HPV Vaccine Schedule for Individuals Starting at Age 15 or Older

Recommended Schedule for Ages 15+

For individuals initiating HPV vaccination at ages 15 through 26 years, the Centers for Disease Control and Prevention recommends three doses of HPV vaccine 3
The recommended 3-dose schedule is: first dose at elected date, second dose 1-2 months after the first dose, and third dose 6 months after the first dose 1, 3, 4
The minimum interval between the first and second doses is 4 weeks, and the minimum interval between the second and third doses is 12 weeks 5

The American Academy of Pediatrics notes that immune response to HPV vaccination is age-dependent, with stronger responses seen in younger individuals 6
Studies show that individuals who start vaccination after age 15 require three doses to achieve adequate protection against HPV infection, as recommended by the Centers for Disease Control and Prevention 3

The Centers for Disease Control and Prevention recommends that immunocompromised individuals, including those with HIV, should receive the 3-dose schedule regardless of age at initiation 2, 3
Men who have sex with men should receive HPV vaccination through age 26 if not previously vaccinated, according to the Centers for Disease Control and Prevention 4, 7

If the vaccination schedule is interrupted, it does not need to be restarted, as stated by the Centers for Disease Control and Prevention 5

The Centers for Disease Control and Prevention notes that HPV vaccination is most effective when administered before potential exposure to HPV through sexual contact 4, 7
Providers should inform individuals aged 22-26 years who have not been previously vaccinated that vaccination at older ages may be less effective in lowering cancer risk, as recommended by the American College of Obstetricians and Gynecologists 4, 7

As of January 2017, the 9-valent HPV vaccine (9vHPV, Gardasil-9) is the only HPV vaccine available in the United States, protecting against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, as reported by the American Academy of Pediatrics 6
HPV types 16 and 18 are responsible for approximately 70% of HPV-related cancers, according to the Centers for Disease Control and Prevention 2, 6

The Centers for Disease Control and Prevention recommends no prevaccination testing to establish the appropriateness of HPV vaccination 3
All women, regardless of vaccination status, should continue to follow cervical cancer screening guidelines, as recommended by the American College of Obstetricians and Gynecologists 2