Yes, Absolutely Give the Second HPV Vaccine Dose
Yes, you should absolutely administer the second HPV vaccine dose even though a year has elapsed since the first dose—the vaccine series does not need to be restarted, and you should continue from where you left off. 1, 2
Key Principle: Never Restart the Series
- The HPV vaccine series should never be restarted regardless of how long the interruption lasts between doses. 1, 2, 3
- If the series is interrupted after the first dose, administer the second dose as soon as possible without any upper time restriction. 1, 2
- There is no maximum time interval between doses, and the vaccine does not "expire" or lose effectiveness if doses are delayed. 1, 2
Longer Intervals May Actually Be Better
- A 12-month interval between the first two doses produces a more robust immune response than a 6-month interval, which is superior to shorter intervals. 1, 2
- The extended interval in this case (one year) may provide enhanced antibody responses compared to the standard 6-month spacing. 1
- Evidence demonstrates that longer intervals between doses generate stronger antibody titers across all HPV vaccine types. 1, 2
Determining How Many Total Doses Are Needed
The critical factor is the age when the first dose was given, not when subsequent doses are administered:
- If the first dose was given before age 15: Only 2 total doses are needed, with the second dose given 6-12 months after the first (minimum 12 weeks). 1, 2, 3
- If the first dose was given at age 15 or older: 3 total doses are required (at 0,1-2, and 6 months), with minimum intervals of 4 weeks between doses 1 and 2, and 12 weeks between doses 2 and 3. 1, 2, 3
- For immunocompromised individuals: Always use a 3-dose schedule regardless of age at initiation. 1, 2
Practical Implementation
- No additional testing is needed before administering the remaining dose—no HPV DNA testing, antibody testing, or Pap testing is required. 1
- The vaccine can be co-administered with other age-appropriate vaccines using separate syringes at different anatomic sites. 1, 2
- Have the patient sit or lie down for 15 minutes after administration due to syncope risk in adolescents. 2, 3
Common Pitfall to Avoid
Do not delay vaccination waiting for "optimal" timing. Approximately 24% of adolescents report sexual intercourse by 9th grade, and HPV infection incidence is nearly 60% within 2 years after sexual initiation. 1, 3 Even if the patient is already sexually active, they should still be vaccinated according to age-based recommendations, as they are unlikely to have been infected with all vaccine HPV types. 1, 2