CDC HPV Vaccination Age Recommendations
The CDC recommends routine HPV vaccination be initiated at age 11 or 12 years, though vaccination can begin as early as age 9 years. 1, 2
Routine Vaccination Schedule
Primary recommendation: HPV vaccination should be routinely started at age 11-12 years for all children, regardless of sex 1, 2
Early start option: The vaccination series can be initiated beginning at age 9 years 1, 2
Optimal timing: The series should ideally be completed by the 13th birthday for maximum effectiveness, as this provides protection before likely HPV exposure through sexual activity 1, 3, 2
Dosing Schedule Based on Age at Initiation
The number of doses required depends on the age when vaccination begins:
Ages 9-14 years: A 2-dose schedule is recommended, with the second dose given 6-12 months after the first dose 3, 2, 4
Ages 15-26 years: A 3-dose schedule is required (0,1-2 months, 6 months), with minimum intervals of 4 weeks between doses 1 and 2, and 12 weeks between doses 2 and 3 3, 2
Catch-Up Vaccination Recommendations
Through age 26: Catch-up vaccination is recommended for all persons through age 26 years who were not adequately vaccinated 1, 2
Females aged 13-26 years: Catch-up vaccination is recommended if not previously vaccinated or series incomplete 1, 3
Males aged 13-21 years: Catch-up vaccination is recommended if not previously vaccinated 1, 3
Males aged 22-26 years: May be vaccinated, though effectiveness is lower due to likely prior HPV exposure 1, 3, 2
Special Populations
Men who have sex with men: Should be vaccinated through age 26 years regardless of prior vaccination status 1, 3
Immunocompromised individuals (including HIV-positive persons): Should receive a 3-dose schedule through age 26 years, even if starting before age 15 3, 2
Adults Aged 27-45 Years
Not routinely recommended: The CDC does not recommend catch-up vaccination for all adults in this age range 1
Shared clinical decision-making: Some adults aged 27-45 years who are not adequately vaccinated and may be at risk for new HPV infection might benefit from vaccination, but this requires individualized discussion 1, 5
Limited benefit: Vaccination in this age range prevents only an additional 0.5% of cancer cases compared to stopping at age 26, as most sexually active adults have already been exposed to HPV 5
Rationale for Age 11-12 Years
The recommendation for routine vaccination at age 11-12 years is based on several key factors:
Pre-exposure protection: HPV acquisition generally occurs soon after first sexual activity, making pre-adolescent vaccination critical for maximum effectiveness 1
Stronger immune response: Younger adolescents mount a more robust immune response to the vaccine 4
Fewer doses needed: Starting before age 15 allows completion with only 2 doses instead of 3 3, 2, 4
Bundling with other vaccines: This timing aligns with other routine adolescent vaccines (Tdap and MCV4), facilitating administration 1