What is the recommended age for administration of Gardasil (Human Papillomavirus vaccine) to adults?

From the Guidelines

Gardasil 9 is not recommended for routine use in adults over 26 years old, as the effectiveness and cancer prevention potential of vaccination in this age group are low, according to the American Cancer Society guidelines 1. When considering the use of Gardasil 9 in adults, it's essential to weigh the potential benefits against the risks and limitations. The vaccine is most effective when administered before potential exposure to HPV, ideally in early adolescence.

Key Points to Consider

• The Advisory Committee on Immunization Practices recommends catch-up HPV vaccination for all persons through age 26 years, but does not recommend routine vaccination for adults over 26 years old 1.
• Shared clinical decision-making is recommended for adults aged 27-45 who are not adequately vaccinated, taking into account individual risk factors for HPV exposure and potential benefits 1.
• The American Cancer Society does not endorse the recommendation for shared clinical decision-making for some adults aged 27 through 45 years who are not adequately vaccinated, due to the low effectiveness and low cancer prevention potential of vaccination in this age group 1.

Administration and Safety

• For adults aged 27-45, the vaccine is given as a three-dose series at 0,2, and 6 months.
• The vaccine protects against nine HPV types that cause approximately 90% of cervical cancers and most genital warts.
• Side effects are generally mild and include pain at the injection site, headache, and fatigue.
• The vaccine is contraindicated in those with severe allergies to yeast or any vaccine component and should be delayed during moderate to severe illness.

From the Research

GARDASIL Recombinant Vaccine for Adults

• The GARDASIL recombinant vaccine is a quadrivalent vaccine that protects against human papillomavirus (HPV) types 6,11,16, and 18 2.
• A study published in 2025 recommends a 3-dose HPV vaccination schedule for all adults through age 45 years, regardless of sex, to prevent genital warts, anogenital cancers, as well as oropharyngeal infections and cancers 3.
• The vaccine has been shown to be effective in preventing HPV-related diseases, including cervical cancer, with a real-world effectiveness study finding that vaccination at ages 16 years and younger or 17-19 years significantly reduced the incidence of cervical cancer 4.

Safety and Efficacy

• The safety and efficacy of the GARDASIL vaccine have been extensively studied, with long-term follow-up of clinical trials demonstrating durable effectiveness, immunogenicity, and safety 5.
• The vaccine has been shown to provide strong protection against future disease, even among those with past infections, with no evidence of waning protection 5.
• A review of safety and efficacy data on HPV vaccines found that the GARDASIL vaccine is highly effective in preventing HPV-related diseases, with a significant reduction in cancer and cancer precursors 2.

Adult Vaccination

• Adult vaccination against HPV is important, as the risk of acquiring HPV infections and associated diseases is lifelong 5.
• A study published in 2021 found that HPV vaccine effectiveness against cervical cancer at the population level is high among girls vaccinated younger than age 20 years, highlighting the importance of early age at vaccination 4.
• The GARDASIL vaccine is recommended for adults through age 45 years, regardless of sex, to prevent genital warts, anogenital cancers, as well as oropharyngeal infections and cancers 3.