Gardasil Vaccination Schedule
Standard Dosing by Age
The recommended Gardasil schedule depends on the age at which vaccination is initiated: a 2-dose schedule for those starting before age 15, and a 3-dose schedule for those starting at age 15 or older. 1
For Ages 9-14 Years (2-Dose Schedule)
- Administer the first dose at age 11-12 years (can start as early as age 9) 2, 1, 3
- Give the second dose 6-12 months after the first dose 1, 4
- A 12-month interval between doses produces a more robust immune response than a 6-month interval 1
- The minimum interval between doses is 5 months, but 6 months is preferred 1
For Ages 15-26 Years (3-Dose Schedule)
- Administer dose 1 at day 0 2, 5
- Administer dose 2 at 1-2 months after dose 1 1, 5
- Administer dose 3 at 6 months after dose 1 2, 1, 5
- The minimum interval between dose 2 and dose 3 is 12 weeks (24 weeks from dose 1) 1
Age-Specific Recommendations
Routine Vaccination
- Routine vaccination is recommended at age 11-12 years for both males and females 2, 1, 3
- Vaccination provides the greatest protection when given before sexual activity begins 1, 3
Catch-Up Vaccination
- Catch-up vaccination is recommended through age 26 years for all individuals not previously vaccinated 2, 3, 6
- For those aged 13-26 years who have not been previously vaccinated, use the 3-dose schedule 2
Adults Ages 27-45 Years
- Shared clinical decision-making is recommended for adults aged 27-45 years 1, 6
- Vaccine effectiveness may be lower in adults with multiple lifetime sex partners due to likely previous HPV exposure 1
Special Populations
Immunocompromised Individuals
- Always use the 3-dose schedule regardless of age for immunocompromised persons 1, 7
- This includes people living with HIV, who should receive the full 3-dose series 1
Interrupted Schedules
If the vaccine series is interrupted, do not restart the series—simply continue where you left off 1
- Administer the next dose as soon as possible 1
- Maintain the minimum intervals: at least 4 weeks between doses 1 and 2, and at least 12 weeks between doses 2 and 3 1
Administration Details
- Give intramuscularly, 0.5 mL per dose 5
- Can be administered at the same visit as other age-appropriate vaccines using separate syringes at different anatomic sites 1
- Store at 2°C-8°C (36°F-46°F); do not freeze 3
Important Clinical Considerations
Prior HPV Exposure
- Vaccination is still recommended even if the patient has a history of genital warts, abnormal Pap test, or positive HPV DNA test 2, 3
- Sexually active individuals should still be vaccinated, as they may not have been infected with all vaccine HPV types 2, 3
Contraindications
- Hypersensitivity to vaccine components 5
- Pregnancy (defer until after delivery) 5
- Use caution in patients with bleeding disorders or on anticoagulant therapy 5