HPV Vaccination Guidelines

Routine Vaccination Recommendations

The American College of Obstetricians and Gynecologists (ACOG), American Academy of Pediatrics (AAP), and Advisory Committee on Immunization Practices (ACIP) recommend routine vaccination of females aged 11-12 years with HPV vaccine, though vaccination can start as young as 9 years of age 1, 2, 4
Catch-up vaccination is recommended for females aged 13-26 years who have not been previously vaccinated or who have not completed the full vaccine series 1, 2
For males, routine vaccination is recommended at age 11-12 years, with catch-up vaccination through age 21 years, and through age 26 years for men who have sex with men (MSM) and immunocompromised persons 3

Three HPV vaccines have been licensed: bivalent (2vHPV), quadrivalent (4vHPV), and nonavalent (9vHPV) 5
The nonavalent vaccine (9vHPV) provides protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, potentially preventing approximately 90% of cervical and other HPV-related cancers 5
For individuals aged 15 years and older, a three-dose schedule is recommended (0, 2, and 6 months) 1, 2
The minimum interval between the first and second doses is 4 weeks, and between the second and third doses is 12 weeks 2

HPV vaccination is recommended regardless of sexual activity status; however, it is most effective when administered before potential exposure to HPV through sexual contact 1, 2
The vaccine can be administered to patients who are breastfeeding 2
The vaccine can be administered to immunocompromised persons due to disease or medication 2, 3

The American Cancer Society (ACS), ACOG, and U.S. Preventive Services Task Force (USPSTF) recommend that all women should have a Pap test for cervical cancer screening within 3 years of beginning sexual activity or by age 21 years, whichever occurs first 6
Women aged >30 years with three normal consecutive Pap tests should be screened every 2-3 years 6

Condom use may reduce the risk for HPV and HPV-associated diseases; one study demonstrated a 70% reduction in HPV infection when partners used condoms consistently and correctly 6
Abstaining from sexual activity is the surest way to prevent genital HPV infection 6

The efficacy of HPV vaccines against persistent infection, precancerous lesions, and genital warts caused by vaccine-targeted HPV types has been demonstrated in clinical trials 1
The vaccine has been demonstrated to provide protection for at least 5 years without evidence of waning protection 1

HPV vaccination does not appear to protect against persistent infection, cervical cancer precursor lesions, or genital warts caused by an HPV type that individuals are infected with at the time of vaccination 1
Females already infected with one or more vaccine HPV types before vaccination would still be protected against disease caused by the other vaccine HPV types 1
Although the overall vaccine effectiveness would be lower when administered to sexually active individuals, the majority would still derive at least partial benefit from vaccination 1