners: If you have had fewer sexual partners, you are less likely to have been exposed to all vaccine-type HPV strains. 1, 2
Not in a long-term mutually monogamous relationship: Persons in long-term, mutually monogamous relationships are not likely to acquire new HPV infections. 2
Immunocompromising conditions: If you have conditions affecting your immune system, you may be at higher risk and could benefit more from vaccination. 1
Important Limitations to Understand
The vaccine is prophylactic only - it prevents new HPV infections but does not treat existing infections or HPV-related diseases. 1, 2
Most sexually active adults have already been exposed to some HPV types, though not necessarily all vaccine-type HPV strains. 1, 2
No clinical antibody test exists to determine whether you are already immune or still susceptible to any given HPV type, so vaccination decisions cannot be guided by testing. 1, 2
Vaccine effectiveness might be lower among persons with multiple lifetime sex partners who likely have previous infection with vaccine-type HPV. 1
Why the Recommendation Changes After Age 26
The number needed to vaccinate (NNV) to prevent one case of cancer increases dramatically with age: 202 for the current program (adolescents) versus 6,500 for extending routine vaccination to age 45 years. 2 This reflects that:
- HPV acquisition generally occurs soon after first sexual activity 1
- Most new HPV infections occur in adolescents and young adults 1
- Vaccine efficacy is highest among persons who have not been exposed to vaccine-type HPV before vaccination 1, 2
What the Vaccine Protects Against
The 9-valent HPV vaccine (Gardasil 9) - the only HPV vaccine currently distributed in the United States - protects against:
- HPV types 16 and 18: Cause the majority of HPV-associated cancers (cervical, anal, oropharyngeal, penile, vaginal, vulvar) 1
- HPV types 6 and 11: Cause anogenital warts 1
- HPV types 31,33,45,52, and 58: Five additional high-risk cancer-causing types 1
Important Caveats
HPV vaccination does not change cervical cancer screening recommendations - you should continue following standard screening guidelines regardless of vaccination status. 1, 2
Pregnancy: If you are pregnant, vaccination should be delayed until after pregnancy, though pregnancy testing is not required before vaccination. 1, 2
Breastfeeding: You can receive the HPV vaccine if breastfeeding or lactating. 1, 2
Bottom Line
At age 31, you should have a conversation with your healthcare provider about HPV vaccination. The vaccine is FDA-approved, safe, and can provide benefit if you have not been adequately vaccinated previously, particularly if you anticipate new sexual partners or have had limited prior HPV exposure. 1, 2 While the public health benefit is lower than vaccinating adolescents, individual benefit may still be substantial depending on your specific circumstances. 1