From the Guidelines
Gardasil 9 is not recommended for a 35-year-old individual who previously received Gardasil as a child, as the benefits of additional protection are minimal and the CDC does not recommend routine HPV vaccination for adults over age 26. The original Gardasil protected against HPV types 6,11,16, and 18, which cause approximately 70% of cervical cancers, and the additional protection from Gardasil 9 would be limited at this age 1. According to the Advisory Committee on Immunization Practices, the majority of HPV-associated cancers are caused by HPV 16 or 18, types targeted by all three vaccines, and most sexually active adults have already been exposed to HPV 1.
The American Cancer Society guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors also notes that the efficacy and potential benefit of HPV vaccines for females aged 19 years and older in the general population are less clear than for girls younger than age 19 years 1. Additionally, the risk of exposure to carcinogenic and noncarcinogenic HPV types increases with the number of lifetime sex partners, and many currently or previously sexually active females will have been exposed to HPV16 and/or HPV18 1.
Instead of receiving Gardasil 9, it is recommended to continue with regular cervical cancer screening according to guidelines, which is more important for someone at this age who may have already been exposed to HPV 1. If there are specific concerns about HPV risk, it is best to discuss them with a healthcare provider who can evaluate individual circumstances. Insurance typically does not cover Gardasil 9 for adults over 26, further supporting the decision not to recommend it for this age group.
Key points to consider:
- The CDC does not recommend routine HPV vaccination for adults over age 26
- Most sexually active adults have already been exposed to HPV
- The original Gardasil provides protection against the most high-risk HPV types
- The additional protection from Gardasil 9 would be minimal at this age
- Regular cervical cancer screening is more important for someone at this age who may have already been exposed to HPV 1.
From the Research
Gardasil 9 Indication for a 35-year-old Individual
- The indication for Gardasil 9 (Human Papillomavirus 9-valent Vaccine) in a 35-year-old individual who previously received Gardasil (Human Papillomavirus Quadrivalent Vaccine) as a child is not directly addressed in the provided studies.
- However, according to the study 2, Gardasil 9 is recommended for routine vaccination at age 11 or 12 years, and also recommended for females aged 13 through 26 years and males aged 13 through 21 years not vaccinated previously.
- The study 2 also mentions that vaccination is recommended through age 26 years for men who have sex with men and for immunocompromised persons, but it does not provide information on the use of Gardasil 9 in individuals over 26 years old who have previously received Gardasil.
- The study 3 discusses the optimal cervical cancer screening strategies in women vaccinated against human papillomavirus, but it does not provide information on the use of Gardasil 9 as a booster dose in individuals who have previously received Gardasil.
Cervical Cancer Screening and Vaccination
- The studies 4, 5, and 6 discuss the importance of cervical cancer screening and vaccination in preventing human papillomavirus (HPV) infections and cervical cancer.
- The study 5 mentions that the most effective strategy for cervical cancer prevention involves vaccination to prevent HPV infections during adolescence followed by screening to detect HPV infections during adulthood.
- The study 6 reviews the molecular basis of HPV, its pathogenesis, and the epidemiology of HPV infection and associated cervical cancer, and discusses the methods of currently available HPV testing assays as well as recent guidelines for HPV screening.