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HPV is a group of more than 150 related viruses that infect men and women. These common viruses infect about 13 million people, including teens, every year. Some HPV infections can lead to certain types of cancer.
HPV is spread through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV is so common that nearly all men and women get it at some point in their lives.
The Centers for Disease Control and Prevention, American Academy of Family Physicians, and American Academy of Pediatrics strongly recommend children receive all vaccines according to the recommended vaccine schedule.
Three vaccines that prevent infection with disease-causing HPV have been licensed in the United States: Gardasil, Gardasil 9, and Cervarix. Gardasil 9 has, since 2016, been the only HPV vaccine used in the United States. It prevents infection with the following nine HPV types:
The HPV vaccine is given as a series of shots. ACIP specifies different dosing schedules, depending on the age when the vaccination series is started (6). Children who start the vaccine series before their 15th birthday need only two doses to be fully protected. People who start the series at age 15 or older and people who have certain conditions that weaken the immune system need three doses to be fully protected.
Although Cervarix and Gardasil prevent infection with just two high-risk HPV types, HPV16 and HPV18, these two HPV types are responsible for most HPV-caused cancers. In a 2017 position paper, the World Health Organization stated that the HPV vaccines have comparable efficacy (15). In addition, Cervarix has been found to provide substantial protection against a few additional cancer-causing HPV types, a phenomenon called cross-protection (16). Women who received three doses of Cervarix experienced strong protection against new infections with HPV types 31, 33, and 45 (17).
To date, protection against infections with the targeted HPV types has been found to last for at least 10 years with Gardasil (18), up to 11 years with Cervarix (17), and at least 6 years with Gardasil 9 (19). Long-term studies of vaccine efficacy that are still in progress will help scientists better understand how long protection lasts (20).
Like other immunizations that guard against viral infection, HPV vaccines stimulate the body to produce antibodies that, in future encounters with HPV, bind to the virus and prevent it from infecting cells.
The combination of HPV vaccination and cervical screening can provide the greatest protection against cervical cancer. Also, HPV vaccination reduces the risk of developing cancers caused by HPV at sites other than the cervix.
Widespread HPV vaccination has the potential to reduce cervical cancer incidence around the world by as much as 90% (16, 19). In addition, the vaccines may reduce the need for screening and subsequent medical care, biopsies, and invasive procedures associated with follow-up from abnormal cervical screening, thus helping to reduce health care costs and anxieties related to follow-up procedures (24).
Yes. More than 12 years of safety monitoring show that the vaccines have caused no serious side effects. The most common problems have been brief soreness and other local symptoms at the injection site. These problems are similar to those commonly experienced with other vaccines.
Syncope (fainting) is sometimes observed with Gardasil, as with other vaccines. Falls after fainting may sometimes cause serious injuries, such as head injuries. These can largely be prevented by keeping the person seated for up to 15 minutes after vaccination. The FDA and CDC have reminded health care providers that, to prevent falls and injuries, all vaccine recipients should remain seated or lying down and be closely observed for 15 minutes after vaccination. More information is available from the CDC on its HPV Vaccine page.
ACIP recommends that people who have an HPV infection and/or an abnormal Pap test result that may indicate an HPV infection should still receive the HPV vaccine if they are in the appropriate age group (9 through 26 years) because the vaccine may protect them against high-risk HPV types that they have not yet acquired. However, these people should be told that the vaccination will not cure them of current HPV infections or treat the abnormal results of their Pap test (31).
Although HPV vaccines have been found to be safe when given to people who are already infected with HPV, the vaccines provide maximum benefit if a person receives them before he or she is sexually active (32, 33).
It is likely that someone previously infected with HPV will still get some residual benefit from vaccination, even if he or she has already been infected with one or more of the HPV types included in the vaccines.
Yes. Because HPV vaccines do not protect against all HPV types that can cause cancer, women who have been vaccinated are advised to follow the same screening recommendations as unvaccinated women. There could be future changes in screening recommendations for vaccinated women.
Most private insurance plans cover HPV vaccination. The federal Affordable Care Act requires most private insurance plans to cover recommended preventive services (including HPV vaccination) with no copay or deductible.
Medicaid covers HPV vaccination in accordance with ACIP recommendations, and immunizations are a mandatory service under Medicaid for eligible individuals under age 21. In addition, the federal Vaccines for Children Program provides immunization services for children younger than 19 years who are Medicaid eligible, uninsured, underinsured, or Native American or Alaska Native.
Merck, the manufacturer of Gardasil 9, offers the Merck Vaccine Patient Assistance Program, which provides Gardasil 9 for free to people aged 19 to 45 years who live in the United States, do not have health insurance, and have an annual household income less than a certain amount.
If a single dose of HPV vaccine were effective, that would be an important advance. A large observational study using national data from women across Australia found that one dose of HPV vaccine was as effective as two or three doses in preventing high-grade cervical lesions (34). An analysis of data from a community-based clinical trial of Cervarix in Costa Rica, found that even one dose of the vaccine caused the body to produce approximately nine times more antibodies against HPV than the body produces in response to a natural HPV infection, and those antibody levels persisted for 11 years (35). In addition, the rates of HPV infection remained low for at least 10 years (35).
Another prevention strategy that is being explored is topical microbicides. Carrageenan, a compound that is extracted from a type of seaweed and used widely in foods and other products, has been found to inhibit HPV infection in laboratory studies. An interim analysis of data from a randomized clinical trial showed that consistent use of a lubricant gel that contains carrageenan reduced the risk of genital HPV infection in healthy women (36).
Dehlendorff C, Baandrup L, Kjaer SK. Real-world effectiveness of human papillomavirus vaccination against vulvovaginal high-grade precancerous lesions and cancers. Journal of the National Cancer Institute 2020:djaa209. doi: 10.1093/jnci/djaa209.
Arnheim-Dahlstrm L, Pasternak B, Svanstrm H, Sparn P, Hviid A. Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: Cohort study. British Medical Journal 2013; 347:f5906.
The American Academy of Pediatrics (AAP), Centers for Disease Control and Prevention (CDC) and other medical groups all agree on the schedule of recommended immunizations. They recommend these vaccines at specific ages. Why? There are two main reasons:
Is your preteen or teen behind on some of their immunizations? It is important for them to see their pediatrician and make sure they are fully protected. Vaccines keep others safe, too. That's why all 50 states have laws requiring children and teens to get vaccines before they can attend school or child care.
Meningococcal: At age 11 or 12, your teen should get their first dose of meningococcal vaccine. The vaccines protect against up to 5 bacterial strains, which are labeled with the letters A, B, C, W and Y.
Meningococcal B (MenB) vaccine is another type of meningococcal vaccine. It protects against a different strain of the bacteria. MenB vaccine is recommended for kids who have certain chronic health conditions that make them more vulnerable or anyone age 16-18 years who decided with their pediatrician to get the vaccine.
Meningococcal ABCWY (MenABCWY) combines protection from MenACWY and MenB into one shot. If available, it can be used in place of separate injections of MenACWY and MenB if both vaccines are recommended at the same visit for kids age 10 years or older.
Tetanus, diphtheria and pertussis booster: At age 11 or 12, we give a vaccine called Tdap. This vaccine is a booster to protect against three diseases: tetanus, diphtheria and pertussis (whooping cough). It's a slightly different version of a vaccine your child received as a baby (DTaP). The version for adolescents and adults has a different name because it has lower doses of the diphtheria and pertussis vaccines. (It has the same amount of tetanus vaccine, though.) After your child gets Tdap vaccine at age 11 or 12, they will need a booster dose of Tdap or tetanus and diphtheria (Td) vaccine every 10 years as an adult as well.
Tetanus is caused by bacteria that naturally live in the soil or dust. You can be exposed to the bacteria through any break in your skin, like a cut or puncture wound. Tetanus produces a toxin that causes painful muscle contractions. Another name for tetanus is lockjaw, because it often causes a person's neck and jaw muscles to lock making it hard to open the mouth or swallow. We will never eliminate this bacterium from our world, so the vaccine is the best way to prevent tetanus.
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