HPV Vaccination Completion for a 28-Year-Old Male with One Prior Dose
This 28-year-old male needs 2 additional doses of Gardasil to complete the 3-dose series, administered at 1-2 months and 6 months after restarting the series. 1
Standard Dosing Schedule
The complete HPV vaccine series consists of 3 doses total for adults who initiate vaccination at age 15 years or older 1:
- Dose 1: At elected date (already received years ago)
- Dose 2: 1-2 months after dose 1
- Dose 3: 6 months after dose 1 (at least 24 weeks after first dose) 1
Critical Point: Series Does Not Need to Be Restarted
If the HPV vaccine schedule is interrupted, the vaccine series does not need to be restarted. 2 The patient should simply continue where he left off and receive the remaining 2 doses according to the standard intervals.
Age Considerations for This Patient
At 28 years old, this patient falls into a special category:
- Routine catch-up vaccination is recommended through age 26 years for all males 1, 3
- For ages 27-45 years, shared clinical decision-making is recommended rather than routine vaccination 4, 5
- However, since this patient already initiated the series, completing it is appropriate 2
Factors Supporting Completion at Age 28
The following factors would particularly support completing the series 4:
- Having new sex partners or anticipating new partners in the future
- Being a man who has sex with men (MSM), as they may especially benefit from protection against condyloma and anal cancer 1, 3
- Being immunocompromised 1
Important Caveats About Prior Infection
A history of genital warts, abnormal test results, or positive HPV DNA does not preclude vaccination 1, 4:
- HPV vaccines protect against multiple types (types 6,11,16,18, and in Gardasil 9: also 31,33,45,52,58) 4, 6
- Most sexually active adults have been exposed to some HPV types, but not necessarily all vaccine-type HPV 4
- The vaccine is prophylactic only—it prevents new infections but does not treat existing infections or HPV-related diseases 4, 5
Practical Administration Details
- Route: Intramuscular injection into the deltoid muscle of the arm or anterolateral thigh 7
- Dose volume: 0.5 mL per dose 7
- Can be given with other vaccines at the same visit using separate syringes at different anatomic sites 2
Expected Protection
Completing the 3-dose series provides: