Is a repeat of the entire Human Papillomavirus (HPV) vaccine series necessary if the third dose is missed?

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Last updated: May 1, 2025View editorial policy

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From the Guidelines

No, a repeat of the entire HPV vaccine series is not necessary if you missed the third dose, and you should simply get the missed third dose as soon as possible. The HPV vaccine series does not need to be restarted if it is interrupted, according to the recommendations of the Advisory Committee on Immunization Practices (ACIP) 1. If the series is interrupted after the first dose, the second dose should be administered as soon as possible, and the second and third doses should be separated by an interval of at least 12 weeks. However, if only the third dose is delayed, it should be administered as soon as possible, without the need to restart the series. Some key points to consider when dealing with an interrupted HPV vaccine series include:

  • The immune system forms memory cells after the initial doses, so even with a delay, your body will recognize the vaccine and mount an appropriate immune response when you receive the final dose.
  • Public health authorities recommend completing the series rather than restarting it, as the previous doses still provide partial protection and prime your immune system for the final dose.
  • The HPV vaccine series consists of either two or three doses depending on the age when the series was started, and the timing of the doses can be adjusted based on the individual's circumstances. It's essential to consult with a healthcare provider to determine the best course of action for completing the HPV vaccine series, as they can assess individual circumstances and provide personalized guidance 1.

From the Research

HPV Vaccine Series Completion

  • The HPV vaccine is a three-dose series, and completion of the series is crucial for optimal protection against HPV-related diseases 2.
  • Studies have shown that incomplete HPV vaccination rates are high, especially among individuals over 26 years old 3.
  • Factors such as age, neighborhood, and provider awareness can affect HPV vaccine series completion rates 3, 4.

Missed Opportunities for Vaccination

  • Missed opportunities for vaccination can occur when individuals attend clinic visits but do not receive the next dose of the vaccine 4.
  • Provider awareness of vaccine updates and patient interventions can improve vaccine series completion rates 4.

Delayed Dosing Intervals

  • Delayed dosing intervals for the quadrivalent HPV vaccine do not reduce antibody avidity, and may even result in higher antibody titers 5.
  • Longer intervals between doses can result in higher antibody avidity, providing further evidence that delayed dosing does not hinder the immune response 5.

Repeat of Entire Series

  • There is no direct evidence to suggest that a repeat of the entire HPV vaccine series is necessary if an individual misses the third dose.
  • However, it is essential to consult with a healthcare provider to determine the best course of action for completing the vaccine series 2, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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